Aust Prescr
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[This corrects the article DOI: 10.18773/austprescr.2021.029.].
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Thyroid nodules are common clinically and even more common as an incidental finding during ultrasonography. Routine screening of thyroid nodules in patients with hyperthyroidism or hypothyroidism without risk factors for thyroid cancer is not recommended. ⋯ Malignant thyroid nodules require surgical management. Most thyroid cancers are well-differentiated papillary or follicular thyroid neoplasms, which have an excellent prognosis with a low mortality rate.
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Acute coronary syndromes are a significant cause of morbidity and mortality in Australia. Outcomes are likely to be improved by rapid and accurate diagnosis, and early intervention The development of high-sensitivity troponin assays has revealed previously unrecognised types of myocardial injury, for which conventional management guidelines for myocardial infarction may not confer similar benefits. The distinction between myocardial injury and myocardial infarction has therefore become increasingly important Once the diagnosis of acute myocardial infarction has been made, individualised acute reperfusion strategies including percutaneous coronary intervention or fibrinolytic therapy should be considered. Secondary prevention strategies should be implemented before hospital discharge.
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Cirrhosis can be suspected by a thorough clinical assessment, but compensated liver disease is often asymptomatic. Select investigations are therefore critical for identifying patients with advanced liver disease and cirrhosis Biomarkers and validated serum tests can evaluate liver damage and synthetic function. ⋯ They reduce the need for liver biopsy Careful monitoring, prescribing and appropriate specialist referral are key considerations in cirrhosis management. Early diagnosis can help to improve the outcomes for patients.
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Iron deficiency without anaemia is common. Patients may present with unexplained, non-specific symptoms. Iron studies will usually show a low ferritin and low transferrin saturation with a normal haemoglobin concentration. ⋯ Further investigations are needed if the iron deficiency has not been corrected. Some patients, including those who have not responsed to oral supplements may benefit from intravenous iron. There is no role for intramuscular injections of iron.