Information for GPs

What investigations should be performed prior to referral for a thyroid nodule?

Thyroid/Neck Ultrasound
Thyroid function test
Calcium and PTH
Cytology results from FNA if required (see information pamphlet to see when is this indicated)
CT chest and neck if concerns of retrosternal extension

What investigations should be performed prior to referral for an adrenal tumour?

CT scan
Plasma metanephrines
Aldosterone-renin ratio
Fasting am cortisol after 1mg of dexamethasone at 10pm the night prior
Renal function tests
Alternatively, 24 hour urine collection of catecholamines and steroids can be done in place of the morning cortisol and metanephrines

What investigations should be performed prior to referral for hyperparathyroidism?

Calcium corrected levels & PTH
Vit D
24 hour urine calcium & creatinine ratio

Postoperative Care Instructions

Dressings - steristrips are left on for 14 days and can be removed after, if these start to peel off in between, they can be reinforced with other steristrips
Infection - if there is redness and pain, antibiotics should be commenced and the patient contact us
Haematoma - if there is concerns the patient should present to the nearby emergency department or contact the rooms if they are well otherwise (a soft swelling, seroma is common after surgery and resolves usually)

My patient is on caltrate and rocaltrol

If the patient is discharged with caltrate and rocaltrol, these patients will have blood tests repeated regularly and be followed up in the consulting rooms regularly for hypoparathyroidism. Typically it is temporary and they will be weaned off the medication gradually. Contact the rooms if you have any concerns.