Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MBCHB IV > Breast & Endocrine Surgery > Flashcards

Breast & Endocrine Surgery Flashcards

1
Q

US characteristics raising suspicion for malignancy

A
  • hypoechoic solid
  • microcalcifications <2mm
  • irregular borders
  • increased intra nodular blood flow
  • absent halo sign
  • taller than wide
  • local invasion / lymphadenopathy
  • chaotic vascularity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Imaging for thyroid

A
  • ultrasound
  • scintigraphy
  • CT/ MRI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Features of hyperthyroidism

A
  • fatigue
  • loss of weight
  • diaphoresis
  • palpitations
  • heat intolerance
  • muscle weakness
  • insomnia
  • anxiety
  • restlessness
  • irritable
  • tremor
  • diarrhoea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Features of hypothyroidism

A
  • fatigue
  • weight gain
  • constipation
  • depression
  • impaired mentation
  • muscle cramps
  • dry skin
  • brittle nails
  • cold intolerance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

WHO classification of goitre

A

0 = no goitre palpable or visible
1a = goitre detected by palpation only
1b = goitre palpable and visible with neck extended
2 = goitre visible with neck in normal position
3 = large goitre visible from distance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Signs of compression

A
  • stridor
  • Pemberton’s sign (plethora in cheeks when raising hands above head)
  • Berry’s sign (absent carotid pulses)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Differential of a single nodule

A
  • hyperplastic nodule
  • colloid nodule
  • cyst
  • thyroiditic nodule
  • neoplasm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Different types of neoplasms of the thyroid

A

BENIGN = Follicular adenoma

MALIGNANT=
well differentiated
- papillary carcinoma (follicular)
- follicular carcinoma (follicular)
non-well differentiated
- medullary carcinoma (parafollicular)
- anaplastic carcinoma (BAD) (follicular)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What factors male favour a thyroidectomy over a lobectomy

A
  • > 4cm
  • aggressive histological variant
  • gross extrathyroidal extension
  • multifocal
  • lymphovascular invasion
  • when RAI indicated
  • Hurthle cell carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Cause of death with anaplastic carcinoma of thyroid

A
  1. external compression of trachea
  2. intraluminal tumour extension
  3. bilateral vocal cord paralysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Complications of thyroid surgery

A
  • recurrent laryngeal nerve damage causing vocal cord paralysis
  • hypoparathyroidism causing hypocalcemia
  • bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Different types of benign thyroid diseases

A
  1. simple non-toxic goitre
  2. toxic goitre
  3. inflammatory goitre
  4. developmental conditions
  5. rare conditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Examples of simple non-toxic goitres

A

-multinodular goitre: hyperplastic/colloid
- solitary nodule: mostly neoplastic follicular adenoma
- Cyst : causes infections, inflammatory, degenerative in MNG, neoplastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Causes of Toxic goitre

A
  • Grave’s disease: diffuse goitre, autoimmune AB stimulating TSH, thyroid eye disease, pretibial myxedema
  • Toxic multinodular goitre: long standing
  • Toxic solitary adenoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Inflammatory goitre causes

A
  • Hashimoto/Chronic lymphocytic = autoimmune TPO/ thyroglobulin
  • Subacute lymphocytic
  • DeQuervain’s subacute granulomatous = secondary to viral infection = secondary to viral infection
  • Acute suppurative thyroiditis = bacterial parasitic fungal infections
  • Invasive fibrous thyroiditis Riedel’s struma = rare painless hard assoc with systemic fibrosis can mimic anaplastic carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Developmental conditions benign thyroid conditions

A
  • thyroglossal duct cyst = persistence of duct remnant
  • ectopic/lingual thyroid = failure/abnormal descent
17
Q

Thyrotoxicosis

A

Thyrotoxicosis is state of inappropriately high levels of thyroid hormones T3 and/or T4 in the body from any cause

18
Q

Indications for surgery

A
  • compression (trachea, oesophagus, RLN, Venous outflow)
  • suspicion of malignancy
  • hyperthyroidism
  • cosmetic
  • patient preference
19
Q

Anatomical origin of superior parathyroid glands

A

from 4th pharyngeal pouch found at level of the upper two thirds of the thyroid

20
Q

Anatomical origin of inferior parathyroid glands

A

from 3rd pharyngeal pouch migrates with thymus located anywhere along this path of descent

21
Q

Blood supply of parathyroids

A

inferior thyroid artery branch of thyrocervical trunk

22
Q

Role of vitamin D

A
  • terminal ileum = increases calcium absorption
  • bone = calcium release
  • kidneys = decrease calcium excretion promotes PO4 excretion
23
Q

Functions of the parathyroids

A
  • produce & secretes PTH
  • activates bone reabsorption ie calcium & phosphate release causing hypercalcaemia and hypercalciuria
  • inhibits osteoblasts & activates osteoclasts
  • increases renal tubular resorption of calcium
  • decreases renal tubular resorption of phosphate
  • activates vitamin D
  • synthesis of activated Vitamin D (calcitriol)
24
Q

Primary Hyperparathyroidism

A

over-secretion of PTH with an elevated calcium and inappropriately elevated unsuppressed PTH

25
Q

Causes of Primary Hyperparathyroidism

A
  • Adenoma
  • Hyperplasia
  • Carcinoma
26
Q

Risk factors for Adenoma

A
  • female
  • older age
  • previous neck irradiation
  • lithium therapy
27
Q

Secondary hyperparathyroidism

A

Appropriate physiological response to hypocalcaemia with elevated PTH and normal/low calcium
CAUSES:
- GIT disorder with malabsorption
- Dietary VIT D deficiency
- Synthetic Vit D deficiency dt renal insufficiency
- Drugs lithium and thiazides

28
Q

Tertiary Hyperparathyroidism

A

excessive PTH secretion after longstanding secondary hyperparathyroidism resulting in hypercalcemia

29
Q

Persistent vs. Recurrent hyperparathyroidism

A

persistent = within 6mo after parathyroidectomy
recurrent = 6-12mo after parathyroidectomy

30
Q

Medical treatment of hyperparathyroidism

A
  • bisphosphonates
  • calcimimetics agonists of CaSR receptor to suppress PTH secretion
31
Q

Indications for surgery

A

symptomatic
asymptomatic:
- Serum Ca >0.25mmol/L above upper limit of normal
- creat <60ml/min
- osteoporosis
- <50yrs old
- patient request

32
Q

Imaging for parathyroid glands

A
  • U/S
  • Sestamibi
  • CT scan 4D CT
  • MRI
33
Q

signs and symptoms of hypocalcemia

A
  • weakness/tetany
  • ECG changes
  • tingling around mouth or extremities
  • Trousseau’s sign: BP cuff causing carpopedal spasm
  • Chvostek’s sign: masseter muscle spasm response to tapping on facial nn
  • laryngo/bronchospasm
  • convulsions
  • arrhythmias
34
Q

Mechanism of Renal Hyperparathyroidism

A

reduced GFR causes phosphate retention
phosphate levels increase which reduces serum Ca stimulating PTH production & secretion
cannot activate Vit D due to renal impairment therefore less Ca is absorbed from terminal ileum stimulating more PTH

35
Q

MOA of calcimimetics

A

binds to the CaSR and reduces PTH secretion

36
Q
A

MBCHB IV (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions