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ABD 2 > CHAPTER 22 THYROID > Flashcards

CHAPTER 22 THYROID Flashcards

1
Q

benign thyroid neoplasm characterized by complete fibrous encapsulation

A

adenoma

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2
Q

rare, undifferentiated carcinoma occurring in middle age

A

anaplastic carcinoma

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3
Q

remnant of embryonic development that appears as a cyst in the neck

A

branchial cleft cyst

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4
Q

a thyroid hormone that is important for maintaining a dense, strong bone matrix and regulating the blood calcium level

A

calcitonin

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5
Q

refers to a normal functioning thyroid gland

A

euthyroid

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6
Q

use of a fine-gauge needle to obtain cells from a mass

A

fine-needle aspiration

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7
Q

occurs as a solitary malignant mass within the thyroid gland

A

follicular carcinoma

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8
Q

enlargement of the thyroid gland that can be focal or diffuse; multiple nodules may be present

A

goiter

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9
Q

autoimmune disorder characterized by a diffuse toxic goiter, exophthalmos (bulging eyes), and cutaneous manifestations

A

Graves’ Disease

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10
Q

chronic inflammation of the thyroid gland caused by the formation of antibodies against normal thyroid tissue

A

Hashimoto’s thyroiditis

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11
Q

disorder associated with elevated serum calcium level, usually caused by a benign parathyroid adenoma

A

Hyperparathyroidism

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12
Q

oversecretion of thyroid hormones

A

Hyperthyroidism

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13
Q

low phosphatase level, which can be seen with hyperparathyroidism

A

hypophosphatasia –

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14
Q

undersecretion of thyroid hormones

A

hypothyroidism

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15
Q

small piece of thyroid tissue that connects the right and left lobes of the gland

A

isthmus

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16
Q

wedge-shaped muscle posterior to the thyroid lobes

A

longus colli muscle

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17
Q

disorder characterized by localized or generalized enlargement of the lymph nodes or lymph vessels

A

lymphadenopathy

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18
Q

neoplastic growth that accounts for 10% of thyroid malignancies

A

medullary carcinoma

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19
Q

tiny echogenic foci within a nodule that may or may not shadow

A

microcalcifications

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20
Q

nodular enlargement of the thyroid associated with hyperthyroidism

A

multinodular goiter

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21
Q

degenerative nodules within the thyroid

A

nodular hyperplasia

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22
Q

most common form of thyroid malignancy

A

papillary carcinoma

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23
Q

a hormone that is secreted by the parathyroid glands, which regulate serum calcium levels

A

parathyroid hormone (PTH)

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24
Q

enlargement of multiple parathyroid glands

A

parathyroid hyperplasia

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25
Q

oversecretion of parathyroid hormone, usually from a parathyroid adenoma

A

primary hyperparathyroidism

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26
Q

present in a small percentage of patients; extends superiorly from the isthmus

A

pyramidal lobe

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27
Q

enlargement of parathyroid glands in patients with renal failure or vitamin D deficiency

A

secondary hyperparathyroidism

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28
Q

lab value that is elevated with hyperparathyroidism

A

serum calcium

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29
Q

large muscles anterolateral to the thyroid

A

sternocleidomastoid muscles

30
Q

group of three muscles (sternothyroid, sternohyoid, and omohyoid) that lie anterior to the thyroid

A

strap muscle

31
Q

viral infection of the thyroid that causes inflammation

A

subacute (de Quervain’s) thyroiditis

32
Q

congenital anomalies that present in midline of the neck anterior to the trachea

A

thyroglossal duct cysts

33
Q

inflammation of the thyroid

A

thyroiditis

34
Q

a hormone secreted by the pituitary gland that stimulates the thyroid gland to secrete thyroxine and triiodothyronine

A

thyroid-stimulating hormone (TSH)

35
Q

What is the three hormones that the thyroid produces?

A

Triiodothyronine (T3)
Thyroxine (T4)
Calcitonin

36
Q

What are the functions of the thyroid?

A
  • It maintains metabolism, growth, and development

- Produces, stores, and secretes thyroid hormones

37
Q

Is the thyroid part of the exocrine or endocrine system?

A

Endocrine

38
Q

Where is the thyroid gland located?

A

Located in the anterorinferior neck at the level of the thyroid cartilage

39
Q

Rt. and Lt. thyroid lobes located on each side of the _________. They are connected across midline by the _______ and bound laterally by the _____artery and _______ vein

A

Trachea

Isthmus

Carotid artery and jugular vein

40
Q

Do females or males have larger thyroid glands?

A

Females

41
Q

What are the adult measurements of the thyroid?

A

Adults
Length- 40-60mm (4-6cm)
AP- 20-30mm (2-3cm)
Width- 15-20mm (1.5-2cm)

Isthmus
AP- 4-6mm (0.4-0.6cm)

42
Q

When in transverse, make sure you see the _______ in the measuring image.

Also where do you measure?

A

Isthmus

AP as well as length.
*
* *
*

43
Q

If you are unable to get a clear measuring image of the thyroid gland is SAG what can you do?

A

Switch to a curvilinear transducer.

44
Q

Where does the Thyroid get its blood supply?

A

Two superior thyroid arteries arise from external carotid artery (ECA) and descend to the upper poles

Two inferior thyroid arteries arise from the thyrocervical trunk of the subclavian artery and ascend to the lower thyroid poles

Corresponding veins drain into the internal jugular veins.

45
Q

The pituitary gland produces ____ then controlled by ______, and the _____ secretion controls the release of thyroid hormones.

A

TSH

Hypothalamus

TSH secretion

46
Q

The mechanism for producing thyroid hormones is ________

A

iodine metabolism

47
Q

When the thyroid is producing the correct amount of thyroid hormone this is called ___________.

A

euthyroid

48
Q

Causes-

1) Low intake of iodine (goiter) in the body
2) Inability of the thyroid to produce adequate amount of the thyroid hormone
3) A pituitary gland that does not control the thyroid production

What is the diagnosis and the treatment?

A

Hypothyroidism which is the undersecretion of thyroid hormones

Treatment would be hormone medication.

49
Q

A patient comes in and complains that she has recently lost some hair, gained weight, been very cold, and her voice has deepened.

What could this indicate?

A

Hypothyroidism

50
Q

Occurs when the entire gland is out of control or when a localized neoplasm (adenoma) that causes overproduction of the thyroid hormone

A

Hyperthyroidism

51
Q

A patient comes in and complains of weight loss, excessive sweating and heat intolerance, and you notice her eyes seem to be protruding from her eye sockets.

What could this indicate?

A

Hyperthyroidism (the sudden increase of thyroid hormones

52
Q

What are some questions you should ask the patient before starting the exam?

A

Has there been any changes in your health?
Any use of thyroid medication or history of use?
Previous imaging of thyroid?
Family history of hyperparathyroidism or thyroid cancer?

53
Q

Sonographically the thyroid gland is enlarged heterogenous w/ isoechoic/hyperechoic nodules with a thin peripheral halo and calcifications.

What could this indicate?

A

goiter

54
Q

most common malignancy of the thyroid that is more commonly found in females.

90% hypoechoic
Microcalcification with or without shadowing
90% hypervascular

What is this?

A

Papillary Carcinoma

55
Q

Carcinoma that spreads through the blood stream versus the lymphatics. It is also more aggressive that papillary. Mets to bone, lung, brain and liver.

Sonographically-
Irregular margin with thick irregular halo
Nodular enlargement
Tortuous internal blood vessel

A

Follicular Carcinoma

56
Q

5% of thyroid cancers—Often familial- 20% of the time

May be multicentered and/or bilateral in familial cases

High incidence in metastatic involvement of lymph nodes

Ultrasound findings
Similar to papillary ca.- hypoechoic
Calcium deposits are often noted
Careful evaluation of the entire neck are and liver to rule out metastases

A

Medullary Carcinoma

57
Q

Rare- less than 2% that usually occurs after age 50

Hard fixed mass with rapid growth

Growth is locally invasive in surrounding neck structures
It usually causes death by compression and asphyxiation due to invasion of the trachea

Ultrasound Findings
Hypoechoic
Invasion of surrounding muscles and vessels

A

Anaplastic Carcinoma

58
Q

Which of the carcinomas of the thyroid can cause death by compression and asphyxiation due to invasion of trachea?

A

Anaplastic Carcinoma

59
Q

________ in the thyroid is usually non-Hodgkin type
Affects older females and 4% of all thyroid malignancies

Clinically-rapid growing neck mass

Many cases patient has preexisting chronic lymphocytic thyroiditis (Hashimoto’s disease) or hypothyroidism

Ultrasound findings
Nonvascular
Hypoechoic
Lobulated
Thyroid tissue may be heterogenous because of associated thyroiditis
Can have areas of cystic necrosis
A

Lymphoma

60
Q

Most common type of thyroiditis
Characterized by destructive autoimmune disorder, which leads to chronic inflammation of thyroid commonly found in young or middle age female

Painless and diffuse enlargement

Ultrasound Findings
Coarse and slightly more hypoechoic
Initially homogenous enlargement occurs with nodularity then progresses to inhomogenous enlargement.
Can develop into hypothyroidism

A

Hashimoto’s Thyroiditis

61
Q

People who have ____________ thyroiditis are at risk to develop hypothyroidism

A

Hashimoto’s Thyroiditis

62
Q

Characterized by thyrotoxicosis and is the most frequent cause of hyperthyroidism

Findings-
hypermetabolism, diffuse toxic goiter, exophthalmos, and cutaneous manifestations
Thyroid gland is diffusely homogeneous and enlarged

A

Graves’ Disease

63
Q

What is the most common cause of thyroid disorders worldwide and what can it lead to?

A

iodine deficiency

goiter formation and hypothyroidism

64
Q

What is the most common carcinoma of the thyroid?? Is it more common in females or males?

A

Papillary.

Females

65
Q

Which cancer is more aggressive? Papillary or follicular?

A

Follicular

66
Q

How does follicular carcinoma spread??

A

Through the bloodstream

67
Q

What is the most common case of thyroiditis?

A

Hashimoto’s Thyroiditis

68
Q

What can Hashimoto’s Thyroiditis lead to ?

A

Hypothyriodism

69
Q

How many parathyroid glands do most people have?

A

4 but there can be 3-5

Most commonly there is two superior and two inferior

70
Q

What is most common cause of primary hyperparathyroidism?

A

Adenoma (80% cases)

71
Q

What is the most frequent cause of hyperthyroidism

A

Graves disease

ABD 2 (5 decks)

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