Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Surgery > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Anatomy of the thyroid gland?

A

two triangular lobes connected by a central isthmus
found between C5-T1 within the pre-tracheal fascia

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

Anatomy of the parathyroid glands?

A

two pairs in total, found on the posterior aspect of the thyroid gland, within the pre-tracheal fascia

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

DDx for neck swelling?

A

congenital:
cystic hygroma
branchial cyst
thyroglossal cyst

inflammatory:
post-viral lymphadenopathy
bacterial/suppurative lymphadenopathy

neoplastic:
mets
salivary gland
lymphoma
lipoma
thyroid
carotid body tumours

goitre

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

Investigations in thyroid disease?

A

TFTs
autoantibodies
US
nuclear-imaging scintigraphy
CT neck non-contrast
FNAC

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

Features on US suggestive of malignant disease?

A

solid
irregular margins
microcalcifications
increased vascularity
size >5cm
lymphadenopathy

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

Indications for thyroidectomy?

A

cancer
compression of adjacent structures
cosmesis (goitre, eyes)
carbimazole or other medical treatment failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Investigations for hyperthyroidism?

A

ECG (AFib, sinus tachycardia)
TFTs
autoantibodies
US
scintigraphy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Scintigraphy results in hyperthyroidism causes?

A

diffuse uptake -> Grave’s
patchy uptake -> TMG
single area of uptake -> solitary nodule

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

Mx of hyperthyroidism?

A

propranolol for symptoms
anticoagulation if AFib
carbimazole
propylthiouracil
radioiodine
surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Mx of Grave’s disease?

A

beta blockers symptomatic carbimazole for 18 months
propylthiouracil alternatively

if refractory -> radioiodine or surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Mx of TMG?

A

radioiodine therapy followed by surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Mx of solitary adenoma?

A

surgery followed by radioiodine treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Mx of thyroiditis?

A

analgesia (NSAIDs)
beta blockers

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

Features of Grave’s disease?

A

hyperthyroidism
smooth diffusely enlarged goitre
TSH receptor antibodies
thyroid eye disease
pretibial myxoedema
thyroid acropachy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Side effects of carbimazole/propylthiouracil?

A

teratogenic (C)
agranulocytosis
hepatoxicity (PTU)
rash, urticaria, arthralgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Side effects of radioactive iodine?

A

hypothyroidism
transient thyroiditis
transient worsening of Graves’ ophthalmology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Options for thyroid surgery in hyperthyroidism?

A

thyroidectomy
subtotal thyroidectomy (risk of recurrence)

patients should be euthyroid prior to surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Types of thyroid cancer?

A

papillary
follicular
medullary
anaplastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Features of papillary thyroid cancer?

A

most common
best prognosis
30-50 females
not encapsulated
may be partially cystic
2-10% will have metastatic disease at presentation (lungs, bone)

20
Q

Prognostic factors in papillary thyroid cancer?

A

prognosis generally quite good

younger age positive
smaller tumour positive
soft tissue invasion negative
distant mets negative

21
Q

RFs for papillary thyroid cancer?

A

radiation exposure
FHx

22
Q

RFs for follicular thyroid cancer?

A

radiation exposure
FHx
iodine deficiency

23
Q

Features of follicular thyroid cancer?

A

capsulated
don’t spread to LNs
haematogenous spread to bone and lungs
mets may be hormonally active -> hyperthyroidism

24
Q

Features of medullary thyroid cancer?

A

neuroendocrine tumour of C cells
produces calcitonin
sometimes produces CEA
may be sporadic or as part of MEN2
prior to surgery -> must be evaluated for other neuroendocrine tumours

25
Features of anaplastic thyroid cancer?
older women with rapidly enlarging neck mass aggressive and undifferentiated palliative care early no indication for surgical intervention chemorads for symptomatic relief
26
Investigations for thyroid cancer?
ECG TFTs FBC, U&E, LFTs Imaging (US, scintigraphy, staging CT (no contrast!!)
27
Mx of thyroid cancer?
MDT thyroidectomy mainstay (thyroid lobectomy in smaller cancers) modified radical neck dissection if evidence of mets can use radioiodine therapy following surgery to reduce micro-metastases radiation used in anaplastic cancer for symptomatic relief life-long levothyroxine replacement (higher-dose than for replacement therapy to suppress TSH as some tumours hormone dependent)
28
Complications of thyroidectomy?
Early: strap haematoma transient hypoparathyroidism hypocalcaemia anaesthesia side effects seroma recurrent laryngeal nerve injury vocal cord paresis Intermediate: infection Late: permanent hypoparathyroidism
29
Mx of strap haematoma?
emergency as may lead to airway obstruction immediate decompression by opening of deep wound layers before return to theatre
30
Features of primary hyperparathyroidism?
85% due to solitary adenoma 10-15% due to hyperplasia of multiple glands, usually in the context of MEN syndromes
31
Diagnosis of primary hyperparathyroidism?
high calcium high of inappropriately normal PTH incr. 24hr urinary calcium excretion (excludes familial hypocalciuric hypercalcaemia) imaging to plan minimally invasive surgery
32
Mx of primary hyperparathyroidism?
Acute: correct calcium (IV fluids) avoid bisphosphonates if surgery anticipated Definitive: parathyroidectomy isolating responsible gland for minimally invasive surgery intraoperative PTH measurement serum calcium monitored post-op
33
Presentation of primary hyperparathyroidism?
may be asymptomatic bones stones moans groans
34
What is secondary hyperparathyroidism?
hyperplasia of all 4 glands due to chronic hypocalcaemia caused by: CKD Vit D deficiency high PTH, low or normal calcium, high phosphate
35
Mx of secondary hyperparathyroidism?
treat underlying cause
36
What is tertiary hyperparathyroidism?
excess PTH secretion due to hyperplasia of the parathyroids due to prolonged secondary hyperparathyroidism after the underlying cause is addressed high PTH, high Ca
37
Mx of tertiary hyperparathyroidism?
parathyroidectomy of 3.5 glands remaining 1/2 can be left in the neck or implanted into upper arm
38
Causes of hyperparathyroidism?
primary secondary tertiary malignant (PTHrP SCLC)
39
Features of phaechromocytoma?
catecholamine-producing tumours of the neural crest may be associated with MEN, VHL, NF 10% bilateral, 10% extra-adrenal, 10% familial episodic headache, sweating, tachycardia HTN
40
Investigations for phaechromocytomas?
24-hr urine metanephrines plasma metanephrines CT/MRI
41
Mx of phaechromocytoma?
alpha-block beta-block total adrenalectomy if bilateral disease -> partial resection
42
Causes of Cushing's syndrome?
Cushing's disease Adrenal adenoma Paraneoplastic Exogenous steroids
43
Investigations for Cushing's syndrome?
cortisol levels overnight dexamethasone suppression test high-dose dexamethasone suppression test ACTH CT/MRI
44
Mx of Cushing's syndrome?
depends on cause Iatrogenic: taper down steroids Cushing's disease: trans-sphenoidal surgery Ectopic tumours: excision Adrenal adenoma: surgical excision, unilateral adrenalectomy bilateral adrenal hyperplasia: bilateral adrenalectomy
45
Post-op Mx of adrenalectomy?
cortisol replacement bilateral -> lifelong glucocorticosteroid and mineralocorticosteroid unilateral -> hydrocortisone post-op, oral prednisolone, may take months for cortisol levels to recover
46
Investigations for Conn's syndrome?
plasma aldosterone: renin ratio adrenal vein sampling for localisation CT/MRI
47
Mx of Conn's syndrome?
unilateral: adrenalectomy smaller lesions may allow partial adrenalectomy bilateral: medical therapy with aldosterone antagonist

Surgery (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions