Brainscape's Knowledge GenomeTM

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


See full index

Surgery > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Common presentation of benign thyroid nodule?

A
  • Generally asymptomatic swelling in neck, moves on swallowing
  • Local pressure symptoms: dysphagia, persistent cough, stridor, hoarse voice or SVC obstruction
    Toxic nodule will present with symptoms of thyrotoxicosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Investigations for Thyroid nodule

A

TFT: TSH, T3 & T4
FNA with USS for cytology
Capsular or vascular invasion on histology
If thyrotoxic: nuclear medicine scan`

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

Treatment for thyroid nodule?

Indications for surgery?

A 
- Benign on FNAC do not require treatment. 
Indications for surgery:
- presence of obstructive symptoms
- Thyrotoxicosis 
- Malignancy 
- Atypical changes on FNAC

Thyroxine suppression is generally ineffective in decreasing the size of single thyroid nodule.

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

MNG: cause

A

Result of repeated cycles of hyperplasia, nodule formation, degeneration and fibrosis occurring throughout gland.

  • In response to iodine deficiency
  • Dominant nodule within MNG most likely hyperplastic or colloid nodule.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Clinical presentation of MNG

A

asymptomatic mass in neck +/- obstructive symptoms.

May have thyrotoxicosis

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

Investigations of MNG

A

TFT
FNAC
CT (retrosternal extension)

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

Treatment of MNG

A

Indications for surgery (total thyroidectomy):

  • obstructive symptoms
  • Thyrotoxicosis
  • Suspicious or malignant change on FNAC
  • Family history of thyroid cancer
  • Retrosternal extension
  • Past Hx of head and neck irradiation
  • Cosmetic

Lifelong thyroxine replacement required post thyroidectomy

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

Common types of Thyroid cancer

A
  1. Papillary: 85%, younger age, multifocal, local lymphatic spread, good prognosis
  2. Follicular: older age, single tumour, bloodstream metastasis, worse prognosis, associated with previous exposure to ionising radiation
  3. Anaplastic (undifferentiated): elderly, rapidly enlarging, spreads locally, terrible prognosis
  4. Medullary (of C-cells) Secretes calcitonin, MEN IIA - associated phaeochromocytoma & hyperparathyroidism.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Clinical presentation of Thyroid cancer

A

Single thyroid nodule or dominant nodule of MNG.

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

Investigations of Thyroid cancer

A

FNAC & CT to determine extend and lymph node involvement
Serum calcitonin levels raised in medullary tumours

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

Treatment of thyroid cancer

A

Total thyroidectomy with removal of involved LN.
Followed by radioactive iodine (detection and ablation of metastatic disease and lifelong thyroxine suppression.
If low risk (follicular with capsular penetration & small papillary cancers) can be removed via lobectomy.

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

Thyrotoxicosis pathology/types

A
  1. Hypersecretory goitre (Grave’s)
  2. Toxic MNG (Plummer’s disease)
  3. Toxic follicular adenoma
  4. Initial stages thyroiditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Clinical presentation of thyrotoxicosis

A 
Tachycardia 
Heat intolerance 
Sweating 
Weight loss 
Anxiety 
Exophthalmos & pre-tibial oedema (Graves)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Thyrotoxicosis Treatment

A
  1. Antithyroid medication: Carbimazole or prophylthiouracil (prevent coupling of iodotyrosine)
    Treated for 12-18 months
  2. Radioactive iodine (40+ years)
  3. Total thyroidectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Thyroiditis classifications

A

Lymphocytic (Hashimoto’s)
Subacute (de Quervain’s)
Acute (bacterial)
Fibrosing (Reidel’s)

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

Treatment of thyroiditis

A

Subacute: high-dose steroids & aspiring .
Lymphocytic: thyroxine suppression
Surgery may be required for lymphocytic thyroiditis with persistent or suspicious nodules, or pressure symptoms.

17
Q

Complications of thyroidectomy

A

All general complications of operations (bleeding, wound infection, reaction to GA)
Damage to:
- Recurrent laryngeal nerve (Hoarse voice)
- External branch of superior laryngeal nerve (inability to sing, shout or project voice)
- Parathyroid glands (hypoparathyroidism)
Temporary damage or oedema requires short term oral calcium and 1,25-dihydroxyvitamin D

18
Q

FNAC can reliably diagnose all types of thyroid cancer EXCEPT:

a) follicular
b) papillary
c) anaplastic
d) medullary
e) metastasis from renal cell cancer

A

d) Medullary thyroid cancer

Surgery (9 decks)

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