Endocrine - surgery

Question 1

What are the differential diagnoses of neck masses?

Answer 1

Thyroid and parathyroid diseases
Foreign body-induced abscess or sinus tract
Salivary mucocoeles
Oesophageal foreign body
Neoplasia
Lymphadenopathy
Congenital neck cysts

Question 2

What is a solid painless adherant mass in the neck likely to be in dogs?

Answer 2

Malignant thyroid neoplasia

Question 3

What is the treatment for malignant thyroid neoplasia in dogs?

Answer 3

Surgery - good survival rate if not adherent/locally invasive/metastatic
Radiation
Chemo

Question 4

What are the different surgical approaches to feline hyperthyroidism?

Answer 4

Intracapsular - challenging, likely to leave some behind
Extracapsular - easiest, but removes thyroid and parathyroid
Modified intracapsular - fiddly, preserves thyroid glands
Modified extracapsular - preferred option, leaves some capsule so preserves cranial parathyroid gland

Question 5

What are the surgical complications of thyroidectomy?

Answer 5

Haemorrhage
Seroma formation
Laryngeal paralysis
Hypocalcaemia - parathyroids affected
Recurrence

Question 6

What is the treatment for primary hyperparathyroidism?

Answer 6

Parathyroidectomy

Question 7

What are the different presentations of adrenal gland disease?

Answer 7

Incidentaloma - just find when doing something else
Related to function - hormone imbalances
Haemoabdomen - spontaneous bleeding

Question 8

How can you surgically treat adrenal gland disease?

Answer 8

Adrenalectomy - very challenging, lots of haemorrhage

Question 9

What are the 3 main sources of blood to the spleen? Which is most likely to rupture?

Answer 9

Splenic artery/vein
Gastroepiploic artery
Short gastric artery - most likely to rupture

Question 10

What are the different splenic conditions?

Answer 10

Generalised enlargement
Splenic mass - benign or malignant
Splenic torsion
Splenic trauma

Question 11

What are the different splenic surgeries? What can you use?

Answer 11

Partial splenectomy
Total splenectomy - easier
Done with ligatures, staplers or electrosurgery

Question 12

What are some post splenectomy complications?

Answer 12

Haemorrhage
Pancreatitis
Immunosuppression - rare
Arrhythmias

Question 13

Where is the best place to biopsy the pancreas?

Answer 13

Right limb adjacent to duodenum

Question 14

What diseases of the pancreas are there?

Answer 14

Endocrine disease
Exocrine disease
Pancreatitis
Pancreatic abscessation
Pancreatic cysts
Insulinoma

Question 15

What surgical treatment can you do on the pancreas?

Answer 15

Partial pancreatectomy

Question 16

What are the indications for partial pancreatectomy?

Answer 16

Necrotising pancreatitis
Sterile abscess/pseudocysts
Trauma

Question 17

Where can you resect from the pancreas and how much?

Answer 17

Much better from the periphery than from the middle
Up to 80% of pancreas can be resected

Question 18

What are the different partial pancreateactomy technique options?

Answer 18

Guillotine (suture-fracture) technique
Blunt dissection technique
Monofilament suture

Question 19

What are the different biopsies you can take from the lymph nodes?

Answer 19

FNA
Incisional
Excisional - remove whole lymph node

Question 20

How can you tell the primary affected lymph node from a mass?

Answer 20

Inject blue dye into mass - first to show it