Endocrine Surgery

Question 1

RECAP- what do thyroid hormones get synthesised from?

Answer 1

Iodine

-> one of the only glands in the body that takes up iodine

Question 2

What does iodine get coupled to to produce T3/4?

Answer 2

Tyrosine

Question 3

If someone has a large goitre, what are they likely to be deficient in?

Answer 3

Iodine

Question 4

List the effects of TH.

Answer 4

Increase is catabolism of carbs/lipids
Increase in protein synthesis
Increase in basal metabolic rate
Growth and maturation

Question 5

What does the thyroid gland develop from embryologically?

Answer 5

Foramen cecum

Question 6

Which part of the neck does the thyroid gland lie?

Answer 6

Anterior triangle of neck

Question 7

What is the blood supply for the thyroid gland?

Answer 7

Superior thyroid artery
Inferior thyroid artery

Question 8

What is the superior thyroid artery a branch of?

Answer 8

Carotid artery

Question 9

What is the inferior carotid artery a branch of?

Answer 9

Thyroid cervical trunk

Question 10

Damage to which nerve causes change in voice, vocal changes or loss?

Answer 10

Recurrent laryngeal nerve

Question 11

Thyrotoxicosis?

Answer 11

Clinical syndrome of excess circulating TH, commonly sue to hyperthyroidism

Question 12

What are some of the primary causes of hypothyroidism?

Answer 12

Autoimmune thyroiditis
Dietary insufficiency
Surgery
Radioiodine

Question 13

What are some of the secondary causes of hypothyroidism?

Answer 13

Pituitary failure

Question 14

Goitre?

Answer 14

Enlargement of thyroid gland

Question 15

What is Pemberton’s sign used to evaluate?

Answer 15

Venous obstruction in patients with goitres

Question 16

How can goitres affect airways?

Answer 16

Can cause compression of the airway

->classical sign of airway compression is stridor

Question 17

What are the most common complications of a thyrodidectomy?

Answer 17

Damage to recurrent laryngeal nerve
Damaging parathyroid glands, in turn causing low calcium levels
Bleeding
Wound problems
Requiring long term thyroid supplements

Question 18

What are the four types of thyroid cancer?

Answer 18

Papillary
Follicular
Medullary
Anaplastic

Question 19

Where does medullary thyroid cancer arise from?

Answer 19

Calcitonin releasing C-cells

Question 20

Thyroid cancer has a good prognosis except for which type?

Answer 20

Anaplastic- very poor prognosis

Question 21

Where can thyroid cancer spread to?

Answer 21

Bone, lymph nodes and lungs

Question 22

How do we get a tissue diagnosis to determine the type of thyroid cancer?

Answer 22

Fine needle aspiration cytology (FNAC)

Question 23

What are some of the treatment options for thyroid cancer?

Answer 23

Surgery
Radioiodine

Question 24

What are the parathyroid glands developed from embrylogically?

Answer 24

Pharyngeal pouches

Question 25

What does the parathyroid hormone do?

Answer 25

Control homeostasis of calcium in the bloodstream, along with vitamin D

Question 26

RECAP- what are the classic symptoms of hypercalcaemia?

Answer 26

Stones, bones, moans and psychic groans -kidney stones, bone pain, abdominal pain and constipation

Question 27

RECAP- if calcium levels are low, what should the PTH levels be like?

Answer 27

High

Question 28

What is a sesatmibi scan?

Answer 28

Sestamibi is a radio labelled isotope which is taken up by metabolically active tissue. Helps to work out which parathyroid gland is the issue in parathyroid surgery

Question 29

What supplies blood to the adrenal glands?

Answer 29

Branches of the renal artery

Question 30

In post-menopausal women, where does the main source of testosterone and oestrogen come from?

Answer 30

Adrenal gland

Question 31

RECAP- what does excess cortisol cause?

Answer 31

Cushing's syndrome

Question 32

RECAP- symptoms of Cushing's. Signs of Cushing's.

Answer 32

Symptoms- weight gain, central obesity, moon face, easy bruising, thin skin, purple abdominal striae, infertility Signs- hypertension, diabetes, impaired glucose tolerance, osteoporosis

Question 33

What is produced in excess in Conn's syndrome?

Answer 33

Mineralocorticoids

Question 34

Random but

Answer 34

This lecture is a pretty good overview of everything learned so far if want one lecture for overview xx

Question 35

What does the adrenal medulla produce when stimulated by the sympathetic NS?

Answer 35

Adrenaline and noradrenaline

Question 36

Why are pheochromocytoma's referred to as the 10% tumour?

Answer 36

10% of them arise outwith the adrenal gland 10% familial 10% malignant 10% multiple

Question 37

When diagnosing pheochromocytoma's, what is measured?

Answer 37

Metabolites known as metanephrines in the urine ->not adrenaline measured as levels fluctuate so quickly in the bloodstream

Question 38

What do neuroendocrine tumours secrete?

Answer 38

Serotonin and chromogranin

Question 39

MEN (multiple endocrine neoplasia)?

Answer 39

A group of familial symptom syndromes where patients have multiple endocrine tumours of the pituitary, parathyroid, thyroid, adrenal and the pancreas

Question 40

What is MEN1?

Answer 40

Tumours of the parathyroid glands which are often accompanied with tumours of the anterior pituitary and endocrine pancreas

Question 41

What is MEN2?

Answer 41

Medullary thyroid cancer often accompanied with pheochromocytoma and parathyroid tumour