Endocrine: Thyroid Flashcards
What antibodies do you test for if you suspect graves disease?
Ant Tg
Anti TPO
(Anti TSH)
What dies a radio iodine scan show is graves disease?
Diffuse uptake
What is the treatment for graves disease?
Block hyperthyroid until remssion. Carbimizole titrates
Block and replace with high dose carbimazole and thyroxine
When is Propothyuriacil used for hyperthyroid?
Only in pregnancy as it can cause liver failure.
What are the main specific complications of thyroid surgery?
Dame to the recurrent laryngeal nerve
Hypoparathyroidism
When is the use of radioiodine for treatment of hyperthyroid contraindicated?
Pregnancy
Childre
Thyroid eye disease
Incontinence
Whys houdl you try and avoid block and replace regimes in pregnant women with hyperthyroid?
Anti thyroid drugs cross the placenta more easily than thyroxine so there is a risk of fetal hypothyroidism
Why does amioderone cause thyroid disease?
Contains a lot of iodine and has a long half life
What can amioderone do to your thyroid?
Can cause deranged thyroid function in up to 50%
Frank hyper or hypothyroidism in up to 20%
What is the tretmanet of a thyroid adeonoma?
surgery
radio iodine ablation
What should you do to investigate thyroid nodules?
Fine needle aspiration cytology
Are thyroid cancers hot or cold nodules?
Cold - these should always be treated with suspicion
Which is the most common type of thyroid cancer?
Papillary
How does papillary thyroid cancer typiclly spread?
via the lymphatic system
whya re slightly higher doses of thyroxine given after the thyroid has been taken ourt for thyroid cancer?
Tos upress the TSH and removing the trophic drive to any thyroid cells.
Whata re the prognosis’s of paplliary, follicular, medulllary and anaplastic thyroid cancers?
Papillary - Good
Follicular = Good
Medulalary = Poor
Anaplastic = Very poor
Which thyroid cancer is part of MEN?
Medullary
What thyroid cancer tends to affect young women?
Papillary
Which type of thyroid cancer tends to affect middle aged women?
Follicular
Which thyroid cancer affects old people?
Anaplastic
What investigation would you do if you suspect thyroid cancer?
Ultrasound and FNA and cytology
Which type of thyroid cancer is found in areas with low iodine?
Follicular
What other thyroid condition is associated with papillary thyroid cancer?
Hashimotos thyroiditis
what organs does papillary thyroid cancer spread to?
Lungs
Bone
Liver
Brain
Which type of thyroid cancer is more likely to spreak to the lymoh nodes?
Papillary
When is calcium checked after surgery? Why and what do the results mean?
Checked within 24 hours
If below 2 then calcium replacment started
What follow up do you get forthyroid cancer?
Whole body iodine scanning in those who have undergone sub total or toral thyroidectomy. This is usually performed at 3 -6 months post op. T3 (2 weeks) and T4 (weeks) must be stopped prior to scan
What blood test can be used as a marker for thyroid cancer after thyroid rememanct ablation?
Thyroglobulin
What cancer are you at increased risk of if you have thyroid remenant ablation?
AML
What is the treatment of choice in toxic multinodular goitre?
Radioiodine therapy
