Endocrine: Thyroid

Question 1

What antibodies do you test for if you suspect graves disease?

Answer 1

Ant Tg
Anti TPO
(Anti TSH)

Question 2

What dies a radio iodine scan show is graves disease?

Answer 2

Diffuse uptake

Question 3

What is the treatment for graves disease?

Answer 3

Block hyperthyroid until remssion. Carbimizole titrates

Block and replace with high dose carbimazole and thyroxine

Question 4

When is Propothyuriacil used for hyperthyroid?

Answer 4

Only in pregnancy as it can cause liver failure.

Question 5

What are the main specific complications of thyroid surgery?

Answer 5

Dame to the recurrent laryngeal nerve

Hypoparathyroidism

Question 6

When is the use of radioiodine for treatment of hyperthyroid contraindicated?

Answer 6

Pregnancy
Childre
Thyroid eye disease
Incontinence

Question 7

Whys houdl you try and avoid block and replace regimes in pregnant women with hyperthyroid?

Answer 7

Anti thyroid drugs cross the placenta more easily than thyroxine so there is a risk of fetal hypothyroidism

Question 8

Why does amioderone cause thyroid disease?

Answer 8

Contains a lot of iodine and has a long half life

Question 9

What can amioderone do to your thyroid?

Answer 9

Can cause deranged thyroid function in up to 50%

Frank hyper or hypothyroidism in up to 20%

Question 10

What is the tretmanet of a thyroid adeonoma?

Answer 10

surgery

radio iodine ablation

Question 11

What should you do to investigate thyroid nodules?

Answer 11

Fine needle aspiration cytology

Question 12

Are thyroid cancers hot or cold nodules?

Answer 12

Cold - these should always be treated with suspicion

Question 13

Which is the most common type of thyroid cancer?

Answer 13

Papillary

Question 14

How does papillary thyroid cancer typiclly spread?

Answer 14

via the lymphatic system

Question 15

whya re slightly higher doses of thyroxine given after the thyroid has been taken ourt for thyroid cancer?

Answer 15

Tos upress the TSH and removing the trophic drive to any thyroid cells.

Question 16

Whata re the prognosis’s of paplliary, follicular, medulllary and anaplastic thyroid cancers?

Answer 16

Papillary - Good
Follicular = Good
Medulalary = Poor
Anaplastic = Very poor

Question 17

Which thyroid cancer is part of MEN?

Answer 17

Medullary

Question 18

What thyroid cancer tends to affect young women?

Answer 18

Papillary

Question 19

Which type of thyroid cancer tends to affect middle aged women?

Answer 19

Follicular

Question 20

Which thyroid cancer affects old people?

Answer 20

Anaplastic

Question 21

What investigation would you do if you suspect thyroid cancer?

Answer 21

Ultrasound and FNA and cytology

Question 22

Which type of thyroid cancer is found in areas with low iodine?

Answer 22

Follicular

Question 23

What other thyroid condition is associated with papillary thyroid cancer?

Answer 23

Hashimotos thyroiditis

Question 24

what organs does papillary thyroid cancer spread to?

Answer 24

Lungs
Bone
Liver
Brain

Question 25

Which type of thyroid cancer is more likely to spreak to the lymoh nodes?

Answer 25

Papillary

Question 26

When is calcium checked after surgery? Why and what do the results mean?

Answer 26

Checked within 24 hours

If below 2 then calcium replacment started

Question 27

What follow up do you get forthyroid cancer?

Answer 27

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

Question 28

What blood test can be used as a marker for thyroid cancer after thyroid rememanct ablation?

Answer 28

Thyroglobulin

Question 29

What cancer are you at increased risk of if you have thyroid remenant ablation?

Answer 29

AML

Question 30

What is the treatment of choice in toxic multinodular goitre?

Answer 30

Radioiodine therapy