Head Neck Thyroid Parathyroid Flashcards

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1
Q

Mucous retention cyst of sublingual gland

A

Ranula

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2
Q

Benign tumor of the tongue derived from schwann cells?

Treatment?

A

Giant cell myoblastoma (ABRIKOSSOF TUMOR)

Tx: wide excision

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3
Q

Arise from dental lamina associated with impacted tooth
Presents as painless mandibular mass
Xray: “soap bubble appearance”

A

Ameloblastoma

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4
Q

Cyst of oral mucosa due to rupture of ductal system hence submucosal accumulation of mucus

A

Mucous retention cyst

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5
Q

Where does left Recurrent LN crosses?

A

Aorta

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6
Q

Where does right Recurrent LN crosses?

A

Subclavuan artery

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7
Q

In radionuclide imaging, what kind of iodine is used to see residual thyroid after surgery or for metastatic cancer?

A

Iodine-123 (half life: 12-14 hours)

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8
Q

In radionuclide imaging, what kind of iodine is used to screen and treat well differentiated thyroid cancers?

A

Iodine-131 (half life: 8-10 days)

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9
Q

Adverse effect of methimazole

A

Congenital aplasia

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10
Q

Adverse effect of anti-thyroid drugs

A

Granulocytopenia/ agranulocytosis
Peripheral neuritis
Aplastic anemia (irreversible)

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11
Q

Action of PTU and methinazolr

A

Inhibit iodine organification and coupling of iodotyronine

PTU: also inhibit peripheral conversion of T4 to T3

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12
Q

Disadvantage of Radioactive iodine therapy

A

Progression of ophthalmopathy

Increased rate of cardiovascular mortality

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13
Q

Advantage of RAI in hyperthyroidism

A

Eurhyroid in 2 months

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14
Q

Absolute contraindication for RAI

A

Pregnant and breastfeeding

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15
Q

Indication of RAI

A

Elderly male with small-moderate goiters

relapse after surgery

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16
Q

What are the components of hartley-dunhill procedure?

A

Total ipsilateral lobectomy
Isthmusectomy
Contralateral subtotal thyroidectomy

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17
Q

Signs and symptoms are sinilar to grave’s but extrathyroidal sx are absent

A

Toxic multinodular goiter

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18
Q

Occurs in young patient with long standing nodule with hyperthyroidism

A

PLUMMER’s disease (Toxic Adenoma)

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19
Q

If with recurrent acute thyroiditis, suspect what anomaly?

A

3rd branchial cleft anomaly

Persistent PYRIFORM SINUS fistula

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20
Q

Thyroiditis common in children, preceded by URTI

A

Acute suppuratice thyroiditis

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21
Q

Kind of thyroiditis viral in origin

A

Subacute thyroiditis PAINFUL type

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22
Q

Sub acute Thyroiditis that is auto immune in origin

A

Subacute thyroiditis PAINLESS Type

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23
Q

Most common inflammatory disorder of thyroid gland

A

Hashimoto’s/ Lymphocytic/Chronic thyroiditis

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24
Q

Leading cause of hypothyroidism

A

Hashimoto’s/ Lymphocytic/Chronic thyroiditis

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25
Q

Hard woody thyroid gland
Painless hard anterior mass
Compressive

A

REIDEL’S thyroiditis/ invasive fibrous thyroiditis

26
Q

Single most important test in evaluation of thyroid nodules

A

FNAB (gauge 23 needle)

27
Q

Diagnostic procedure for HURTLE CELL and FOLLICULAR CA

A

Tissue biopsy/ frozen section

They can’t be diagnosed with FNAB

28
Q

In FNAB of thyroid nodule, components of optimum cytology

A

6 follicles
10 cells/ follicle
In 2 aspirates

29
Q

After thyroidectomy, how many weeks will you give RAI?

A

6 weeks

30
Q

Dose of maintenance LT4 post op

A

1.5 mcg/kg

31
Q

Test to request after TSH in the evaluation od thyroid nodule

A

Euthyroid/ hypothyroid: FNAB

Hyperthyroid: RAI SCAN

32
Q

Diagnostic for non palpable thyroid nodule

A

Ultrasound

33
Q

Management of simple thyroid cyst

A

Aspiration (up to 3x)

But for >4cm and complex cyst: unilateral lobectomy

34
Q

Management for colloid adenoma

A

3cm: lobectomy+isthmusectomy

35
Q

Common thyroid CA in children, radiation exposure and iodine sufficient

A

Papillary CA

36
Q

Orphan annie nuclei

Psamomma bodies

A

Papillary thyroid CA

37
Q

Type of thyroid carcinoma with presence of vascular invasion

A

Follicular thyroid CA

38
Q

Marker for recurrence of well differentiated (papillary/follicular) thyroid CA

A

Thyroglobulin

39
Q

Thyroid CA secondary to germ line mutation at the ret proto oncogene

A

Medullary thyroid CA

40
Q

Arisea from parafollicular cells at superolateral lobe of thyroid gland

A

Medullary thyroid CA

41
Q

Hormones produced in medullary thyroid CA

A
Calcitonin
CEA
CGRP
Histaminidase
Serotonin
42
Q

Pre malignant lesion of medullary thyroid CA

A

Chief cell hyperplasia

43
Q

Diseases in MEN 2A

A

Medullary thyroid CA
Pheochromocytoma
Prinary hyperparathyroidism

44
Q

Diseases in MEN 2B

A

Medullary thyroid CA
Pheochromocytoma
Marfanoid habitus
Mucocutaneous ganglioneuromatosis

45
Q

Diagnostics for postoperative follow up of medullary Thyrois CA

A

Annual CEA and calcitonin

46
Q

When is total thyroidectomy done in MEN 2A patients?

A

Before 6 years old

47
Q

When is total thyroidectomy done in MEN 2B patients?

A

Before 1 year old

48
Q

Arises usually from hashimoto’s thyroiditis with similar symptoms with anaplastic carcinoma but painless

A

Thyrois lymphoma

Tx: CHOP

49
Q

Most common metastasis to thyroid

A

Renal cell CA

50
Q

Bleeding under platysma

A

Bull neck deformity

Involves middle thyroid vein

51
Q

Blood supply of parathyroid

A

Inferior thyroid artery

52
Q

Most common location of supernumerary glands

A

Thymus

53
Q

Most common location of ectopic parathyroid

A

Paraesophageal

54
Q

Most common cause of primary hyperparathyroidism?

A

Parathyroid adenoma

2nd: hyperplasia

55
Q

Primary hyperparathyroidism pentad

A
Kidney stones
Bone pains
Abdominal groans
Psychic moans
Fatigue overtone
56
Q

Treatment for parathyroid CA

A

En bloc resection + ipsilateral thyroid lobe

57
Q

Mainstay treatment for hypercalcemic crises

A

IV 0.9 saline hydration

58
Q

3 esophageal narrowing

A

Cricopharyngeus
Left mainstem bronchi
Diaphragmatic hiatus

59
Q

Hallmark of intestinal metaplasia in barret’s esophagus

A

Intestinal goblet cells

30-100x risk for adenoCA

60
Q

Gold standard diagnostic for persistent GERD

A

24 hour pH monitoring