Kirila Thyroid

Question 1

which condition may not improve after treatment in a setting of grave’s?

Answer 1

exopthalmous

Question 2

in Graves which antibody supports diagnosis

Answer 2

TSI

Question 3

TSH will demonstrate what?

Answer 3

that the driver for the hyperthyroidism is NOT the pituitary: TSH will be suppressed

Question 4

the iodine scan in graves pattern. what is used to accomplish this scan?

Answer 4

homogenous, diffusely increased uptake, radioactive iodine and technetium

Question 5

what kind of β blocker do you want to use in graves?

Answer 5

non-selective: it will reduce the symptoms FAST, so they are the drug of choice to reduce symptoms, especially if thyroid storm is suspected

Question 6

what condition do you want to consider if administering a β blocker for thyroid storm?

Answer 6

asthma: avoid β blockers in this circumstance

Question 7

how long will it take for methimazole and PTU to take effect?

Answer 7

2-8 weeks

Question 8

d

Answer 8

d

Question 9

TSH and Free T4

Answer 9

TSH to screen; T4 to confirm

Question 10

thyroid acropachy

Answer 10

clubbing effect due to thyroid disease

“an extreme manifestation of autoimmune thyroid disease. It presents with digital clubbing, swelling of digits and toes, and periosteal reaction of extremity bones. It is almost always associated with ophthalmopathy and thyroid dermopathy.”

Question 11

a lump in the throat: what is the first lab

Answer 11

TSH

Question 12

TSH is low- that means what in relation to a nodule? what is the next order?

Answer 12

it is a primary. condition; a thyroid scan with iodine is the next order

Question 13

If the TSH is…low…for to what? If the TSH is high, do what?

Answer 13

thyroid scan, FNA

Question 15

physical appearance of a patient with a large goiter

Answer 15

patient may be contorting their body to improve respiration, their circulation may be compromised by compression and causing him to squirm

Question 16

1. FNA: senstitivity, specifict
2. main limitations
3. what is required of the clinician?

Answer 16

1. sensitivity- 80%; specificity- 90%.
2. poor technique or a hypocellular sample not adaquate for a diagnosis
3. watch and wait

Question 17

which finding supports diagnosis of a benign nodule?

Answer 17

tenderness

Question 18

RFs for benign nodule

Answer 18

1. family hx of them
2. hashimotos
3. tenderness
4. mobile nodule
5. concomitant diagnosis of hypo or hyperthyroidism

Question 19

RFs for malignant nodule

Answer 19

1. very young
2. very old
3. men
4. history of neck irradiation
5. firm fixed nodule
6. one more thing i missed

Question 20

hyperthroid patient with a high TSH

Answer 20

rare, but possible for it to be a functional pituitary adenoma secreting TSH and resists negative feedback

Question 21

TSH high; T4 almost normal; T3 is high

Answer 21

pituitary adenoma

Question 22

iodine scan for viral thyroiditis

Answer 22

diffuse bilaterally

Question 23

queen ann sign

Answer 23

hypothyroidism: dry skin, brittle hair, thinning or loss of the outer third of the eyebrows

Question 24

desiccated thyroid

Answer 24

T3 from pigs and cow thyroids. kirila said it wasn’t a reliable drug.