The neck Flashcards
1
Q
What is a thyroglossal cyst?
A
- Dilatation of thyroglossal duct remnant
- May become infected
- Midline; grows with age
- Moves on tongue protrusion
- Need ultrasound scan prior to removal to ensure functioning thyroid tissue elsewhere
- Excised but chance of recurrence
2
Q
What could a solitary thyroid nodule be?
A
- Cyst: due to localised haemorrhage
- Adenoma: benign follicular tissue
- Carcinoma
- Lymphoma
- Prominent nodule in multinodular goitre
3
Q
How do you investigate a solitary thyroid nodule?
A
- Investigate by fine-needle aspiration cytology (FNAC) AND ultrasound scanning
- FNAC CANNOT distinguish between a follicular adenoma AND a follicular carcinoma
- Therefore tissue required for histological diagnosis
- THYROID LOBECTOMY
4
Q
What could a diffuse thyroid enlargement be?
A
- Colloid goitre: due to gland hyperplasia, iodine deficiency puberty, pregnancy, lactation
- Grave’s disease
- Thyroiditis
5
Q
What are the indications of a thyroidectomy?
A
- Airway obstruction
- Malignancy or suspected malignancy
- Thyrotoxicosis
- Cosmesis
- Retrosternal extension
6
Q
What are the complications of a thyroidectomy?
A
- Bleeding-primary or secondary
- Voice hoarseness
- Thyroid storm (release of hormones)
- Infection
- Hypoparathyroidism
- Hypothyroidism
- Scar (keloid/ hypertrophic)
7
Q
What can parathyroid disease cause?
A
- Renal calculi, polyuria, renal failure
- Pathological fractures, osteoporosis, bone pain
- Abdominal pain, constipation, peptic ulceration, pancreatitis, weight loss
- Anxiety & depression, confusion, paranoia
8
Q
What tests do you do for parathyroid disease?
A
- Urea & electrolytes, creatinine, calcium, phosphate
- Parathyroid hormone, bicarbonate
- Vitamin D
- Ultrasound scan
- CT/MRI: identify ectopic glands
- Isotope scanning: detect diseased glands
9
Q
What is the treatment of hyperparathyroidism?
A
Surgery only
