Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y4 Gen Med > Thyroid > Flashcards

Thyroid Flashcards

1
Q

What is thyroxine also known as?

A

T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Do you measure free or bound thyroxine?

A

Free

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is more common primary or secondary hyperthyroidism?

A

Primary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are fT4 and TSH in primary hyperthyroidism?

A

High fT4

Low TSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are fT4 and TSH in secondary hyperthyroidism?

A

High fT4

High TSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Name 3 causes of primary hyperthyroidism. What is the commonest’s cause?

A

Grave’s disease - commonest
Toxic multinodular goitre
Thyroiditis
Hot nodule - solitary toxic adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What autoantibody is seen in Grave’s disease?

A

TRAbs thyroid receptor antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What features in Grave’s disease are not seen in other causes of hyperthyroidism?

A

Thyroid eye disease
Thyroid acropachy
Pretibial myxedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What features of a goitre help differentiate the cause of hyperthyroidism?

A

Grave’s: large smooth non-tender goitre
Toxic multinodular goitre: lumpy tender
Thyroiditis: smooth tender

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name 3 causes of thyroiditis

A

Post viral infection
Post-partum
Amiodarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the management of grave’s thyroid eye disease?

A

Steroids
(IV/PO depending on severity)
(sight loss risk)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Name 1 cause of secondary hyperthyroidism

A

TSH secreting pituitary tumour, ectopic thyroid tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What type of imaging is used first for investigating hyperthyroidism?

A

US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Is a nuclear medicine technetium uptake test done for all with hyperthyroidism?

A

If antibody negative or diagnostic uncertainty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is seen on Graves’ disease and toxic multinodular goitre in a nuclear medicine technetium uptake test?

A

Grave’s uniform uptake

TMNG patchy uptake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the first line management of Graves’ disease?

A

Carbimazole
(titrate dentist every 6 week until euthyroid)
(cures 50% patients)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the management of Graves’ disease if pregnant or intolerant of carbimazole?

A

PTU propylthiouracil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the common side effect of carbimazole? How is it managed?

A

Itch/rash – antihistamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the rare but important side-effect of carbimazole?

A

Agranulocytosis - sore throat, dry cough, mouth ulcers, bruising, fever
(monitor FBC, neutrophils, reversible if stop)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the use of beta-blockers in hyperthyroidism?

A

For adrenergic type symptoms: tremor sweat anxiety palpitations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is a hot and cold nodule?

A

Hot - making hormone

Cold – doesn’t make anything (suspicious cancer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Deficiency of what can cause a goitre?

A

Iodine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Following radioactive iodine treatment, how long should patients isolate for?

A

3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What nerve may be injured in thyroid surgery?

A

Recurrent laryngeal nerve – hoarse voice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Untreated hyperthyroidism can lead to what complication?

A

Thyroid storm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Thyroid storm

  • High or low temp
  • Dehydration or fluid overload
  • Low or high HR
  • Low or high BP
A 
High temp
Dehydration
High HR
Low BP
Also confusion/anxiety/delirium, N+V, arrhythmias
27
Q

What is the management of a thyroid storm?

A 
Fluids + 
propranolol + 
PTU + 
hydrocortisone + 
paracetamol + 
phenobarbital + 
furosemide/ACEI
28
Q

What are fT4 and TSH in primary hypothyroidism?

A

low fT4

TSH high

29
Q

What are fT4 and TSH in secondary hypothyroidism?

A

low fT4

low TSH

30
Q

Name 3 causes of primary hypothyroidism

A 
Hashimoto's disease
Idiopathic
Thyroiditis
Iodine deficiency
History of thyroid irradiation/surgery
31
Q

Name 2 causes of secondary hypothyroidism

A

Pituitary neoplasm
Hypothalamic neoplasm
Congenital
Sheehan syndrome (pituitary necrosis/apoplexy)

32
Q

Does lithium cause hypo or hyperthyroidism?

A

Either

33
Q

What autoantibody is associated with Hashimoto’s disease?

A

TPO

34
Q

What is the first line management of hypothyroidism

A

Levothyroxine T4

35
Q

What is a complication of decompensated hypothyroidism?

A

Myxedema coma

36
Q

What would be seen on blood results in subclinical hypothyroidism?

A

Normal fT4, high TSH

37
Q

What is the management of subclinical hypothyroidism?

A

Repeat TFTs in a few months

38
Q

What is the management of myxoedema coma?

A

Supportive + IV hydrocortisone + IV levothyroxine T4

39
Q

What is the 5% rule with thyroid cancer?

A

5% of women have thyroid lumps, 5% of them are malignant

40
Q

Most thyroid nodules are benign hyperplastic lesions – true or false

A

True

41
Q

Is a thyroid cancer lump tethered to surrounding structures or mobile?

A

Tethered

42
Q

Cytology determines the staging of thyroid cancer – true or false

A

False cytology does grading not staging
Cytology can’t see if invaded the basement membrane
(Graded U2-U5)

43
Q

What is the commonest type of thyroid cancer? What is the second commonest type of thyroid cancer?

A

Commonest papillary

Next follicular

44
Q

TFTs are usually normal in thyroid cancer – T or F

A

True

45
Q

When investigating thyroid cancer should you check for thyroid autoantibodies?

A

Yes for exclusion

46
Q

What type of biopsy is done for thyroid cancer?

A

FNA for cytology

47
Q

Cervical lymphadenopathy + thyroid lump = until proven otherwise

A

Papillary thyroid cancer

48
Q

If you find cervical lymphadenopathy on the examination, what should he do next on examination?

A

Check axilla/groin LN

lymphoma

49
Q

Are a isotope scan and a technetium uptake scan the same thing?

A

Yes

50
Q

What is a hot nodule on an isotope scan diagnostic off?

A

Solitary toxic adenoma

51
Q

How old is papillary thyroid cancer and most commonly metastasise?

A

Lymphatic spread

52
Q

Is papillary thyroid cancer associated with younger or elderly patients? More male or female?

A

Young

M = F

53
Q

Papillary thyroid cancer has an excellent prognosis – true or false

A

True

54
Q

What is TSH levels in papillary or follicular thyroid cancer?

A

Normal or slightly elevated

55
Q

Does follicular thyroid cancer metastasise early or late? Where does it spread to?

A

Early to bone/lung

56
Q

What type of thyroid cancer is associated with CEA?

A

Medullary

57
Q

What type of thyroid cancer is associated with MEN?

A

Medullary

58
Q

What is used as a tumour marker for monitoring thyroid cancer post surgery?

A

Thyroglobulin

59
Q

What is the presentation of MEN1?

A

3 Ps

Parathyroid, phaeochromocytoma, pancreas (insulinoma, gastrinoma, PUD Zollinger Ellison syndrome)

60
Q

What gene is mutated in MEN1?

A

MEN 1 gene

61
Q

What gene is mutated in MEN2?

A

RET gene

62
Q

What is the Mx of low risk thyroid cancer (under 50yr, under 4cm)?

A

Lobectomy (most function ok after few months with half thyroid)

63
Q

What is the Mx of low risk thyroid cancer (over 50yr, over 4cm)?

A

Total thyroidectomy

Y4 Gen Med (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions