Thyroid Flashcards
Unilateral thyroid nodule
Low Tsh
Technetium scan
Hot radio active iodine or surgery
Cold as per cold nodule slide
Unilateral thyroid nodule
TSH normal
Sonography acr ti rads risk assessment
Low risk - 2 yr follow up nil FNB
Medium to high risk
FNB
Thyroid lumps and cancer
95% benign
Folicular Adenoma
5% malignant
Papilliary
FOlicular
Medullary
Anaplastic
Hypothyroidism
biochemistry
high TSH low T4 primary
low TSH low T4 Secondary
hashimotos thyroiditis
anti TPO anti TG positive
Hypoithyroidism symtoms
lethargy loss of lateral third of eye brow hair
weight gain heavy irregular periods course hair
Hashimotos thyroiditis
Autoimmune distruction of the thyroid tissue
anti TPO anti TG positive
follicle destruction lymphocytic inflitration near germinal centres
fibrotic changes
Hurthle cells ( multinucleate giant cells multiple mitochondial cells )
Graves Disease
Auto antibodies for TSH receptor
TSHr autoantibodies titire
Myxodema - non pitting oedema
GAG accumulation in unusual tissue
Orbits= exopthamopathy
Hyperthyroidism Symptoms
Myxodema
lid lag
fine tremour
restlessness
insomnia
weight loss
sweaty skin
AF
hyperreflexia
Follicular Adenoma
Benign
2 cm firm rubbery mass 4 5th decade
Female 7 to 1
Cold nodule
Thin encapsulation
Colloid still present
Papillary Carcinoma
Papillary most popular
Papillar branches
Pupils orphan Annie eyes
Psammoma bodies
Associated with FAP familial adenomatous polyposis
Follicular Carcinoma
Fifty Older patient >50
Frequent Vascular invasion
Follicular cells
Cannot differentiate between adenoma on FNB
Medullary Carcinoma of the Thyroid
Medullary carcinoma of thyroid
parafolliclar cells
MEN 2
II a II b
Surrounded by amyloid
Produces Calcitonin parafollicular cells
C CELLS
Anaplastic Thyroid Cancer
Anaplastic Thyroid Cancer
spindle cells mitotic changes pleomorphic giant cells
asymtomatic
mass effect
dysphagia
hoarseness
thyroid surgery complications
Anatomical such as recurrent laryngeal nerve damage.
Bleeding. Owing to the confined space haematoma’s may rapidly lead to respiratory compromise owing to laryngeal oedema.
Damage to the parathyroid glands resulting in hypocalcaemia.
