Thyroid Flashcards
Hyperthyroid symptoms (6)
Hyperactive
Weight loss (despite increased appetite
Heat intolerance (prefer cold)
Diarrhea
Palpitations, tremors
Oligomenorrhoea
Hypothyroid symptoms (6)
Lethargy
Weight gain (despite reduced appetite)
Cold intolerance (prefer warmth)
Constipation
Bradycardia
Menorrhagia
What type of autoimmune disease is associated with thyroid disease? (4)
- Type I DM
- SLE
- RA
- Pernicious anemia (a/w Graves & Hashimoto’s)
Risk factors for thyroid disease? (6)
- History of autoimmune disease
- History of cancer elsewhere
- History of thyroid disease
- Occupational history: ionising radiation exposure
- Family history of thyroid cancer
- Smoking
What are the compressive symptoms? (3)
-Dyspnea
- Dysphagia
- Hoarseness of voice
Inspection of thyroid gland (5)
- Swelling
- Scars
- Skin changes over the mass
- stigmata of hyperthyroid/ hypothyroid
- Plethora of face, distended neck veins
A thyroid swelling moves on swallowing, a thyroglossal cyst moves on?
- Swallowing AND
- Protrusion of tongue
Characteristics of lump (5)
Site (ant triangle)
Size
Consistency (soft, cystic, hard, multinodular)
Mobility
Tenderness
Lymph nodes palpated (7)
Submental
Submandibular
Down SCM (II, III, IV)/ Anterior triangle
Posterior triangle
Pre- auricular
Post- auricular
Occipital
If LN are…
a. Separate and tender?
b. Hard and clustered?
c. Soft and rubbery?
suggestive of?
a. Reactive hyperplasia
b. Carcinoma
c. Lymphoma
What to look for in the eyes? (6)
a. Lid lag
b. Lid retraction
c. Exophthalmos
d. Chemosis
e. Opthalmoplegia
f. Proptosis
Which of the following are seen in Grave disease?
(eyes)
a. Lid lag
b. Lid retraction
c. Exophthalmos
d. Chemosis
e. Opthalmoplegia
f. Proptosis
c-f
Describe Lid retraction
Sclera visible between upper limbus of iris and upper eyelid
Describe Exophthalmos
Sclera visible between lower limbus and lower eyelid
Describe proptosis
Eye visible over supraorbital ridge
Lid lag and lid retraction are a result of?
Excess sympathetic activity
Describe pretibial myxoedma.
Elevated shin lesions with well defined edges, purplish red or brown and shiny skin with thickened orange peel appearance
Pretibial myxedema seen in?
- Graves disease
-Hypothyroidism
Carpal tunnel syndrome associated with?
Hypothyroidism
What are the 2 branches of artery arising from the common carotid artery that supply the thyroid gland?
- Superior thyroid artery
- Inferior thyroid artery
Benign (2) vs Malignant (4) thyroid swelling
Benign:
- Multinodular swelling
- Hypo/hyperthyroid
Malignant:
- Progressively increase in size
- Solitary
- Painless
- Euthyroid
Complications of swelling? Mass effect. (3)
- Dysphagia
- Dyspnea
- SVC obstruction: SOB, edema of upper extremities & face, prominent dilated veins
Voice hoarseness of dyspnea suggests?
MALIGNANCY
Voice hoarseness: RLN invasion
Dyspnea: RLN invasion x2
Risk factor for thyroid mass? (4)
- Irradiation history of thyroid
- Radiation exposure (Hiroshima, Nagasaki)
- Low iodine (mountainous area)
- Family history of thyroid ca
Why do surgery in thyroid mass?
- > 20% increase in size over 6 months
- Cancer
- Compressive symptoms
- Strong family history of thyroid ca
