THYROID

Question 1

Pressure signs

Answer 1

Stridor
SVC syndrome
Vocal cord palsy
Hoarseness

Question 2

Thyroid patient investigations

Answer 2

Biochemical
Imaging
Cytology and histology

Question 3

Biochemical investigations in a thyroid patient

Answer 3

1.TSH- (best for Hypothalamus-pituitary-thyroid axis integrity)
2.free T4 and T3-if TSH is abnormal
3.Antibodies- (in thyroiditis)
4.Serum thyroglobulin-Increased in follicular destruction such as de Quervian’s thyroiditis and follow up post total thyroidectomy for malignancy to reassess recurrence of metastatic disease
5.Calcitonin- in medullary cancer

Question 4

Imaging in thyroid patient

Answer 4

CXR
U/S
Radionucleotide scanning
CT and MRI

Question 5

CXR in a thyroid patient may show

Answer 5

Metastasis
Retrosternal extension
TB associated with thyroid

Question 6

Radionuclide scanning in a thyroid pt

Answer 6

1. “I” 123- low dose and short half life
2. “I” 131- high dose and long half life- used to screen and treat patients with metastatic thyroid malignancy
3. Provides information on thyroid morphology and function
4. May be therapeutic
5. Can’t distinguish between benign and malignant

Exposes patients to radiation whichcan cause thyroiditis, thyroid storm and worsening of eyesigns