Thyroid

Question 1

What thyroid-related hormone comes from the hypothalamus?

Answer 1

TRH

Question 2

What thyroid-related hormone comes from the anterior pituitary?

Answer 2

TSH

Question 3

What are the usual causes of thyroiditis?

Answer 3

Viral infection or autoimmune reaction

Question 4

Is thyroid cancer usually curable?

Answer 4

Yes

Question 5

As a goiter enlarges in a patient, what symptoms are common?

Answer 5

Respiratory problems d/t trachea compression

Swallowing difficulty d/t esophageal compression

Question 6

What are some adverse effects of Methimazole?

Answer 6

Agranulocytosis (bone marrow suppression)

Liver failure

Question 7

What is first-line treatment for hyperthyroidism in a pregnant patient?

Answer 7

PTU

Question 8

Most common causes of hyperthyroidism?

Answer 8

GRAVE’S DISEASE
Toxic nodule
Toxic multinodular goiter
Early subacute thyroiditis

Question 9

What is a thyroid storm?

Answer 9

Emergency; symptoms:

• Fever
• Hypotension
• CHF

Question 10

Treatment for thyroid storm?

Answer 10

Methimazole plus:
Anti-adrenergics
Corticosteroids

Question 11

What arrhythmia is associated with hyperthyroidism?

Answer 11

Atrial fibrillation

Question 12

What will a thyroid scan show in Grave’s disease?

Answer 12

Diffuse uptake without nodularity

Question 13

What is treatment for Grave’s disease?

Answer 13

PTU or Methimazole
Beta-blockers
Radioactive iodine

Question 14

What is only cure for hyperthyroidism?

Answer 14

Radioactive iodine ablation

• Can’t give to children or pregnant women
• Can’t give to patient with exopthalmos

Question 15

What is Plummer’s disease?

Answer 15

Toxic multinodular goiter
Normal T3 and T4 common
Elevated TSH
Treatment: Meds first; then RAI or thyroidectomy

Question 16

What is a toxic nodule?

Answer 16

Hyperthyroid symptoms

Treatment: meds first; RAI or thyroid lobectomy

Question 17

Treatment for subacute thyroiditis?

Answer 17

NSAIDS and thyroid replacement

Question 18

What antibodies are found with Hashimoto’s thyroiditis?

Answer 18

Antithyroglobulin

Antimicrosomal

Question 19

What are two stages of Hashimoto’s?

Answer 19

1) Enlarged during inflammation

2) Small d/t gland destruction

Question 20

Is surgery usually indicated in Hashimoto’s?

Answer 20

Rarely

Question 21

What sized thyroid nodules should be removed?

Answer 21

> 1 cm

Question 22

Treatment for cancerous thyroid nodule?

Answer 22

Total thyroidectomy

-Use radioactive iodine after if surgery is good

Question 23

Is thyroid cancer more common in males or females?

Answer 23

More common in females

More aggressive in males

Question 24

Most common thyroid cancer?

Answer 24

Papillary

-Least aggressive

Question 25

Most aggressive thyroid cancer?

Answer 25

Anaplastic

Question 26

Which cells are found in medullary thyroid cancer?

Answer 26

C cells

-Secrete calcitonin

Question 27

What is the AMES criteria?

Answer 27

Thyroid CA prognosis:

Age, Metastases, Extent, Size (over 3 cm?)

Question 28

What should we give if we suspect metastases?

Answer 28

Radioactive iodine

Question 29

What are some familial cancer syndromes?

Answer 29

MEN 2A/2B
Ret oncogene
Familial medullary thyroid cancer

Question 30

Treatment for medullary cancer?

Answer 30

Total thyroidectomy with central compartment lymph node dissection

Question 31

Prophylaxis for family members with familial cancer history?

Answer 31

Surgery as soon as you can

Question 32

Treatment for anaplastic thyroid cancer?

Answer 32

Surgery rare

• Radiotherapy and doxorubicin
• Tracheostomy is trachea is compressed

Question 33

What are thyroglossal ducts?

Answer 33

ALWAYS midline
Cyst
Surgical excision via Sistrunk procedure: involves removing central 1/3 of hyoid bone
If cyst is infected: treat infection then operate