Thyroid

Question 0

What is the function of the thyroid gland?

Answer 0

Regulates metabolism
Long bone formation
Neural development
Affects bodies sensitivity to catecholamines

Question 1

What is the blood supply to the thyroid gland?

Answer 1

Superior and inferior thyroid artery which are branches of aorta

Question 2

How does the thyroid a regulator of metabolism ?

Answer 2

Secretes T3 and T4

Question 3

Which one out of t3 and t4 is active and which one is the precursor?

Answer 3

T3 active

T4 precursor

Question 4

What does the thyroid secrete more of, t3 or t4?

Answer 4

T4

20:1 ratio

Question 5

How much more time potent is t3 than t4?

Answer 5

3/4

Question 6

Which hormone regulated the production of the thyroid hormones?

Answer 6

TSH from any pit

Question 7

Where does the thyroid develop from?

Answer 7

Foramen cecum

Question 8

Where are the thyroid hormones produced?

Answer 8

Follicular cells

Question 9

What are the causes of hyperthyroidism?

Answer 9

Graves’ disease
Toxic MNG
Pregnancy

Question 10

What is the most common cause of hyperthyroidism?

Answer 10

Graves

Question 11

What are the feature of hyperthyroidism?

Answer 11

Weight loss
Too hot
Goitre
Eye symptoms : exophthalmos 
Palpitations
Increase vowel
Tremor on hands
Tachycardia

Question 12

What do the investigations show for hyperthyroidism ?

Answer 12

Serum TSH suppressed
Serum free t3/t4 elevated

Ultrasound scan shows nodule and can consider isoptope scan to differentiate

Question 13

What is the treatment for hyoerthyroidism?

Answer 13

Block and replace: Carbimazole and thyroxine
Dose titration: carbinmazole and propylthiouracil
Radioactive Iodine
Surgery : if failed medical treatment

Question 14

What nerve do you need to be careful of in thyroid surgery?

Answer 14

Recurrent laryngeal

Question 15

What is the side effect of carbimazole?

Answer 15

Neutropenia so take FBC if ulcers and sore throat

If uncontrolled they can have thyroid storm

Question 16

What are the causes of hypothyroidism ?

Answer 16

Primary : thyroid gland and most commonly Autoimmune (hashimoto) and radioiodine therapy for hyperthyroidism
Sedondary : pituitary gland which does not secrete enough TSH due to being damaged from tumour, radiation or sugery. 5-10% of cases
Tertiary: hypothalamus fails to produce enough TRH. This accounts for less than 5% of cases.

Question 17

What are the features for hypothy?

Answer 17

Weight gain
Too cold
Tiredness
Constipation 
Thinking hair

Question 18

What do the tests for hypo show?

Answer 18

TSH elevated

Question 19

How do you manage hypothyroidism?

Answer 19

Avoid GA and opioid analgesics due to risk of myxodema coma
Risk of anaemia and IHD

Thyroxine tabs

Question 20

What is a goitre?

Answer 20

Non specific swelling of thyroid

Question 21

What are the causes of a goitre?

Answer 21

Autoimmune
Physiological 
Iodine def
Thyroiditis
Nodules

Question 22

What investigations would you do for a goitre?

Answer 22

Thyroid function test
Chest x ray
Uptake scan
FNAC

Question 23

What are the symptoms of a thyroid nodule?

Answer 23

Aesthetic
Pain
Pressure
Hormone dysfunction

Question 24

When would you do surgery ok a thyroid nodule?

Answer 24

Compression
More than 5cm
Retrosternal
Cancer risk
Cosmetic

Question 25

Thyroid nodules can be…

Answer 25

Solitary or part of a MNG

Question 26

What investigations care carried out in nodules?

Answer 26

Thyroid status and cytology

Question 27

What are the causes of solitary nodules?

Answer 27

Colloid
Cyst
Carcinoma
Adenoma
Lymphoma

Question 28

What are the sinsiste features of a nodule?

Answer 28

Rapid growth
Hoarse voice
Hx of previous radiation

Question 29

T/F the thyroid is covered in a sheath?

Answer 29

T

Internal and external layers

Question 30

What is the external layer of spthyroid sheath connected to?

Answer 30

Anteriorly with pretracheal fascia

Posteriorly with carotid sheath