Thyroid

Question 0

The sternocleidomastoid muscle is ___ to the thyroid

Answer 0

Anterior lateral

Question 1

The strap muscles of the neck are __ to the thyroid gland

Answer 1

Anterior

Question 2

The common carotid arteries and internal jugular veins are ___ to the thyroid.

Answer 2

Lateral

Question 3

The longus colli muscle is ___ to the thyroid

Answer 3

Posterior

Question 4

The minor neurovascular bundle is ___ to the thyroid

Answer 4

Posterior

Question 5

The normally located parathyroid glands are ___ to the thyroid

Answer 5

Posterior

Question 6

Arterial supply to the thyroid

Answer 6

Rt and lt superior thyroid arteries (branch of external carotid)

Rt and lt inferior thyroid arteries (branches of the thyrocervical arteries which come from subclavian artery)

Question 7

Venous drainage from thyroid

Answer 7

Drained into internal jugular vein by the superior and middle thyroid veins.

Drained into innominates by the inferior thyroid veins.

Question 8

Thyroglossal duct cyst

Answer 8

Congenital anomaly that appears as a superficial cyst in the midline of the neck anterior to the trachea and superior to the thyroid

(Thyroglossal duct normally obliterates in fetal life)

Question 9

The MC malignancy of the thyroid

Answer 9

Papillary carcinoma 75-90%, presents with enlg cervical nodes

Question 10

Chronic lymphocytic (Hashimoto’s) thyroiditis

Answer 10

Autoimmune disease. Painless diffuse enlg of thyroid, young women, mc cause of hypothyroidism, course echo texture. Hypoechoic gland.

Enlg gland cold intolerance, weak, fatigue, facial droop, dry scaly skin, weight gain, intellectual impairment, gradual personality change, course hair, constipation, dec sweating, hair loss

Hypo, norm or inc size, hetero, small Ca+, goiter

Question 11

Pyramidial lobe

Answer 11

Extends off isthmus 15-30%

Question 12

Thyroid

Answer 12

4-6 cm L
1.5-2 cm W
2-3 cm AP
Isthmus 2-6 mm

Question 13

Thyroid

Answer 13

Endocrine gland, controls growth, metabolism, development

Produces T3 triiodothyronine and T4 thyroxine
Produces calcitonin which aids parathyroid and dec Ca in blood.

Requires iodine

Regulated by: TSH & thyrotropin produced by pituitary & TRH from hypothalamus

Question 14

Euthyroid

Answer 14

Normal thyroid hormone levels

Question 15

Hypothyroidism

Answer 15

Under secretion of thyroid hormones

Myxedema, weigt gain, hair loss, subcutaneous tissue around eyes, lethargy, intellectual motor slowing, cold intolerance, constipation, deep husky voice, course hair, dec sweating,facial droops, dry skin

Question 16

Hyperthyroidism

Answer 16

Over secretion of thyroid hormones

Weight loss, inc appetite, nervous, energy tremor, excess sweating, heat intolerance, palpitations, exothalmus

Question 17

Thyroid US

Answer 17

Low mid level echoes, homogeneous, slightly hyperechoic to muscle

Question 18

Variants

Answer 18

Lingual (tongue base)
Sublingual
Suprahyoid
Substernal

Question 19

Multinodular goiter/ adenomatous hyperplasia / nodular hyperplasia

Answer 19

MC cause of thyroid enlargement
Females 50-70yrs

Normal labs, Asymptomatic, pain with hemorrhage

Question 20

Subacute Thyroiditis / De Quervain’s / Granulomatous Thyroiditis

Answer 20

Viral
May cause hyperthyroidism that subsides in weeks-months

Painful thyroid, fever, malaise

Enlg hypo goiter hetero

Question 21

Grave’s Disease / Diffuse Hyperthyroidism / Diffuse Toxic Goiter / Thyrotoxicosis

Answer 21

MC cause if hyperthyroidism
Females
Child bearing age

Enlg goiter, hyperthyroid, inc vascularity, multinodular

Heat intolerance, inc heart rate, tremors, wt loss, nervous, inc metabolism, exothalmus, acropachy, palp lymph nodes, myxedema

Question 22

Thyroid inferno

Answer 22

Increase vascularity

Question 23

Thyroid & pregnancy

Answer 23

Assoc with infertility and abnl menses

Question 24

Silent thyroiditis

Answer 24

3-6 months after birth. Hyper then hypothyroidism. | Hypo enlg

Question 25

Cyst

Answer 25

20% of solitary nodules Cold on nuc med Nodular cyst have Echogenic dot within

Question 26

Adenoma

Answer 26

MC benign neoplasm Young adults, females Neck mass, pain with pressure and hemorrhage Hot on Nuc med. or cold. Usually hot. Well defined, oval/round, any echogenicity, cystic degeneration, hypo halo

Question 27

Thyroid cancer

Answer 27

Rare Females, young adults, hx of radiation Slow growing Hard/fixed Asymptomatic, pressure if large, lump, vocal cord paralysis, solitary Cold on nuc med Most hypo, solid, solitary Cystic, complex, calcification, inc vasc flow, no halo, enlg adj lymph nodes

Question 28

Papillary Carcinoma

Answer 28

``` MC cancer Young adults Child bearing women Least aggressive Mets to nodes, lungs, bone, brain Best prognosis 6% mortality in 20 years ```

Question 29

Follicular Carcinoma

Answer 29

``` 2nd MC cancer 15% of thy ca Slow growing May look like a regular nodule Mets to nodes lung bones ```

Question 30

Medullary carcinoma

Answer 30

5% of thy ca Assoc with MEN'S syndrome Mets to lung nodes bones Ca+

Question 31

Anaplastic Cancer

Answer 31

``` 2% Most lethal Aggressive Males > 50yrs 90% with lymphadenopathy Mets common when dx ```

Question 32

Lymphoma

Answer 32

Usually Non-Hodgkin's Older females Assoc with Hashimoto's thyroiditis Poor prognosis

Question 33

Mets to thyroid

Answer 33

MC from breast ca | Also from bronchogenic, renal, melanoma, gastric cancer

Question 34

Parathyroid glands

Answer 34

4 glands Sup and inf Post / med < 4 mm Calcium metabolism and regulation

Question 35

Hypocalcemia

Answer 35

Dec calcium in blood ``` Numb Tingling lips, tongue, fingers, feet Dementia Depression Psychosis Muscle aches/spasms EKG changes Fatigue Irritability Anxiety ```

Question 36

Hypercalcemia

Answer 36

Inc calcium in blood Polyuria, nocturia, polydipsia, nephro/urolithiasis, osteitis, bone cyst, EKG changes, anorexia, Abd pain, ileus, n/v, arthritis

Question 37

Hypoparathyroidism

Answer 37

Usually due to underlying disease

Question 38

Hyperparathyroidism

Answer 38

Usually due to adenomas, hyperplasia, carcinoma Adenomas MC cause, usually solitary, homo, hypo, well defined

Question 39

Parathyroid hyperplasia

Answer 39

Uncommon cause of Hyperparathyroidism | Usually more than 1 gland involved.

Question 40

Parathyroid carcinoma

Answer 40

Rare cause of Hyperparathyroidism Indistinguishable from Adenoma and hyperplasia Shadowing High serum calcium

Question 41

Brachial Cleft Cyst / Lateral Cervical Cyst

Answer 41

Embryonic remnant | Cyst or complex mass below angle of mandible

Question 42

Lymphadenopathy

Answer 42

Due to infection or malignancy Single or multiple well circumscribed round/oval hypoechoic Malignant degenerative lymph nodes lose reniform shape and fatty hilum

Question 43

Reidel's thyroiditis

Answer 43

Chronic fibrosing disease. Thyroid displaces & compresses trachea & esophagus. Diffuse bilateral enlargement & hetero Women>men