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2MB Endocrinology > Thyroid Disease > Flashcards

Thyroid Disease Flashcards

1
Q

What are the 2 most common types of thyroid cancer?

A

Papillary

Follicular

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2
Q

Thyroid cancer is more common in males. True/False?

A

False

Females

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3
Q

What aetiology has a strong association with thyroid cancer?

A

Radiation exposure

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4
Q

What is the main presenting complaint of thyroid cancer?

A

Palpable nodule in the neck

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5
Q

Follicular thyroid cancer is more common than papillary variant. True/False?

A

False

Papillary is most common

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6
Q

How does papillary thyroid cancer tend to spread?

A

Lymphatics

Also haematogenous

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7
Q

The incidence of follicular thyroid cancer are higher in people deficient of which chemical?

A

Iodine

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8
Q

Lymphatic spread of follicular thyroid cancer is rare. True/False?

A

True

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9
Q

What is the main investigation for thyroid cancer?

A

Ultrasound-guided fine needle aspiration

Can do lymph node biopsy if spread

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10
Q

If the thyroid cancer lesion is greater than _cm, there is clinical prediction of malignancy

A

4cm

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11
Q

What are the main surgical techniques for thyroid cancer?

A

Lobectomy (uncommon)
Sub-total thyroidectomy
Total thyroidectomy

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12
Q

A 36 yr old man with thyroid cancer with no metastases is AMES high risk. True/False?

A

False

Low risk

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13
Q

All patients with metastases of thyroid cancer are AMES high risk. True/False?

A

True

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14
Q

What type of thyroid tumours may be treated by lobectomy?

A

Papillary micro-carcinoma
Minimally invasive follicular carcinoma
AMES low risk

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15
Q

Calcium is checked post-op for thyroid cancer. At what level of calcium is replacement initiated?

A

Less than 2 mmol/L

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16
Q

Why is iodine body scanning done for post-op thyroid cancer?

A

To detect residual cancer cells

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17
Q

How long before an iodine scan must T3 and T4 be stopped?

A

Stop T4 4 weeks prior

Stop T3 2 weeks prior

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18
Q

TSH must be elevated for an iodine scan. True/False?

A

True

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19
Q

What non-surgical technique can be used for thyroid cancer destruction following surgery?

A

Thyroid remnant ablation

20
Q

Thyroid swellings move on swallowing. True/False?

A

True

21
Q

Thyroglossal swellings move with the tongue. True/False?

A

True

22
Q

Autoimmune thyroid disease is the commonest cause of hypo/hyper -thyroidism. True/False?

A

True

23
Q

In hyperthyroidism, TSH levels are high. True/False?

A

False

TSH is low in hyperthyroidism, and high in hypothyroidism

24
Q

Why is TSH low in hyperthyroidism?

A

Hyperthyroidism causes excess T4, so pituitary produces less TSH in order to try and compensate

25
Q

In the context of pituitary gland failure, would TSH levels be high or low in hypothyroidism?

A

Low

pituitary can’t compensate

26
Q

What is myxoedema?

A

Severe hypothyroidism

N.B. pretibial myxoedema is seen in Grave’s disease due to thyrotoxicosis

27
Q

Incidence of hypothyroidism is higher in people with high/low iodine

A

Low iodine is assoc. with hypothyroidism

28
Q

What is the main goitrous cause of hypothyroidism?

A

Hashimoto’s thyroiditis (chronic/autoimmune thyroiditis)

29
Q

List some drug-induced causes of hypothyroidism

A

Amiodarone
Aminosalicyclic acid
Lithium
Iodides

30
Q

What are the 2 main origins of secondary hypo/hyper -thyroidism?

A

Hypothalamus disease

Pituitary disease

31
Q

What happens in Hashimoto’s thyroiditis?

A

Autoimmune destruction of thyroid gland, causing reduced thyroid hormone production

32
Q

Which antibody is very specific for Hashimoto’s thyroiditis?

A

Thyroid peroxidase antibodies (anti-TPO)

33
Q

List some clinical features of hypothyroidism

A 
Sparse hair
Dry skin, puffiness
Cold intolerance
Tiredness
Vitiligo
Constipation
Reduced heart rate
Weight gain
34
Q

Outline treatment of hypothyroidism

A

Restore metabolic rate

Thyroxine (T4) 50-100 micrograms

35
Q

TSH is useful to mark therapeutic success in secondary hypo/hyper -thyroidism. True/False?

A

False

It will be low because problem is with pituitary

36
Q

Who does myxoedema coma predominately affect?

A

Elderly women with longstanding untreated hypothyroidism

37
Q

What is the main autoimmune cause of hyperthyroidism?

A

Grave’s disease

38
Q

List clinical features of hyperthyroidism

A 
Agitation/irritability/anxiety
Palpitations
Heat intolerance/sweating
Tremor
Loose bowels
Exopthalmus, lid lag, proptosis (eye buldging)
Weight loss
39
Q

What causes Grave’s disease?

A

Unknown mix of genetics + environment

Autoimmune destruction

40
Q

Which antibodies are fairly specific for Grave’s disease?

A

Anti-TPO antibody

Anti-TSH-receptor antibody

41
Q

What is the characteristic view of Grave’s disease on scintigraphy?

A

Symmetrical, smooth goitre

Looks like a butterfly

42
Q

What drugs are given for hyperthyroidism?

A

Carbimazole
Propylthiouracil in pregnancy
B-blocker if arrhythmic

43
Q

Medullary thyroid carcinomas are derived from which cells?

A

C cells

44
Q

If the thyroid fails to descend from it embryological origin what is this called?

A

Linguinal thyroid

45
Q

If the thyroid undergoes excessive descent where is it most likely to be located?

A

Retrosternal within the mediastinum

46
Q

What can precede hashimotos thyroiditis?

A

Hyperfunction - Hashitoxicosis

2MB Endocrinology (21 decks)

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