Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y2 ENDOCRINOLOGY > Thyroid Disease > Flashcards

Thyroid Disease Flashcards

1
Q

What are the 2 most common types of thyroid cancer?

A

Papillary

Follicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

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

A

False

Females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What aetiology has a strong association with thyroid cancer?

A

Radiation exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the main presenting complaint of thyroid cancer?

A

Palpable nodule in the neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

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

A

False

Papillary is most common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do papillary and follicular thyroid cancer tend to spread respectively?

A

Lymphatics (also haematogenous)

Haematogenous (also lymphatic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

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

A

Iodine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

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

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the main investigation for thyroid cancer?

A

TSH levels
Ultrasound-guided fine needle aspiration
Can do lymph node biopsy if spread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

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

A

4cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the main surgical techniques for thyroid cancer?

A

Lobectomy + isthmusectomy (uncommon)
Sub-total thyroidectomy
Total thyroidectomy (U3 or greater)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

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

A

False

Low risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

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

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What type of thyroid tumours may be treated by lobectomy?

A

Papillary micro-carcinoma
Minimally invasive follicular carcinoma
AMES low risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

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

A

Less than 2 mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

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

A

To detect residual cancer cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

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

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

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

A

Thyroid remnant ablation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Thyroid swellings move on swallowing. True/False?

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Thyroglossal swellings move with the tongue. True/False?

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

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

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

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

A

False

TSH is low in hyperthyroidism, and high in hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Why is TSH low in hyperthyroidism?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

In the context of pituitary gland failure (secondary thyroid problem), would TSH levels be high or low in hypothyroidism?

A

Low

pituitary can’t compensate

26
Q

What is myxoedema?

A

Severe hypothyroidism causing puffy face, hands, feet

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 
HAIR AND SKIN: Sparse hair, dry skin, vitiligo, puffiness
THERMOGENESIS: Cold intolerance
CNS: Tiredness, muscle stiffness
GI: Constipation
CARDIO: Reduced heart rate
METABOLIC: Weight gain
RESP: Hoarse voice/ sleep apnoea
REPRO: oligo/amenorrhea
34
Q

Outline treatment of hypothyroidism

A

Restore metabolic rate gradually

Levothyroxine (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 
CNS: Agitation/irritability/anxiety, poor sleep
CARDIO: Palpitations, AF
THERMOGENESIS: Heat intolerance
SYMPATHETIC: Sweating, tremo
GI: Loose bowels
VISION: Exopthalmus, lid lag, proptosis
METABOLIC: Weight loss, increased appetite
HAIR/ SKIN: brittle, thin hair
REPRO: oligo/amenorrhea
39
Q

What causes Grave’s disease?

A

Unknown mix of genetics + environment

Autoimmune antibodies bind to TSH receptor causing overactivity, like TSH but goes unchecked by T3+T4

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 for rapid symptom control

43
Q

Medullary thyroid carcinomas are derived from which cells?

A

C cells

44
Q

What does ‘AMES’ stand for?

A

Age
Mets
Extent of primary tumour
Size of primary tumour

45
Q

List the four classifications of malignant thyroid nodule

A

Papillary
Follicular
Medullary
Anaplastic

46
Q

List the common causes of benign thyroid nodules

A

Cyst
Colloid nodule
Benign follicular
Adenoma

47
Q

How do you check a neck mass is in the thyroid and not the lymph node?

A

Thyroid masses move on swallowing

48
Q

A painful thyroid nodule is typically an…

A

Intrathyroidal cyst

49
Q

A rapid onset mass occurring on the neck is typically a…

A

Lymphoma

50
Q

Medullary thyroid cancer is associated with which genetic diseases?

A

MEN 2a/2b

51
Q

What is the management for suspected MEN 2a/2b?

A

Prophylactic thyroidectomy

52
Q

What is a complication of restoring metabolic rate too quickly in hypothyroidism?

A

Arrhythmia

53
Q

List the clinical features of Grave’s Disease

A

Eye disease - exopthalmus, proptosis
Pretibial myxodema - ‘orange peel’ legs
Thyroid acropachy - clubbing, finger and toe swelling, bone reaction

54
Q

Graves disease typically occurs in what group of people?

A

Younger female (20-50yo)

55
Q

What is ‘thyroid storm’?

A

Severe hyperthyroidism, occuring in acute infection and recent thyroid surgery

56
Q

Which B blocker is commonly used in hyperthyroidism?

A

Propranolol

57
Q

What are the treatment options for persisting hyperactive hyperthyroidism?

A

Radioiodine to suppress secretion of excess harmone

Subtotal thyroidectomy

58
Q

What are the clinical features of agranulocytosis? What is the management?

A

Dry cough, sore throat in a person on anti-thyroidal medications
Stop ATDs

59
Q

What are the clinical features of De Quervian’s thyroiditis?

A

Signs of viral infection
Painful neck
Fever

60
Q

Otline the mechanism behind exophthalmus

A

Bulging eyes due to water retaining carbohydrates which build up behind the eyes

Y2 ENDOCRINOLOGY (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions