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2nd year > thyroid, parathyroid and adrenal glands > Flashcards

thyroid, parathyroid and adrenal glands Flashcards

1
Q

benign thyroid enlargement

A

growth of the gland
compression of trachea and oesophagus
stridor and dysphagia
carotid artery can be posteriorly displaced

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2
Q

malignant thyroid enlargement

A

erosion into oesophagus/trachea/carotid sheath
can cause severe haemorrhage
involvement of sympathetic chain = causes horner’s syndrome
invasion of recurrent laryngeal nerve causing hoarseness

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3
Q

what are the types of thyroid cancer?

A 
papillary
follicular
medullary 
anaplastic
lymphoma
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4
Q

papillary thyroid cancer

A

young people
local spread
good prognosis

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5
Q

follicular thyroid cancer

A

middle age
lung/bone spread
usually good prognosis

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6
Q

medullary thyroid cancer

A

familial link
local spread and metastases
poor prognosis

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7
Q

anaplastic thyroid cancer

A

aggressive cancer
local spread
very poor prognosis

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8
Q

lymphoma of thyroid

A

variable

usually poor prognosis

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9
Q

red flag symptoms for thyroid

A 
rapid growth 
cough 
hoarse voice
stridor 
multiple enlarged cervical lymph nodes 
tethering of lump to surrounding structures
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10
Q

treatments for thyroid cancer

A

thyroidectomy
radioiodine therapy
external beam radiotherapy
chemotherapy

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11
Q

radioiodine therapy

A

cannot be given to children and those that work/live with children need to stay away as they are radioactive

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12
Q

chemotherapy for thyroid cancer

A

for lymphoma only

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13
Q

thyroid conditions

A 
hyperthyroidism
hypothyroidism 
graves disease 
hashimoto thyroiditis 
goitre
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14
Q

graves disease

A

exopthalmus due to antibodies attacking thyroid also attack eyes

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15
Q

goitre

A

non-neoplastic non-inflammatory enlargement

can be due to iodine deficiency

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16
Q

thyroidectomy

A

transverse/horizontal incision 2 fingers breadths above suprasternal notch
longitudinal incision once in the fascia
dividing fascia makes structures more mobile

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17
Q

risks of thyroid surgery

A 
hypothyroidism
hypocalcaemia 
airway obstruction 
recurrent laryngeal nerve injury 
general surgical risks
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18
Q

risks of thyroid surgery: hypothyroidism

A

no/underactive thyroid tissue
symptoms typical of hypothyroidism
treat with daily levothyroxine

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19
Q

risks of thyroid surgery: hypocalcaemia

A

due to trauma/devascularisation or accidental excision of parathyroid glands

20
Q

presentation of hypocalcaemia

A 
acute = laryngeal stridor and airway obstruction
subacute = tingling lips/fingertips, carpopedal spasm, tetany, laryngospasm, seizures, QT prolongation and cardiac arrest
21
Q

treatment of hypocalcaemia

A

1g of calcium gluconate slowly

22
Q

risks of thyroid surgery: airway obstruction

A

caused by compressing hematoma or tracheomalacia
need to reopen to evacuate hematoma
re-intubation
consider awake fiberoptic intubation

23
Q

risks of thyroid surgery: recurrent laryngeal nerve injury

A

damage to nerve during excision
causes hoarseness
aphonia, stridor and airway obstruction

24
Q

what are the general surgical risks?

A

wound infection
seroma
scarring

25
Q

what is tracheolmalacia?

A

floppy trachea

26
Q

what are the types of hyperparathyroidism?

A

primary
secondary
tertiary

27
Q

primary hyperparathyroidism causes

A

parathyroid gland adenoma
hyperplasia
carcinoma

28
Q

blood tests for hyperparathyroidism

A

increased/normal PTH
increased Ca2+
decreased phosphate

29
Q

secondary hyperparathyroidism causes

A

hypertrophy of glands in response to prolonged hypocalcaemia
CKD
vitamin D deficiency

30
Q

secondary hyperparathyroidism blood tests

A

raised PTH
decreased calcium
increased phosphate

31
Q

tertiary hyperparathyroidism causes

A

parathyroid hyperplasia after longstanding secondary hyperparathyroidism in renal disease

32
Q

blood tests in tertiary hyperparathyroidism

A

increased PTH
increased calcium - maybe normal
normal or low phosphate

33
Q

what does PTH do?

A

causes bones to release calcium

kidneys reduce calcium clearance and cause vitamin D activation which increases absorption of calcium in gut

34
Q

where are the parathyroid glands?

A

4 - 2 superior and 2 inferior on each side of the thyroid gland

35
Q

what are the risks of parathyroid surgery?

A 
hypocalcemia
bleeding in neck
recurrent laryngeal nerve injury 
wound infection 
seroma
36
Q

bleeding in neck

A

can push on trachea causing difficulty breathing
patients should be wary of difficulty breathing, high squeaky voice, neck swelling and feeling something bad is happening

37
Q

treatment for wound infection

A

antibiotics
incision
drainage

38
Q

what is a a seroma ?

A

fluid collections underneath skin at an incision site - feels like a fullness or swelling

39
Q

symptoms and treatment of seroma

A

can usually disappear within few weeks if minor

if large needs surgical drainage

40
Q

what are the areas of the adrenal gland?

A

zona glomerulosa
zona fasiculata
zona reticularis
adrenal medulla

41
Q

zona glomerulosa

A

mineralocorticoids - aldosterone production

42
Q

zona fasciculata

A

produce glucocorticoids - cortisol

43
Q

zona reticularis

A

androgen production - dehydroepiandrosterone/DHEA

44
Q

adrenal medulla

A

produce stress hormones - adrenaline/noradrenaline

45
Q

what is a pheochromocytoma

A

high adrenaline/noradrenaline

46
Q

what is congenital adrenal hyperplasia?

A

21-hydroxylase deficiency

47
Q

what are the signs and symptoms of adrenal tumours?

A
  • high BP
  • low potassium
  • heart palpitations
  • nervousness
  • feelings of anxiety or panic attacks
  • headaches
  • excessive sweating
  • diabetes
  • abdominal pain
  • unexplained weight gain or loss
  • weakness
  • abdominal stretch marks
  • excessive hair growth
  • changes in genitalia
  • unusual acne
  • change in libido

2nd year (48 decks)

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