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Endocrine > Thyroid Pathology > Flashcards

Thyroid Pathology Flashcards

1
Q

What vertebral level is the thyroid gland at?

A

C6-T1

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2
Q

What lobe may or may not be present due to anatomical variation?

A

Pyramidal lobe

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3
Q

What is the blood supply to the thyroid gland?

A

Superior and inferior thyroid arteries:
Superior = from external carotid
Inferior = from right subclavian

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4
Q

What is the venous drainage of the thyroid gland?

A

Superior, middle and inferior thyroid veins:
Superior and middle = into internal jugular (then brachiocephalic)
Inferior = directly into brachiocephalic

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5
Q

What hormones are secreted by the thyroid gland?

A

T3/4/Thyroxine (from follicular cells),

Calcitonin (from parafollicular cells)

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6
Q

What substance is added to convert T3 - T4?

A

Iodine

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7
Q

What is the role of thyroid hormones?

A

Increase metabolic rate, increase thermogenesis, required for growth and development

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8
Q

How is most thyroxine transported in the blood?

A

Bound to thyroxine binding globulin

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9
Q

What is the most biologically active form of thyroxine?

A

T3 (de-iodinated at cells by enzymes from T4-T3)

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10
Q

What is the system of release of thyroxine (negative feedback)?

A

TRH (hypothalamus) -
TSH (pituitary) -
T3/4 (thyroid)

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11
Q

What is the autoimmune cause of hypothyroidism?

A

Hashimotos

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12
Q

What are the results of investigation of primary hypothyroidism?

A

Low fT3/4, high TSH (due to failure at thyroid gland)

Hashimoto’s: anti TPO antibodies

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13
Q

What are the investigation results of secondary hypothyroidism?

A

Low fT3/4, low TSH (failure at pituitary or hypothalamus)

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14
Q

What is goitrous hypothyroid due to?

A

Hashimoto’s thyroiditis (chronic)

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15
Q

What is the cause of non-goitrous thyroiditis?

A

Atrophic

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16
Q

How does hypothyroidism present?

A

Coarse sparse hair, more common in women, puffy eyes, cold intolerance, overweight, bradycardia, constipation

17
Q

How is hypothyroidism treated?

A

Levothyroxine

18
Q

What is a myxoedema coma?

A

Severe consequence of untreated hypothyroidism - medical emergency requiring intensive care

19
Q

What is the autoimmune cause of hyperthyroidism?

A

Graves disease

20
Q

What are the main causes of hyperthyroidism?

A

Autoimmune, toxic solitary nodule, toxic multi nodular goitre

21
Q

How does hyperthyroidism present?

A

Weight loss, heat intolerance, palpitations/AF, anxiety/nervousness, diarrhoea, muscle weakness, tremor/sweating

22
Q

What are the clinical signs of Graves disease?

A

Women, young, eye disease, pretibial myxoedema, thyroid bruits

23
Q

How is hyperthyroid diagnosed?

A

Raised fT3/4, decreased TSH

Graves: anti-TPO antibodies

24
Q

How is a nodular thyroid disease diagnosed?

A

High uptake or irregular scintigraphy (thyroid uptake) scan

25
Q

What is the first and second line treatment of hyperthyroidism?

A

Carbimazole

Propylthiouracil (PTU)

26
Q

What risk is associated with hyperthyroid treatment and how is this managed?

A

Agranulocytosis

If have severe sore throat and fever immediately stop medication and do FBC

27
Q

What are the types of differentiated thyroid cancer?

A

Papillary (most common) and follicular

28
Q

What is the prognosis of thyroid cancer?

A

Very good

29
Q

How does thyroid cancer present?

A

Asymptomatic, more common in women, palpable nodules

30
Q

How is thyroid cancer diagnosed?

A

Ultrasound guided FNA (fine needle aspiration)

NO thyroid isotope scan/CT/MRI

31
Q

How is a thyroglossal cyst identified and managed?

A

Moves with the tongue when you stick it out, usually benign so just reassure

32
Q

What is a thyroid storm?

A

Inadequately treated thyrotoxicosis - medical emergency

Endocrine (8 decks)

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