Endocrine Surgery Flashcards

1
Q

RECAP- what do thyroid hormones get synthesised from?

A

Iodine

-> one of the only glands in the body that takes up iodine

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2
Q

What does iodine get coupled to to produce T3/4?

A

Tyrosine

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3
Q

If someone has a large goitre, what are they likely to be deficient in?

A

Iodine

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4
Q

List the effects of TH.

A

Increase is catabolism of carbs/lipids
Increase in protein synthesis
Increase in basal metabolic rate
Growth and maturation

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5
Q

What does the thyroid gland develop from embryologically?

A

Foramen cecum

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6
Q

Which part of the neck does the thyroid gland lie?

A

Anterior triangle of neck

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7
Q

What is the blood supply for the thyroid gland?

A

Superior thyroid artery
Inferior thyroid artery

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8
Q

What is the superior thyroid artery a branch of?

A

Carotid artery

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9
Q

What is the inferior carotid artery a branch of?

A

Thyroid cervical trunk

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10
Q

Damage to which nerve causes change in voice, vocal changes or loss?

A

Recurrent laryngeal nerve

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11
Q

Thyrotoxicosis?

A

Clinical syndrome of excess circulating TH, commonly sue to hyperthyroidism

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12
Q

What are some of the primary causes of hypothyroidism?

A

Autoimmune thyroiditis
Dietary insufficiency
Surgery
Radioiodine

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13
Q

What are some of the secondary causes of hypothyroidism?

A

Pituitary failure

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14
Q

Goitre?

A

Enlargement of thyroid gland

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15
Q

What is Pemberton’s sign used to evaluate?

A

Venous obstruction in patients with goitres

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16
Q

How can goitres affect airways?

A

Can cause compression of the airway

->classical sign of airway compression is stridor

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17
Q

What are the most common complications of a thyrodidectomy?

A

Damage to recurrent laryngeal nerve
Damaging parathyroid glands, in turn causing low calcium levels
Bleeding
Wound problems
Requiring long term thyroid supplements

18
Q

What are the four types of thyroid cancer?

A

Papillary
Follicular
Medullary
Anaplastic

19
Q

Where does medullary thyroid cancer arise from?

A

Calcitonin releasing C-cells

20
Q

Thyroid cancer has a good prognosis except for which type?

A

Anaplastic- very poor prognosis

21
Q

Where can thyroid cancer spread to?

A

Bone, lymph nodes and lungs

22
Q

How do we get a tissue diagnosis to determine the type of thyroid cancer?

A

Fine needle aspiration cytology (FNAC)

23
Q

What are some of the treatment options for thyroid cancer?

A

Surgery
Radioiodine

24
Q

What are the parathyroid glands developed from embrylogically?

A

Pharyngeal pouches

25
Q

What does the parathyroid hormone do?

A

Control homeostasis of calcium in the bloodstream, along with vitamin D

26
Q

RECAP- what are the classic symptoms of hypercalcaemia?

A

Stones, bones, moans and psychic groans

-kidney stones, bone pain, abdominal pain and constipation

27
Q

RECAP- if calcium levels are low, what should the PTH levels be like?

A

High

28
Q

What is a sesatmibi scan?

A

Sestamibi is a radio labelled isotope which is taken up by metabolically active tissue.
Helps to work out which parathyroid gland is the issue in parathyroid surgery

29
Q

What supplies blood to the adrenal glands?

A

Branches of the renal artery

30
Q

In post-menopausal women, where does the main source of testosterone and oestrogen come from?

A

Adrenal gland

31
Q

RECAP- what does excess cortisol cause?

A

Cushing’s syndrome

32
Q

RECAP- symptoms of Cushing’s.
Signs of Cushing’s.

A

Symptoms- weight gain, central obesity, moon face, easy bruising, thin skin, purple abdominal striae, infertility

Signs- hypertension, diabetes, impaired glucose tolerance, osteoporosis

33
Q

What is produced in excess in Conn’s syndrome?

A

Mineralocorticoids

34
Q

Random but

A

This lecture is a pretty good overview of everything learned so far if want one lecture for overview xx

35
Q

What does the adrenal medulla produce when stimulated by the sympathetic NS?

A

Adrenaline and noradrenaline

36
Q

Why are pheochromocytoma’s referred to as the 10% tumour?

A

10% of them arise outwith the adrenal gland
10% familial
10% malignant
10% multiple

37
Q

When diagnosing pheochromocytoma’s, what is measured?

A

Metabolites known as metanephrines in the urine

->not adrenaline measured as levels fluctuate so quickly in the bloodstream

38
Q

What do neuroendocrine tumours secrete?

A

Serotonin and chromogranin

39
Q

MEN (multiple endocrine neoplasia)?

A

A group of familial symptom syndromes where patients have multiple endocrine tumours of the pituitary, parathyroid, thyroid, adrenal and the pancreas

40
Q

What is MEN1?

A

Tumours of the parathyroid glands which are often accompanied with tumours of the anterior pituitary and endocrine pancreas

41
Q

What is MEN2?

A

Medullary thyroid cancer often accompanied with pheochromocytoma and parathyroid tumour

42
Q
A