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Endocrine > Thyroid > Flashcards

Thyroid Flashcards

1
Q

T3 or T4 more active?

A

T3 (3-8x more potent)

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2
Q

T3 or T4 longer half life?

A

T3 more active, T4 longer half life

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3
Q

What are the components of a complete thyroid assessment?

A
  1. Serum thyroid hormones (TSH, T3, T4)
  2. Antibodies
  3. Thyroglobulin
  4. Thyroid imaging/scans
  5. Biopsy (FNA)
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4
Q

What are the indications for free T3/T4 testing?

A
  • Secondary or tertiary hyper/hypothyroidism suspected

- Normal TSH levels despite symptoms of hyper/hypo

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5
Q

What increases TBG?

A

Pregnancy, OCP, acute infectious hepatitis, biliary cirrhosis

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6
Q

What decreases TBG?

A

Androgens, glucocorticoids, cirrhosis, hyponatremia, phenytoin, ASA, NSAIDs, nephrotic syndrome.

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7
Q

Which Abs raised in Hashimoto’s?

A

TgAb
Thyroid peroxidase Abs
TSH receptor inhibiting antibodies

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8
Q

Which Abs raised in Grave’s disease?

A

Thyroid stimulating immunoglobulin (TSI)

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9
Q

What is the the use of plasma thyroglobulin?

A

Monitor residual thyroid activity post-thyroidectomy (e.g. for thyroid cancer recurrence - normal/elevated levels suggest persistent, recurrent or metastatic disease)

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10
Q

Normal thyroid size?

A

15-20g

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11
Q

What is the purpose of thyroid ultrasound?

A

Measure size of gland, solid v cystic nodule, facilitate FNA biopsy

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12
Q

What is the purpose of radioisotope thyroid scan?

A

With Technetium-99. Test of STRUCTURE.

  • order if nodule and pt is hyperthyroid with low TSH
  • Differentiates hot (0% chance malignancy) v cold nodules (5% chance malignancy)
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13
Q

What is radioactive iodine uptake scan?

A

Test of FUNCTION.

  • Order if pt is hyperthyroid
  • RAIU measures turnover of iodine by thyroid gland in vivo
  • Increased uptake = hyperthyroid
  • Decreased uptake = gland leaking (thyroiditis); exogenous thyroid hormone intake
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14
Q

Indications for thyroidectomy?

A
  • Malignancy
  • Symptomatic goitre
  • Medically refractory hyperthyroidism (i.e. Graves)
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15
Q

Thyroidectomy contraindications?

A
  • Uncontrolled Graves (concerns re thyroid storm)

- Pregnancy (postpone surgery IF possible: ind in aggressive ca or airway compromise)

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16
Q

Thyroid embyrology?

A

Develops from D24.
Arises from endodermal epithelial cells on median surface of pharyngeal floor (foramen caecum).
Descends W7 anterior to hyoid / cricoid to rest anterior to trachea.

17
Q

What is the pyramidal lobe of the thyroid?

A

Descent of thyroid marked by thyroglossal duct (tubular structure of thyroid tissue). Usually obliterates W7-10. Persistence of inferior aspect = thyroglossal duct.

18
Q

Components of thyroid gland?

A

2 lateral lobes and central isthmus (+/- pyramidal lobe).

19
Q

Which layer is the thyroid located in?

A

Middle layer of deep cervical fascia

20
Q

What does the middle layer of the deep cervical fascia envelop?

A
  • Strap muscles (sternohyoid, sternothyroid, thyrohyoid, and omohyoid muscles).
  • Pharynx, larynx, trachea, esophagus, thyroid, parathyroids, buccinators, and constrictor muscles of the pharynx.
21
Q

What attaches the thyroid to the thyroid and cricoid cartilages?

A

Anterior suspensory ligament

22
Q

What is Berry’s ligament?

A

Posterior suspensory ligament. Attaches thyroid first and second tracheal ring, and the cricoid cartilage.

23
Q

What covers the thyroid anteriorly?

A

Sternohyoid and sternothyroid muscles.

24
Q

Arterial supply to thyroid?

A
  • Superior thyroid artery (off external carotid artery)

- Inferior thyroid artery (off thyrocervical trunk)

25
Q

Venous drainage of thyroid?

A

Superior / middle / inferior thyroid veins.

Join internal jugular or innominate veins.

26
Q

Which lymph nodes drain the thyroid?

A

Prelaryngeal, pretracheal, paratracheal and supraclavicular nodes.

27
Q

Possible locations for parathyroid glands?

A

Anterior or posterior mediastinum, carotid bifurcation, retro-oesophageal, retropharyngeal or retrolaryngeal regions.

28
Q

Vascular supply to parathyroids?

A

Inferior thyroid artery

29
Q

Complications of thyroidectomy?

A
  • Hypocalcemia 2” to hypoparathyroidism
  • Injury to recurrent laryngeal nerve / superior laryngeal nerve
  • Neck haematoma
  • Infection
  • Thyroid storm
30
Q

Vertebral location of thyroid?

A

C5 - T1

Endocrine (21 decks)

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