The neck Flashcards by Lara Rydlewicz

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Q

What is a thyroglossal cyst?

A

Dilatation of thyroglossal duct remnant
May become infected
Midline; grows with age
Moves on tongue protrusion
Need ultrasound scan prior to removal to ensure functioning thyroid tissue elsewhere
Excised but chance of recurrence

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Q

What could a solitary thyroid nodule be?

A

Cyst: due to localised haemorrhage
Adenoma: benign follicular tissue
Carcinoma
Lymphoma
Prominent nodule in multinodular goitre

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Q

How do you investigate a solitary thyroid nodule?

A

Investigate by fine-needle aspiration cytology (FNAC) AND ultrasound scanning
FNAC CANNOT distinguish between a follicular adenoma AND a follicular carcinoma
Therefore tissue required for histological diagnosis
THYROID LOBECTOMY

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Q

What could a diffuse thyroid enlargement be?

A

Colloid goitre: due to gland hyperplasia, iodine deficiency puberty, pregnancy, lactation
Grave’s disease
Thyroiditis

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Q

What are the indications of a thyroidectomy?

A

Airway obstruction
Malignancy or suspected malignancy
Thyrotoxicosis
Cosmesis
Retrosternal extension

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Q

What are the complications of a thyroidectomy?

A

Bleeding-primary or secondary
Voice hoarseness
Thyroid storm (release of hormones)
Infection
Hypoparathyroidism
Hypothyroidism
Scar (keloid/ hypertrophic)

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Q

What can parathyroid disease cause?

A

Renal calculi, polyuria, renal failure
Pathological fractures, osteoporosis, bone pain
Abdominal pain, constipation, peptic ulceration, pancreatitis, weight loss
Anxiety & depression, confusion, paranoia

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Q

What tests do you do for parathyroid disease?

A

Urea & electrolytes, creatinine, calcium, phosphate
Parathyroid hormone, bicarbonate
Vitamin D
Ultrasound scan
CT/MRI: identify ectopic glands
Isotope scanning: detect diseased glands

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Q

What is the treatment of hyperparathyroidism?

A

Surgery only

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