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Endocrine > Thyroid > Flashcards

Flashcards in Thyroid Deck (20)
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1
Q

Referral pathway with unexplained thyroid lump?

A

Urgent referral (<2 weeks) for patients of any age

2
Q

Primary tumours of the thyroid? (5)

A
Papillary (commonest)
Follicular
Lymphoma
Anaplastic
Medullary
3
Q

Thyroid lymphoma is associated with which other thyroid condition?

A

Hashimoto’s thyroiditis

4
Q

Thyroid cancer with worst prognosis?

A

Anaplastic

5
Q

Thyroid cancer associated with familial incidence + adenomas elsewhere?

A

Medullary

6
Q

Commonest thyroid malignancy and age range commonly affected?

A

Papillary; around 10-40, commoner in female

7
Q

Benign thyroid lesions? (3)

A

Thyroid cyst
Thyroid adenoma
Discrete nodule within a nodular goitre

8
Q

Five main types of goitre?

A
Congenital
Physiological
Nodular
Toxic
Inflammatory
9
Q

When might a physiological goitre arise? (3)

A

Puberty
Pregnancy
Iodine deficiency

10
Q

Cause of toxic goitre?

A

Grave’s disease

11
Q

Causes of inflammatory goitres (thyroiditis)?

A

Hashimoto’s
de Quervain’s
Riedel’s

12
Q

Acutely swollen, tender thyroid with transient thyrotoxicosis

A

de Quervain’s

13
Q

Thyroid becomes infiltrates with scar tissue +/- hypothyroidism +/- RLN palsy +/- stridor

A

Riedel’s thyroiditis

14
Q

Starting dose and monitoring of levothyrooxine?

a) <65 and healthy
b) >65 or pre-existing cardiac disease

A

a) 50-100 mcg, re-check after 4 weeks and adjust to keep TSH in normal range
b) 25mcg and increase every 4-6 weeks as per TFTs

15
Q

Management of hyperthyroidism while awaiting specialist review?

A

Carbimazole/propylthiouracil

Propranolol may be helpful for symptom control

16
Q

First-line specialist treatment of hyperthyroidism caused by Grave’s or toxic nodular goitre?

A

Radioactive iodine

17
Q

Adverse effects of carbimazole? (5)

A
Agranulocytosis
Hepatitis
Aplastic anaemia
Lupus-like syndromes 
Pancreatitis
18
Q

How long does it take for the effects of radioactive iodine to become apparent?

A

3-4 months

19
Q

Management of thyrotoxicosis in pregnancy?

A

Propylthiouracil in 1st trimester, switching back to carbimazole in 2nd trimester. Aim to keep free T4 in upper third of normal range

20
Q

Management of hypothyroidism in pregnancy?

A

Increase dose of thyroxine often needed as early as 4-6 weeks