Thyroid

Question 1

How to diff ECA & ICA in the neck?

Answer 1

ICA doesn’t give branches in the neck

Question 2

Inf thyroid artery is a branch of

Answer 2

Thyrocervical trunk, which is a branch of the subclavian artery

Question 3

Thyroid ima artery is a branch of

Answer 3

Arch of aorta (direct branch)
Seen in 3% population

Question 4

Which artery supplies parathyroid glands?

Answer 4

Inf thyroid artery

Question 5

Venous drainage of thyroid

Answer 5

Superior thyroid vein drains into IJV
Middle thyroid vein if present (30% individuals) drains into IJV
Inferior thyroid vein - brachio cephalic vein

Question 6

First vessel to be ligated in thyroidectomy

Answer 6

Middle thyroid vein

Question 7

External laryngeal nerve injury

Answer 7

Tensing of vocal cord affected. High pitch not possible

Question 8

Why is it called the recurrent laryngeal nerve?

Answer 8

Because it winds over the vessels and appear again
Left side- around AoA
Right- around subclavian artery

Question 9

Dvlpt of thyroid gland

Answer 9

From a median down growth as a column of cells from phary floor- b/w 1st & 2nd phary pouches.

The canalised colum bcms thyroglossal duct- displaced forward by developing hyoid.
Duct divides to form lobes

Parafollicular C cells from neural crest through ultimobranchial body

Question 10

Vert extent of thyroid gland

Answer 10

C5-T1

Question 11

Lateral lobes of thyroid covered by

Answer 11

SH, ST, SBoO, SCM

Question 12

Pyramidal lobe

Answer 12

In 30% indiv
From the junction of isthmus and lateral lobe
Conn to hyoid by levator glandulae thyroidiae

Question 13

Surgical avascular plane of thyroid

Answer 13

B/w true and false capsule

Question 14

Lateral relation of thyroid

Answer 14

Carotid sheath
Ansa cerv
Symp chain

Question 15

Posterior relation of thyroid

Answer 15

PTH gland
Tubercle of zuckerkandl

Question 16

Beahrs / Riddles triangle

Answer 16

CCA, ITA, RLN

Question 17

Joll’s triangle

Answer 17

Lat- sup thyroid vessels and sup pole of thyroid
Med- midline
Above- straps
Below(floor)- cricothyroid

Question 18

Congenital anomalies

Answer 18

Thyroid dysgenesis- agenesis, hemiagenesis
Ectopic thyroid (MC anomaly)
Lingual thyroid
TG cyst, fistula
Lateral aberrant thyroid
Dyshormonogenesis

Question 19

Ectopic sites of thyroid

Answer 19

Lingual, intra lingual, sublingual
TG cyst
Retro sternal goitre

Question 20

Mc carcinoma in lingual thyroid

Answer 20

Follicular carcinoma

Question 21

Dd for lingual thyroid

Answer 21

Lingual tonsil hypertrophy
Ca post 1/3rd of tongue
Lipoma, angifibroma, hemangioma

Question 22

Lingual thyroid Rx

Answer 22

Inv- Tc99 pertechnate study
MRI
USG neck
TFT

Rx- thyroxine, excision, Radioisotope therapy

Question 23

TG Cyst

Answer 23

Swelling in neck along the line of TG tract
D/t failure of TG duct to obliterate completely
Has resp epithelium

Question 24

C/F of TG cyst

Answer 24

Midline swelling twds left
Mvmnt with deglu + tongue protrusion
Tugging sensation when protruded while holding
Smooth, soft, fluctuant, non tender, mobile transilluminant

Question 25

Chance of mx in TG cyst

Answer 25

1%

Question 26

Rx of TG CYST

Answer 26

Sistrunk- cyst + tract + central part of body of hyoid More aggressive- koempels suprahyoid technique

Question 27

Hood sign seen in

Answer 27

TG fistula

Question 28

Lateral aberrant thyroid

Answer 28

a mass of tissue having the structure of a normal or pathological thyroid gland, but situated at some definite distance from the normal thyroid, with which it has no connection, or more strictly, lateral to the jugular vein.

Question 29

Pendred syndrome

Answer 29

Hypothyroid + SNHL

Question 30

Accuracy of FNAC

Answer 30

95%

Question 31

FNAC thyroid procedure

Answer 31

6 aspirations with 6 groups of cells. One group- 20 cells. Better if US guided Grading - thy1,2,3,4,5

Question 32

Diffuse hyperplastic goitre

Answer 32

Cause- TSH stimulation Rx- L thyroxine

Question 33

Compli of MNG

Answer 33

2 F HC T Cosm

Question 34

Use of USG in thyroid nodules

Answer 34

Shows: Size Echogenicity Number Solid/ cystic Signi LN Vascularity

Question 35

ACR TIRADS

Answer 35

American college of radiology Thyroid imaging reporting and data system

Question 36

Tirads

Answer 36

1- N 2- Bn 3- probably bn 4- sus 5- mx

Question 37

Quadruple assessment in thyroid

Answer 37

Clinical Imaging Cytology Functional- t3,t4,tsh

Question 38

Define retro sternal goitre

Answer 38

Goitre having >50% below suprasternal notch

Question 39

D/d of retro sternal goitre

Answer 39

Mediastinal tumors

Question 40

Inv of RSG

Answer 40

CXR CT chest and neck TFT Radioiodine study PFTs