Thyroid Flashcards

0
Q

The sternocleidomastoid muscle is ___ to the thyroid

A

Anterior lateral

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1
Q

The strap muscles of the neck are __ to the thyroid gland

A

Anterior

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2
Q

The common carotid arteries and internal jugular veins are ___ to the thyroid.

A

Lateral

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3
Q

The longus colli muscle is ___ to the thyroid

A

Posterior

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4
Q

The minor neurovascular bundle is ___ to the thyroid

A

Posterior

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5
Q

The normally located parathyroid glands are ___ to the thyroid

A

Posterior

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6
Q

Arterial supply to the thyroid

A

Rt and lt superior thyroid arteries (branch of external carotid)

Rt and lt inferior thyroid arteries (branches of the thyrocervical arteries which come from subclavian artery)

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7
Q

Venous drainage from thyroid

A

Drained into internal jugular vein by the superior and middle thyroid veins.

Drained into innominates by the inferior thyroid veins.

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8
Q

Thyroglossal duct cyst

A

Congenital anomaly that appears as a superficial cyst in the midline of the neck anterior to the trachea and superior to the thyroid

(Thyroglossal duct normally obliterates in fetal life)

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9
Q

The MC malignancy of the thyroid

A

Papillary carcinoma 75-90%, presents with enlg cervical nodes

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10
Q

Chronic lymphocytic (Hashimoto’s) thyroiditis

A

Autoimmune disease. Painless diffuse enlg of thyroid, young women, mc cause of hypothyroidism, course echo texture. Hypoechoic gland.

Enlg gland cold intolerance, weak, fatigue, facial droop, dry scaly skin, weight gain, intellectual impairment, gradual personality change, course hair, constipation, dec sweating, hair loss

Hypo, norm or inc size, hetero, small Ca+, goiter

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11
Q

Pyramidial lobe

A

Extends off isthmus 15-30%

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12
Q

Thyroid

A

4-6 cm L
1.5-2 cm W
2-3 cm AP
Isthmus 2-6 mm

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13
Q

Thyroid

A

Endocrine gland, controls growth, metabolism, development

Produces T3 triiodothyronine and T4 thyroxine
Produces calcitonin which aids parathyroid and dec Ca in blood.

Requires iodine

Regulated by: TSH & thyrotropin produced by pituitary & TRH from hypothalamus

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14
Q

Euthyroid

A

Normal thyroid hormone levels

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15
Q

Hypothyroidism

A

Under secretion of thyroid hormones

Myxedema, weigt gain, hair loss, subcutaneous tissue around eyes, lethargy, intellectual motor slowing, cold intolerance, constipation, deep husky voice, course hair, dec sweating,facial droops, dry skin

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16
Q

Hyperthyroidism

A

Over secretion of thyroid hormones

Weight loss, inc appetite, nervous, energy tremor, excess sweating, heat intolerance, palpitations, exothalmus

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17
Q

Thyroid US

A

Low mid level echoes, homogeneous, slightly hyperechoic to muscle

18
Q

Variants

A

Lingual (tongue base)
Sublingual
Suprahyoid
Substernal

19
Q

Multinodular goiter/ adenomatous hyperplasia / nodular hyperplasia

A

MC cause of thyroid enlargement
Females 50-70yrs

Normal labs, Asymptomatic, pain with hemorrhage

20
Q

Subacute Thyroiditis / De Quervain’s / Granulomatous Thyroiditis

A

Viral
May cause hyperthyroidism that subsides in weeks-months

Painful thyroid, fever, malaise

Enlg hypo goiter hetero

21
Q

Grave’s Disease / Diffuse Hyperthyroidism / Diffuse Toxic Goiter / Thyrotoxicosis

A

MC cause if hyperthyroidism
Females
Child bearing age

Enlg goiter, hyperthyroid, inc vascularity, multinodular

Heat intolerance, inc heart rate, tremors, wt loss, nervous, inc metabolism, exothalmus, acropachy, palp lymph nodes, myxedema

22
Q

Thyroid inferno

A

Increase vascularity

23
Q

Thyroid & pregnancy

A

Assoc with infertility and abnl menses

24
Q

Silent thyroiditis

A

3-6 months after birth. Hyper then hypothyroidism.

Hypo enlg

25
Q

Cyst

A

20% of solitary nodules
Cold on nuc med

Nodular cyst have Echogenic dot within

26
Q

Adenoma

A

MC benign neoplasm
Young adults, females

Neck mass, pain with pressure and hemorrhage

Hot on Nuc med. or cold. Usually hot.

Well defined, oval/round, any echogenicity, cystic degeneration, hypo halo

27
Q

Thyroid cancer

A

Rare
Females, young adults, hx of radiation
Slow growing
Hard/fixed

Asymptomatic, pressure if large, lump, vocal cord paralysis, solitary

Cold on nuc med

Most hypo, solid, solitary
Cystic, complex, calcification, inc vasc flow, no halo, enlg adj lymph nodes

28
Q

Papillary Carcinoma

A
MC cancer
Young adults 
Child bearing women
Least aggressive 
Mets to nodes, lungs, bone, brain
Best prognosis 
6% mortality in 20 years
29
Q

Follicular Carcinoma

A
2nd MC cancer
15% of thy ca
Slow growing 
May look like a regular nodule
Mets to nodes lung bones
30
Q

Medullary carcinoma

A

5% of thy ca
Assoc with MEN’S syndrome
Mets to lung nodes bones
Ca+

31
Q

Anaplastic Cancer

A
2%
Most lethal
Aggressive 
Males > 50yrs
90% with lymphadenopathy 
Mets common when dx
32
Q

Lymphoma

A

Usually Non-Hodgkin’s
Older females
Assoc with Hashimoto’s thyroiditis
Poor prognosis

33
Q

Mets to thyroid

A

MC from breast ca

Also from bronchogenic, renal, melanoma, gastric cancer

34
Q

Parathyroid glands

A

4 glands
Sup and inf
Post / med
< 4 mm

Calcium metabolism and regulation

35
Q

Hypocalcemia

A

Dec calcium in blood

Numb
Tingling lips, tongue, fingers, feet
Dementia 
Depression
Psychosis
Muscle aches/spasms
EKG changes 
Fatigue
Irritability
Anxiety
36
Q

Hypercalcemia

A

Inc calcium in blood

Polyuria, nocturia, polydipsia, nephro/urolithiasis, osteitis, bone cyst, EKG changes, anorexia, Abd pain, ileus, n/v, arthritis

37
Q

Hypoparathyroidism

A

Usually due to underlying disease

38
Q

Hyperparathyroidism

A

Usually due to adenomas, hyperplasia, carcinoma

Adenomas MC cause, usually solitary, homo, hypo, well defined

39
Q

Parathyroid hyperplasia

A

Uncommon cause of Hyperparathyroidism

Usually more than 1 gland involved.

40
Q

Parathyroid carcinoma

A

Rare cause of Hyperparathyroidism
Indistinguishable from Adenoma and hyperplasia
Shadowing

High serum calcium

41
Q

Brachial Cleft Cyst / Lateral Cervical Cyst

A

Embryonic remnant

Cyst or complex mass below angle of mandible

42
Q

Lymphadenopathy

A

Due to infection or malignancy
Single or multiple well circumscribed round/oval hypoechoic

Malignant degenerative lymph nodes lose reniform shape and fatty hilum

43
Q

Reidel’s thyroiditis

A

Chronic fibrosing disease. Thyroid displaces & compresses trachea & esophagus. Diffuse bilateral enlargement & hetero
Women>men