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Thyroid Flashcards

(79 cards)

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1
Q

___ is the fascia that coveres the thyroid

A

loose investing fascia

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2
Q

___ ligament attaches the thyroid gland to the cricoid cartilage

A

ligament of berry

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3
Q

the ligament of berry arises from what fascia

A

pre-tracheal fascia

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4
Q

arteries that supply the thyroid gland

A

superior thyroid artery

inferior thyroid artery

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5
Q

Aside from supplying the upper 1/3 of the lobe, the superior thyroid artery also supplies ____

A

upper 1/2 of the isthmus

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6
Q

the inferior thyroid artery is a branch of ___

A

thyrocervical trunk

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7
Q

The tributaries of the superior and middle thyroid vein

A

internal jugular vain

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8
Q

the tributary of the inferior thyroid vein

A

brachiocephalic vein

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9
Q

This nerve loops around the ligamentum arteriosum

A

left RLN

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10
Q

this loops around the subclavian artery

A

right RLN

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11
Q

this nerve crosses the arch of the aorta

A

left RLN

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12
Q

this nerve ascends at the tracheoesophageal groove

A

left RLN

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13
Q

Damage to one RLN leads to paralysis of the ____ (ipsilateral/contralateral) cord

A

ipsilateral cord

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14
Q

___ is a sensory nerve to supraglottic larynx

A

Internal branch of the superior laryngeal nerve

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15
Q

what are the branches of the superior laryngeal nerve?

A

internal and external branch

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16
Q

___ is the only motor NS to cricothyroid

A

external branch of the superior laryngeal nerve

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17
Q

what nerve is affected if…

inability to tense the cord
difficulty hitting high notes
voice fatigue

A

external branch of the superior laryngeal nerve

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18
Q

what descends alongside the external branch of the superior laryngeal nerve?

A

superior thyroid vessels

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19
Q

serum TSH levels reflect the ability of the anterior pituitary to detect ___ (FT3/FT4)

A

FT4

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20
Q

this reflects the output from the thyroid gland

A

total T4

NOT FT4

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21
Q

this reflects the peripheral thyroid hormone metabolism

A

Total T3

NOT FT3

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22
Q

this detects early hyperthyroidism

A

FT3

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23
Q

___ syndrome

endorgan resistance to T4

FT4 increased
TSH normal

A

Refetoff Syndrome

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24
Q

most important in monitoring differentiated thyroid cancer recurrence, after total thyroidectomy and RAI ablation

A

serum thyroglobulin

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25
this is secreted by C cells
calcitonin
26
serum calcitonin is a sensitive marker of _____ cancer
medullary thyroid
27
[thyroid imaging] I 123 vs I 131, which considered a low dose radiation
I 123
28
This radionuclide is better in detecting papillary and follicular CA
Iodine 131
29
[WHO GRADE OF THYROID SIZE] goiter palpable but not visible in normal head positon
Grade II
30
[diagnose] female, 40-60 years old heat intolerance, weight loss, diarrhea, palpitation, amenorrhea, afib, ophthalmopathy, dermopathy
graves disease
31
genes associated with graves disease
HLA B8 HLA DR3 HLA DQA1
32
[diagnose] low TSH with or without elevated FT4/FT3 (+) ophtalmopathy, female
graves
33
[pharma] drugs that block synthesis of new T4 and T3
``` Methimazole Amiodarone Lithium Iodine PTU ``` MA LIP
34
[pharma] drugs that block TRH stimulation
Somatostatin | Glucocorticoids
35
[pharma] drugs that block pituitary secretion
dopamin
36
[pharma] Drug that block peripheral conversion of T4 ot T3
Propanolol, PTU Amiodarone Glucocorticoids Iopanic acid PAGI
37
[pharma] causes congenital aplasia/aplasia cutis
methimazole
38
[pharma] drugs that cause agrarnulocytosis
PTU | Methimazole
39
What is the dose of I 131 as treatment for graves?
Oral dose 8-12 mCi
40
absolute contraindication for RAI therapy
pregnancy | breastfeeding
41
this is given 7 to 10 days prior to thyroidectomy
KISS
42
Potassium iodide saturated solution is given prior to thyroidectomy because
it decreases vascularity of the thyroid
43
Also called plummers disease
toxic multinodular goiter
44
[diagnose] Graves SSx (-) ophthalmopathy
TMNG
45
[diagnose] younger patient low TSH high FT4/FT3 hot nodule
Toxic adenoma
46
A burch-wartofsky score of 40 means that the patient is ___
impending storm (25 to 45)
47
in cases of recurrent acute thyroiditis, you suspect ____ fistula
pyriform sinus
48
[diagnose] painful thyroid, 30-40 years old, women, previous history of URTI What is the etiology?
Subacute thyroiditis, viral self limited
49
most common inflammatory disorders of the thyroid gland
hashimoto thyroiditis
50
leading cause of hypothyroidism
hashimoto thyroiditis
51
[diagnose] CD8 T cells and antibodies directed agains Tg, TPO and TSH, HLA B8 HLA DR3, HLA DR5
hashimoto thyoiditis
52
[diagnose] woman (30--50) moderately painless diffusely enlarged thyroid gland high TSH
hashimoto thyroiditis
53
[diagnose] painless, hard anterior neck mass hard, woody thyroid gland
reidel thyrodiits Wedge resection L thyroxine
54
the single most important test in the evaluation of thyroid nodules
FNAB
55
What is the cut off to say that the FNAB has optimum cytology?
Follicles: at least 6 contains: 10-15 cells in each follicle Aspirates: 2 aspirates
56
These types of CA cant be diagnosed by FNAB
Follicular | Hurthle cell CA
57
FNAB is less reliable in?
patients with history of radiation | Family history of thyroid CA
58
what is the risk of malignancy for cold nodules
20%
59
[Management of thyroid cytopathology] Non-diagnostic/Unsatisfactory
Repeat FNAB with UTZ guided 1-4% risk of CA
60
[Management of thyroid cytopathology] Benign
critical follow-up
61
[Management of thyroid cytopathology] Atypia of undetermined significance OR Follicular lesion of undetermined significance
Repeat FNA
62
Diagnostic modality that is useful for detecting nonpalpable thyroid nodules
ultrasound
63
Characteristic of a malignancy in a cervical lymph node
taller than wide | loss of fatty hilym
64
Papillary thyroid CA accounts for what percent of all thyroid malignancies?
80%
65
[diagnose: type of MEN] 1. Pituitary adenoma 2. Parathyroid hyperplasia 3. Pancreatic tumor
MEN 1
66
[diagnose: type of MEN] 1. Parathyroid hyperplasia 2. Medullary thyroid CA 3. Pheochromocytoma
MEN 2A
67
[diagnose: type of MEN] 1. Medullary thyroid CA 2. Pheochromocytoma 3. Mucosal neuroma 4. Marfanoid body habitus
MEN 2B
68
What thyroid malignancy is common in iodine deficient areas?
follicular CA
69
This thyroid malignancy relies on the presence of capsular and vascular invasion
hurthle cell CA
70
[diagnose: thyroid malignancy] not avid for RAI more likely to metastasize to LN and distant sites
hurthle cell CA
71
What is the thyroglobulin value during post-op surveillance if the patient is taking levothyroxine?
<0.2 ng/mL
72
What is the thyroglobulin value during post-op surveillance when the patient is hypothyroid?
<1ng
73
___ CA that arises from the parafollicular cells
medullary thyroid CA
74
what is the premalignant lesion for medullary thyroid CA?
chief cell hyperplasia
75
[diagnose] woman (7th to 8th decade) long standing neck mass rapidly enlarging
anaplastic thyroid CA
76
most common type of of thyroid lymphoma
Non-hodgkin B cell type
77
Thyroid lymphoma usually arises from ___ thyroiditis
hashimoto
78
Regimen for thyroid lymphoma
RCHOP ``` Rituximab Cyclophosphamide Doxorubicin Vincristine Prednisone ```
79
most common malignancy that metastasize to the thyroid
renal cell CA

Surgery (19 decks)

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