Thyroid disease

Question 1

Differentials for thyroid lumps?

Answer 1

goitre (thyrotoxic, non-toxic nodular, physiological)
Adenoma
Cyst
Thyroiditis: hashimoto's, de quervains
Carcinoma

Question 2

What are the investigations for thyroid lump?

Answer 2

1. Exam
2. Thyroid function T4, TSH
3. USS
4. Fine needle cytology
5. Radio-iodide scan

Question 3

List four causes of hyperthyroidism

Answer 3

primary/grave’s disease
toxic multinodular goitre
toxic adenoma
iatrogenic- too high a dose of thyroxine in hypothyroid patients

Question 4

What are the symptoms of hyperthyroidism?

Answer 4

feeling hot
palpatations
anxiety
diarrhoea
muscle weakness

Question 5

List four signs of hyperthyroidism

Answer 5

tachycardia
hand tremor
exopthalmos
pre-tibilar myxoedema
weight loss

Question 6

What is the treatment for hyperthyroidism?

Answer 6

antithyroid drugs
radioactive iodine
surgery-subtotal thyroidectomy

Question 7

Name two risk factors for thyroid carcinoma?

Answer 7

exposure to radioactive material

neck irradiation

Question 8

Name three types of thyroid carcinoma

Answer 8

1. papillary
2. follicular
3. medullary
4. anaplastic

Question 9

What is the most common thyroid carcinoma?

Answer 9

papillary

Question 10

What is the treatment for thyroid carcinoma?

Answer 10

surgery (total/lobectomy +- lymph node dissection)
radio-iodine
thyroxine replacement

Question 11

Name three complications of thyroid surgery

Answer 11

1. recurrent laryngeal nerve damage (hoarseness and stridor if bilateral)
2. removal of parathyroid glands -> hypocalcaemia
3. haematoma -> laryngeal compression
4. hypothryoidism
5. hypertrophic neck scar