ABSITE ch 22 thyroid.txt

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ABSITE ch 22 thyroid.txt
2010-01-11 11:04:02
thyroid ABSITE

ABSITE thyroid
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  1. Emryologic origin of thyroid
    1st and 2nd pharyngeal pouch
  2. Factor from hypothalamus that causes TSH release from anterior pituitary
  3. Hormone released from anterior pituitary gland that acts on the thyroid
  4. 1st branch off external carotid artery
    Superior thyroid
  5. Branch of thyrocervical trunk; supplies inferior and superior parathyroids
    Inferior thyroid
  6. Superior and middle thyroid veins drain into . . .
    Internal jugular vein
  7. Inferior thyroid vein drains into . . .
    Innominate vein
  8. Motor nerve to cricothyroid muscle
    Superior laryngeal nerve
  9. Injury resulting in loss of voice projection and voice fatiguability
    Superior laryngeal nerve
  10. Motor nerve to all larynx except cricothyroid
    Recurrent laryngeal nerve
  11. Injury resulting in hoarseness and potential obstruction of airway
    Recurrent laryngeal nerve
  12. Nerve that tracks close to superior thyroid artery
    Superior laryngeal nerve
  13. Nerve that runs in tracheoesophageal groove
    Recurrent laryngeal nerve
  14. Course of left RLN
    Loops around aorta
  15. Course of right RLN
    Loops around right subclavian/innominate
  16. Posterior medial suspensory ligament close to RLNs
    Ligament of Berry
  17. Binder that stores T3 and T4 in colloid
  18. Plasma T4:T3 ratio
  19. Binder for thyroid hormone transport
    Thyroid-binding globulin
  20. Most lateral, posterior extensions of thyroid tissue
    Tubercles of Zuckerkandl
  21. Most sensitive indicator of thyroid function
  22. Portion of thyroid producing calcitonin
    Parafollicular C cells
  23. Long term side effect of thyroxine treatment
  24. Tachycardia, fever, numbness, irritability, vomiting, diarrhea, high-output cardiac failure after stress in patients with undiagnosed thyroid disease
    Thyroid storm
  25. Triggers for thyroid storm (4)
    Surgery, anxiety, excessive gland palpation, adrenergic stimulants
  26. Treatment of thyroid storm (6)
    Beta blockers, PTU, Lugol�s solution (KI), cooling, O2, glucose
  27. Giving patients in thyroid storm high doses of iodine to inhibit TSH action
    Wolff-Chaikoff effect (Lugol�s solution given)
  28. Workup for asymptomatic nodule
    Thyroid function tests, FNA, radionucleotide study
  29. Treatment of a hot nodule with indeterminant FNA
    6 months of thyroxine, surgery if increases
  30. Treatment of a cold nodule with indeterminant FNA
  31. Thyroid anomaly extending from isthmus toward thymus
    Pyramidal lobe
  32. Thyroid tissue that persists in area of foramen cecum at base of tongue
    Lingual thyroid
  33. Midline neck mass that moves upward with swallowing, susceptible to infection and premalignant in some cases
    Thyroglossal duct cyst
  34. Surgical approach for thyroglossal duct cyst
    Resection of cyst + hyoid bone
  35. Drug that inhibits peroxidases and prevents DIT and MIT coupling (2)
    PTU, methimazole
  36. Side effects of PTU and methimazole
    Cretinism in newborns (methimazole only), aplastic anemia, agranulocytosis
  37. Toxic diffuse goiter cuasing exophthalmos, pretibial edema, a fib, heat intolerance, thirst, appetite increase, weight loss, sweating, and palpitations
    Grave�s disease
  38. Disease caused by IgG antibodies to TSH receptor
    Grave�s disease
  39. Treatment of Graves (4)
    Thionamides, radioactive iodine, subtotal thyroidectomy, total thyroidectomy
  40. Most common cause of thyroid enlargement
    Toxic multinodular goiter
  41. Indications for surgery for toxic multinodular goiter
    Suspicious nodule
  42. Treatment of single toxic nodule
    Radioactive iodine, thionamdes, lobectomy if failure of medical management
  43. Most common cause of hypothyroidism in adults
    Hashimotos disease
  44. Thyroid disease caused by autoimmune disease (antimicrosomal and antithyroglobulin antibodies)
    Hashimoto�s disease
  45. Treatment of Hashimoto�s disease
    Thyroxine, partial thyroidectomy if symptoms persist or compression occurs
  46. Disease with symptoms of viral URI, tender thyroid, sore throat, mass, weakness
    DeQuervain�s thyroiditis
  47. Treatment of DeQuervain�s thyroiditis
    Steroids and ASA, lobectomy if unilateral, total thyroidectomy for persistent inflammation
  48. Fibrous disease of carotid sheath and strap muscles adjacent to thyroid; can resemble cancer; can cause hypothyroidism and compressive symptoms
    Riedel�s fibrous struma
  49. Treatment of Riedel�s fibrous struma
    Steroids, thyroxine
  50. Most common endocrine malignancy in U.S.
    Thyroid cancer
  51. Thyroid nodule characteristics suspicious for cancer (8)
    Solid, solitary, cold, slow growing, hard, male>50, previous neck XRT, MEN 2a or 2b
  52. Most common thyroid cancer
  53. Risk factor for papillary thyroid cancer
    Childhood XRT, age >40-50
  54. Most common metastatic site for papillary thyroid
    Lungs (overall rare)
  55. Pathologic characteristics seen frequently in papillary carcinoma
    Psammoma bodies, orphan annie nuclei
  56. Patients needing radioactive iodine after removal of papillary thyroid cancer (4)
    Metastatic disease, residual local disease, positive lymph nodes, capsular invasion
  57. Thyroid cancer that requires core/excisional biopsy for definitive diagnosis
  58. Most common metastatic site for follicular carcinoma
  59. Indications for MRND in follicular carcinoma
    Clinically positive nodes, extrathyroidal tissue involvement
  60. Indications for radioactive iodine following surgery for follicular carcinoma
    Lesion >1cm, capsular invasion
  61. Typically the first manifestation of MEN2a and 2b
    Medullary thyroid cancer
  62. Pathologic finding of medullary thyroid cancer
  63. Hormone secreted by medullary thyroid cancer; also used as a tumor marker
  64. Symptoms of calcitonin release
    Flushing, diarrhea
  65. Most common metastatic site for MTC
    Lymph node, lung, liver, bone
  66. Treatment of thyroid in MEN 2a
    Prophylactic thyroidectomy and central node dissection in childhood
  67. Treatment of thyroid in MEN 2b
    Prophylactic thyroidectomy and central node dissection in infancy
  68. 5-year survival of MTC
  69. Largely benign tumor of thyroid, although some are malignant and spread to bone, lung
    Hurthle cell carcinoma
  70. Most aggressive thyroid cancer
  71. Treatment of anaplastic thyroid cancer
    Surgery if able, palliative thyroidectomy for compressive sx, palliative chemo and XRT
  72. Which thyroid cancers is radioactive iodine useful for?
    Papillary, follicular
  73. Which thyroid cancers is XRT useful for?
  74. Side effects of radioactive iodine (6)
    Sialoadenitis, GI symptoms, infertility, bone marrow suppression, parathyroid dysfunction, leukemia
  75. Drug given after radioactive iodine, to suppress TSH and slow metastatic disease