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21 Cards in this Set
- Front
- Back
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arterial supply to thyroid
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external carotid --> superior thyroid artery
subclavian --> thyrocervical trunk --> inferior thyroid aortic arch --> thyroid ima |
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venous drainage of thyroid
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superior, middle and inferior veins --> internal jugular
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thyroid malignancy spreads to which nodes
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cervical nodes,
paratracheal nodes, or tracheoesophageal groove nodes (worst! may go into recurrent nerve, trachea or esophagus) |
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innervation of thyroid
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recurrent laryngeal (crosses over inferior thyroid artery on right) --> external (larynx sensory) and internal (larynx mm)
superor laryngeal nerve --> external (cricothyroid mm) and internal (larynx sensory) |
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thyroid originates from and migrates down from the...
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foramen cecum at the base of the tongue
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substernal goiters usually are from .... do/don't take up radioiodine...and result in ...
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adenomatous hyperplasia
don't take up radioiodine tracheoesophageal compression |
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__ and __ join to form T3 and T4
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iodine and tyrosine
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Parafollicular cells (C cells) make ___ and are part of which cell system?
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calcitonin
APUD |
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is the preferred tx of Grave's disease medical or surgical?
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medical by
1. PO radioiodine (they tend to remit spontaneously) 2. propylthiouracil and methimazole (inhibit peroxidase so iodide -x> iodine and inhibits T3 -> T4) BEWARE drug induced SLE, agranulocytosis |
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name four complications of thyroidectomy
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thyroid storm (prevent by first making patient euthyroid)
hemorrhage hypoparathyroidism (Chovstek's and Trousseau's; tx with IV ca gluconate) recurrent laryngeal n. injury |
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what are the eponyms for 1. diffuse toxic non-nodular goiter and 2. toxic multinodular goiter
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1. Grave's disease
2. Plummer's disease |
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do the nodules in plummer's disease uptake radioiodine? are they suppressed by thyroxine?
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yes
no |
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toxic adenoma of thyroid is caused from?
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autonomous hyperfunctioning solitary nodule
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tx of toxic adenoma/
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surgical excision (lobectomy)
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tx of plummer's disease?
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same as for Grave's (medical first, then surgical)
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how do you distinguish de Quervains thyroiditis (giant cell/granulomatous) from Grave's?
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de Quervains does not take up radioiodine (and therefore antithyroid drugs are ineffective)
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two forms of chronic thyroiditis
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hashimoto's (struma lyphomatosa; eu- or hypothyroid, has anti-thyroid antibodies, tx with thyroxine)
Riedels (fibrous)thyroiditis- gland is replaced with fibrous tissue --> rock hard --> may cause pressure sx like cough) |
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MCC thyroid surgery
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neoplasm
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risks factors for thyroid malignancy vs. benign neoplasm
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men
>age 40 family hx of MEDULLARY thyroid CA radiation exposure hx firm nodulesinfiltration multiple nodules lymph nodes (ipsilateral) immobility of vocal cord |
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MC thyroid malignancy
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papillary carcinoma (esp women with radiation hx)
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thyroid malignancy associated with ...
radiation exposure? iodine deficiency?genetically? from other thyroid neoplasms? |
papillary
follicular medullary (make calcitonin) anaplastic |
