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Absite Killer and Fiser thyroid and parathyroid
mostly from AK
60
Medical
Professional
01/20/2014

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Cards

Term
Embryological origin or parafollicular C cells
Definition
neural crest
Term
Relationship of potency of T3 to T4 and halft life
Definition
T3 is 3x more active as T4
Half life is 3 d
Term
Antithyroid drug that crosses the placenta
Definition
Methimazole
Term
Antithyroid drug that prevents coupling of MIT and DIT in thyroid
Definition
PTU and methimazole
Term
Potential outcome of methimazole in pregnancy
Definition
Cretenism
Term
Rare side effect of PTU
Definition
Aplastic anemia/agranulocytosis
Term
Antithyroid drug that inhibits peroxidases
Definition
PTU and methimazole
Term
Antithyroid drug that prevents peripheral converstion of T4 to T3
Definition
PTU, propanolol, prednisone (all begin with P)
Term
Wolk Chakoff effect
Definition
# Pts given high doses of iodine (KI soln, called Lugol's solution) which inhibits action of TSH on thyroid and inhibits organic coupling of iodide
# useful in thyroid storm
Term
Type of thyroid cancer for which FNA is useless
Definition
follicular or Hurthle cells- FNA can't distinguish b/w malignant and benign follicular cells
Term
Most common type of thyroid CA
Definition
Papillary (P for popular)
Term
method of spread of papillary thyroid CA
Definition
Lymphatics
Term
Effect of node positivity on survival in papillary thyroid CA
Definition
none
Term
Histologic finding a/w papillary thyroid CA
Definition
Psammoma bodies (P with P)
Term
Risk factor for papillary thyroid CA
Definition
radiation exposure
Term
F:M ratio for papillary thyroid CA
Definition
3:1
Term
Age distribution for papillary thyroid CA
Definition
50% before age 40
Term
Management of papillary thyroid CA
Definition
# if < 1 cm, lobectomy
# total thyroidectomy:
* B/L disease
* multicentric
* h/o radiation exposure
* positive margins
* tumors > 1 cm
Term
Role of node dissection in papillary thyroid CA
Definition

# ipsilateral MRND if:

* clinically positive cervical nodes

* extrathyroidal tissue involvement

Term
When post-operative iodine is given and duration for papillary thyroid CA
Definition
# give I-131 for 6 weeks if:
* metastatic disease
* residual local disease
* positive lymph nodes
* capsilar invasion
Term
Feature of papillary thyroid CA that affects prognosis
Definition
Capsular invasion
Term
Role of XRT for papillary thyroid CA
Definition
for unresectable disease not responsive to I-131
Term
Timing of thyroid replacement after treatment for papillary thyroid CA
Definition
after I-131 tx is finished because thyroid hormone replacement will suppress uptake of the radioactive iodine
Term
Survival rates of papillary thyroid CA
Definition
5-yr is 95%
Term
Method of spread for follicular thyroid CA
Definition
Hematogenous
Term
Percentage of pts with papillary and follicular thyroid CA who p/w mets
Definition
# papillary- 20% of adults and 80% of children p/w positive nodes
# follicular- 60% p/w mets
Term
Demographics of follicular thyroid CA
Definition
F:M is 3:1
Peak incidence is in 50s
Term
management of follicular thyroid CA
Definition
# Total thyroidectomy with ablative Iodine therapy for lesions > 1 cm or extra-thyroidal disease
# Ipsilateral MRND if clinically positive nodes or extrathyroidal involvement (includinc capsular invasion)
# 6 wks of post-operative I-131 tx if > 1 cm or extrathyroidal disease
# if less than 1 cm, just lobectomy
Term
5-year survival for follicular thyroid CA
Definition
70%
Term
Pathognomonic histological finding for medullary thyroid CA
Definition
Amyloid
Term
Percentage of MTC pts that have MEN2 syndrome
Definition
20%
Term
Provocative test for MTC
Definition
Gastrin promotes increase calcitonin
Term
Gene diagnostic for MEN2 syndrome
Definition
RET proto-oncogene
Term
Tx for MTC
Definition
total thyroidectomy and neck dissection for positive node
Term
Additional testing needed for pts dx'ed with MTC
Definition
screening for pheochromocytoma and hyperparathyroidism
Term
Diagnosis if an enlarged lateral neck lymph node shows normal thyroid tissue
Definition
Pappilary hroid CA
Term
Interpretation of radionuclide thyroid scan
Definition
# hot nodule likely benign
# cold nodule higher chance of malignancy
Term
1st and 2nd step in w/u of thyroid nodule
Definition
H&P and FNA
Term
Management of thyroid CA during pregnancy
Definition
operate in 2nd trimester and no radioactive iodine tx
Term
Nerve that provides motor innervation to the cricothyroid muscle and manifestation of injury
Definition
# external branch of superior laryngeal nerve
# injury causes loss of voice projection and easy fatiguability of voice
Term
Side more common for superior laryngeal nerve injury
Definition
Right side
Term
Nerve that tracks close to the superior thyroid artery
Definition
Superior laryngeal nerve
Term
Position of RLN in thyroidectomy
Definition
Posterior to thryoid lobes in the tracheoesophageal groove
Term
Function of RLNs
Definition
motor innervation to all of the larynx except for the cricothyroid
Term
Anatomical relationships of looping of Right and Left RLN
Definition
Left loops around the aorta, Right loops around subclavian or inominate artery
Term
MC blood supply to the parathyroid glands
Definition
inferior thyroid artery
Term
Active end of PTH
Definition
N termal
Term
Specific effects of PTH
Definition
# Increase calcium binding protein to increase Ca absorption in gut
# stimulate osteoclast to release Ca and Phosphate
# increase renal calcium absorption
# increase renal phosphate secretion
Term
Source of superior thyroid artery
Definition
1st branch off external carotid
Term
Source of inferior thyroid artery
Definition
Thyrocervical trunk
Term
Source and course of thyroid IMA artery if present
Definition
Comes from aorta or innominate and goes behid the isthmus
Term
Venous drainage of thyroid
Definition
# superior and middle thyriod veins drain into IJV
# inferior thryoid vein drains into innominate vein
Term
Oncogene that increases risk of parathyroid adenomas
Definition
PRAD-1
Term
Lab abnormalities a/w hyperparathyroidism
Definition
Increase Ca, decrease Phosphate, Cl:Ph > 33:1
Term
Pathognomonic finding for hyperparathyoidism
Definition
Osteitis fibrosa cystica- bone lesions from calcium resorption
Term
W/u of hypercalcemia
Definition
Check urine Ca: if low, familiar hypocalciuric hypercalcemia
Term
MC pattern of parathyroid adenomas
Definition
# 85% have single gland adenoma
# MEN pts have 4 gland hyperplasia
Term
MEN I
Definition
PPP:
# Pancreatic islet cell tumors
# Pituitary tumors
# hyperParathyroidism
Term
MEN IIa
Definition
2 MPH
# MTC (nearly all pts)
# Pheo
# Hyperparathyroidism
Term
MEN IIb
Definition
# MTC (nearly all pts)
# Pheo
# mucosal neuromas/Marfan's syndrome
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