22 Thyroid
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Questions and Answers

Which factor released from the hypothalamus acts on the anterior pituitary gland and causes the release of TSH?

  • Thyrotropin-releasing factor (TRF) (correct)
  • T3
  • Thyroid-stimulating hormone (TSH)
  • T4
  • What is the mechanism through which TSH acts on the thyroid gland to release T3 and T4?

  • Decreasing cAMP levels
  • Stimulating TRF release
  • Inhibiting TRF release
  • Increasing cAMP levels (correct)
  • Which artery is the first branch off the external carotid artery?

  • Superior thyroid artery (correct)
  • Inferior thyroid artery
  • Thyrocervical trunk
  • Ima artery
  • Which vein drains into the internal jugular vein?

    <p>Superior thyroid vein</p> Signup and view all the answers

    Which nerve is motor to the cricothyroid muscle and runs lateral to the thyroid lobes?

    <p>Superior laryngeal nerve</p> Signup and view all the answers

    What is the most common injured nerve following thyroidectomy?

    <p>Superior laryngeal nerve</p> Signup and view all the answers

    What is the main purpose of performing a palliative thyroidectomy?

    <p>To relieve compressive symptoms</p> Signup and view all the answers

    Which type of thyroid cancer is 131 I effective for?

    <p>Papillary and follicular</p> Signup and view all the answers

    When should thyroid replacement be given after treatment with 131 I?

    <p>After treatment with 131 I</p> Signup and view all the answers

    In which patients is 131 I therapy used?

    <p>Patients with papillary and follicular cell cancer only</p> Signup and view all the answers

    What is the main purpose of total thyroidectomy in patients with papillary or follicular cell cancer and metastases?

    <p>To facilitate uptake of 131 I to the metastatic lesions</p> Signup and view all the answers

    What is the main side effect of 131 I therapy?

    <p>Sialoadenitis</p> Signup and view all the answers

    What is the primary reason for not using 131 I therapy in children, pregnant women, or lactating mothers?

    <p>Increased risk of cretinism</p> Signup and view all the answers

    What is the most common cause of death in thyroid storm?

    <p>High-output cardiac failure</p> Signup and view all the answers

    What is the role of the ligament of Berry in relation to the recurrent laryngeal nerves?

    <p>It is a suspensory ligament that needs careful dissection during thyroid surgery</p> Signup and view all the answers

    What is the main action of peroxidases in the context of thyroid function?

    <p>Link iodine and tyrosine together</p> Signup and view all the answers

    What is the function of thyroxine-binding globulin in the circulation?

    <p>Binds the majority of T3 and T4</p> Signup and view all the answers

    What is the most sensitive indicator of thyroid gland function?

    <p>TSH</p> Signup and view all the answers

    What is the preferred initial test for an asymptomatic thyroid nodule?

    <p>Ultrasound-guided fine-needle aspiration (FNA)</p> Signup and view all the answers

    What is the recommended follow-up if an FNA result shows atypia of undetermined significance (AUS/FLUS)?

    <p>Repeat FNA</p> Signup and view all the answers

    What is the next step if cyst fluid from a thyroid nodule recurs or is bloody?

    <p>Lobectomy</p> Signup and view all the answers

    Which type of thyroiditis is associated with hyperthyroidism initially and can be preceded by a viral upper respiratory infection?

    <p>De Quervain’s thyroiditis</p> Signup and view all the answers

    What is the most common endocrine malignancy in the United States?

    <p>Thyroid cancer</p> Signup and view all the answers

    Which type of thyroid carcinoma has the best prognosis and is the least aggressive?

    <p>Papillary thyroid carcinoma</p> Signup and view all the answers

    Which type of carcinoma has hematogenous spread with bone being the most common site of metastasis?

    <p>Follicular thyroid carcinoma</p> Signup and view all the answers

    Which type of thyroid cancer is most commonly associated with MEN IIa or IIb?

    <p>Medullary thyroid carcinoma</p> Signup and view all the answers

    What is the usual precursor for bacterial thyroiditis?

    <p>Viral upper respiratory tract infection</p> Signup and view all the answers

    What is a characteristic feature of pathology in medullary thyroid carcinoma?

    <p>Amyloid deposition</p> Signup and view all the answers

    What distinguishes De Quervain’s thyroiditis from Riedel’s fibrous struma?

    <p>Woody, fibrous component involving adjacent strap muscles and carotid sheath</p> Signup and view all the answers

    What is the primary cause of death in papillary thyroid carcinoma?

    <p>Local disease</p> Signup and view all the answers

    What indicates the need for total thyroidectomy as a treatment for papillary and follicular thyroid carcinomas?

    <p>Extrathyroidal disease beyond the capsule</p> Signup and view all the answers

    What can be a challenging aspect of pathology in follicular adenomas?

    <p>Difficulty in distinguishing between follicular adenoma and carcinoma on FNA</p> Signup and view all the answers

    Which thyroid condition is characterized by exophthalmos and pretibial edema?

    <p>Graves' disease</p> Signup and view all the answers

    What is the first-line drug for treating hyperthyroidism?

    <p>Propylthiouracil (PTU)</p> Signup and view all the answers

    What is the primary cause of hyperthyroidism in most patients?

    <p>Graves' disease</p> Signup and view all the answers

    What is the preferred initial treatment for toxic multinodular goiter in most patients?

    <p>Thyroidectomy</p> Signup and view all the answers

    Which thyroid condition can cause thyrotoxicosis in the acute early stage?

    <p>Hashimoto's disease</p> Signup and view all the answers

    What is the recommended treatment for a single toxic nodule that is > 3cm and symptomatic?

    <p>Lobectomy</p> Signup and view all the answers

    Which medication is safe to use in pregnancy for treating hyperthyroidism?

    <p>Propylthiouracil (PTU)</p> Signup and view all the answers

    What is the most common cause of hypothyroidism in adults?

    <p>Hashimoto's disease</p> Signup and view all the answers

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