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 (A)</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 (D)</p> Signup and view all the answers

What is the most common injured nerve following thyroidectomy?

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

What is the main purpose of performing a palliative thyroidectomy?

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

Which type of thyroid cancer is 131 I effective for?

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

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

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

In which patients is 131 I therapy used?

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

What is the main side effect of 131 I therapy?

<p>Sialoadenitis (B)</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 (D)</p> Signup and view all the answers

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

<p>High-output cardiac failure (C)</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 (B)</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 (A)</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 (A)</p> Signup and view all the answers

What is the most sensitive indicator of thyroid gland function?

<p>TSH (A)</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) (D)</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 (B)</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 (B)</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 (B)</p> Signup and view all the answers

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

<p>Thyroid cancer (D)</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 (B)</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 (A)</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 (D)</p> Signup and view all the answers

What is the usual precursor for bacterial thyroiditis?

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

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

<p>Amyloid deposition (B)</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 (D)</p> Signup and view all the answers

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

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

Which thyroid condition is characterized by exophthalmos and pretibial edema?

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

What is the first-line drug for treating hyperthyroidism?

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

What is the primary cause of hyperthyroidism in most patients?

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

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

<p>Thyroidectomy (D)</p> Signup and view all the answers

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

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

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

<p>Lobectomy (B)</p> Signup and view all the answers

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

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

What is the most common cause of hypothyroidism in adults?

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

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