40 Questions
Which factor released from the hypothalamus acts on the anterior pituitary gland and causes the release of TSH?
Thyrotropin-releasing factor (TRF)
What is the mechanism through which TSH acts on the thyroid gland to release T3 and T4?
Increasing cAMP levels
Which artery is the first branch off the external carotid artery?
Superior thyroid artery
Which vein drains into the internal jugular vein?
Superior thyroid vein
Which nerve is motor to the cricothyroid muscle and runs lateral to the thyroid lobes?
Superior laryngeal nerve
What is the most common injured nerve following thyroidectomy?
Superior laryngeal nerve
What is the main purpose of performing a palliative thyroidectomy?
To relieve compressive symptoms
Which type of thyroid cancer is 131 I effective for?
Papillary and follicular
When should thyroid replacement be given after treatment with 131 I?
After treatment with 131 I
In which patients is 131 I therapy used?
Patients with papillary and follicular cell cancer only
What is the main purpose of total thyroidectomy in patients with papillary or follicular cell cancer and metastases?
To facilitate uptake of 131 I to the metastatic lesions
What is the main side effect of 131 I therapy?
Sialoadenitis
What is the primary reason for not using 131 I therapy in children, pregnant women, or lactating mothers?
Increased risk of cretinism
What is the most common cause of death in thyroid storm?
High-output cardiac failure
What is the role of the ligament of Berry in relation to the recurrent laryngeal nerves?
It is a suspensory ligament that needs careful dissection during thyroid surgery
What is the main action of peroxidases in the context of thyroid function?
Link iodine and tyrosine together
What is the function of thyroxine-binding globulin in the circulation?
Binds the majority of T3 and T4
What is the most sensitive indicator of thyroid gland function?
TSH
What is the preferred initial test for an asymptomatic thyroid nodule?
Ultrasound-guided fine-needle aspiration (FNA)
What is the recommended follow-up if an FNA result shows atypia of undetermined significance (AUS/FLUS)?
Repeat FNA
What is the next step if cyst fluid from a thyroid nodule recurs or is bloody?
Lobectomy
Which type of thyroiditis is associated with hyperthyroidism initially and can be preceded by a viral upper respiratory infection?
De Quervain’s thyroiditis
What is the most common endocrine malignancy in the United States?
Thyroid cancer
Which type of thyroid carcinoma has the best prognosis and is the least aggressive?
Papillary thyroid carcinoma
Which type of carcinoma has hematogenous spread with bone being the most common site of metastasis?
Follicular thyroid carcinoma
Which type of thyroid cancer is most commonly associated with MEN IIa or IIb?
Medullary thyroid carcinoma
What is the usual precursor for bacterial thyroiditis?
Viral upper respiratory tract infection
What is a characteristic feature of pathology in medullary thyroid carcinoma?
Amyloid deposition
What distinguishes De Quervain’s thyroiditis from Riedel’s fibrous struma?
Woody, fibrous component involving adjacent strap muscles and carotid sheath
What is the primary cause of death in papillary thyroid carcinoma?
Local disease
What indicates the need for total thyroidectomy as a treatment for papillary and follicular thyroid carcinomas?
Extrathyroidal disease beyond the capsule
What can be a challenging aspect of pathology in follicular adenomas?
Difficulty in distinguishing between follicular adenoma and carcinoma on FNA
Which thyroid condition is characterized by exophthalmos and pretibial edema?
Graves' disease
What is the first-line drug for treating hyperthyroidism?
Propylthiouracil (PTU)
What is the primary cause of hyperthyroidism in most patients?
Graves' disease
What is the preferred initial treatment for toxic multinodular goiter in most patients?
Thyroidectomy
Which thyroid condition can cause thyrotoxicosis in the acute early stage?
Hashimoto's disease
What is the recommended treatment for a single toxic nodule that is > 3cm and symptomatic?
Lobectomy
Which medication is safe to use in pregnancy for treating hyperthyroidism?
Propylthiouracil (PTU)
What is the most common cause of hypothyroidism in adults?
Hashimoto's disease
Test your knowledge on the management of thyroid goiter, including the use of thyroxine, indications for surgery, and treatment options for both nontoxic and toxic goiter.
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