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Questions and Answers
What is a potential effect of longstanding large thyroid swelling on the trachea?
Which symptom may indicate pressure effects on the recurrent laryngeal nerve due to thyroid swelling?
What is a potential consequence of retrosternal extension of thyroid swelling?
What should be assessed in the history and examination of a patient with thyroid swelling to determine thyroid hormone status?
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Which condition is associated with MEN type 2A?
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Study Notes
Effects of Longstanding Thyroid Swelling
- Large thyroid swellings can exert pressure on the trachea, potentially leading to tracheal compression or narrowing.
- Airway obstruction may occur in severe cases, causing breathing difficulties and stridor.
Recurrent Laryngeal Nerve Pressure Symptoms
- Hoarseness or changes in voice may indicate pressure effects on the recurrent laryngeal nerve resulting from thyroid swelling.
- This nerve supplies the majority of the intrinsic muscles of the larynx, and its involvement suggests significant compression.
Consequences of Retrosternal Extension
- Retrosternal extension of thyroid swelling can lead to further complications, including mediastinal compression.
- This may result in symptoms like dyspnea (difficulty breathing) and can impact cardiovascular function if great vessels are compressed.
Assessment of Thyroid Hormone Status
- Patient history should include any symptoms of hyperthyroidism or hypothyroidism, such as weight changes, energy levels, and temperature sensitivity.
- Physical examination should include checking for signs of thyroid dysfunction, such as tremors or bradycardia, as well as examining the thyroid swelling itself.
MEN Type 2A Association
- Multiple Endocrine Neoplasia (MEN) type 2A is associated with medullary thyroid carcinoma, pheochromocytoma, and primary hyperparathyroidism.
- This genetic syndrome necessitates screening and monitoring for endocrine tumors due to the risk of malignancy.
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Description
Test your knowledge on conducting a thorough history and examination of patients with thyroid swelling. Learn to assess size, duration, and pressure effects on surrounding structures. Practice identifying potential complications such as tracheomalacia and retrosternal extension.
