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left behind with subtotal thyroidectomy
tubercles of zuckerkandl
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how can you treat post thyroidectomy hoarsness > 6mo
medialize vocal cord
-
thyroid hormone receptor found where
nucleus
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function of thyroglobulin
stores t3 and t4 in colloid
-
what are the serum thyroid hormone binding proteins
TBG, transthyretin, albumin
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malignancy risk with lingual thyroid
1%
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tx of lingual thyroid
- thyroxine suppression for sxs
- also can resect or ablate with I131
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1st initial test for thyroid nodule
u/s and fna
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what can present as a complex cyst
papillary
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fna shows colloid
repeat fna and follow if still shows colloid
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fna is indeterminate
get technetium scan and if it is a hot nodule treat with thyroxine for 6 weeks; lobectomy if no decrease in size
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predicts poor prognosis in thyroid lymphoma
b2 microglobulin LDH
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chance of malignancy with follicular cells found on fna
5-10%
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type of follicular adenomas
colloid, embryonal, fetal
-
prognosis of papillary thryoid ca is determined by
local invasion
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indications for total thyroidectomy for papillary ca
- tumor>1cm
- extrathyroidal dz
- multicentric/bilateral
- previous xrt
-
indications for MRND in papillary thyroid ca
extra thyroidal (capsular invasion, pos nodes metastatic dz
-
mets from follicular go where
bone (hematogenous spread)
-
sxs of medullary thyroid ca
diarrhea, flushing
-
test for medullary thyroid ca
gastrin, causes increased calcitonin
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path in medullary thyroid ca shows
amyloid
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what prevents any attempt at cure with medullary thyroid ca
liver and bone mets
-
age of prophylactic total thyroid with central neck dissection for MEN IIa and IIb
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path of anaplastic thyroid ca
vesicular nuclei
-
side effects of I131
sialoadenitis, gi sxs, infertility, parathyroid dysfunction, bone marrow suppression, leukemia
-
decreases vascularity before operating on graves
lugols
-
tx of graves in pregnancy
ptu until 2nd trimester then surgery if still having sxs. Cannot use propranolol in 3rd trimester
-
dx of hashimotos
increase thyroid peroxidases and anti-thyroglobulin abs
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