Chapter 116 - Thyroid Quiz

The RLN (recurrent laryngeal nerve) enters the laryngeal framework between the arch of the cricoid cartilage and the inferior cornu of the thyroid cartilage.

Follicular carcinoma is a type of thyroid cancer that tends to grow slowly and can invade nearby tissues. Local extension refers to the spread of cancer cells into the surrounding tissues and organs near the initial disease site. Therefore, local extension is the primary method of spread for follicular carcinoma beyond the initial disease site. Regional metastasis refers to the spread of cancer to nearby lymph nodes, while distant metastasis refers to the spread of cancer to distant organs or tissues. However, in the case of follicular carcinoma, local extension is the main mode of spread.

Hypothyroidism is a condition characterized by an underactive thyroid gland, which can lead to various symptoms throughout the body. Otolaryngologic manifestations refer to symptoms related to the ears, nose, and throat. Sinus congestion is not typically associated with hypothyroidism, as it is more commonly seen in conditions such as allergies or sinus infections. However, otolaryngologic manifestations of hypothyroidism can include sensorineural hearing loss (SNHL) and tinnitus, enlargement of the tongue, and a husky, raspy voice.

Papillary carcinoma is the most common form of thyroid carcinoma. It arises from the cells that produce and store thyroid hormones. It typically has a slow growth rate and a good prognosis. Papillary carcinoma is characterized by the presence of papillary structures and nuclear abnormalities, such as nuclear grooves and pseudoinclusions. It is more common in women and often occurs in younger individuals. Treatment usually involves surgical removal of the thyroid gland, followed by radioactive iodine therapy and hormone replacement therapy.

The correct answer is the inferior thyroid artery. The superior parathyroid glands receive their primary blood supply from the inferior thyroid artery. This artery arises from the thyrocervical trunk, which is a branch of the subclavian artery. The inferior thyroid artery supplies blood to the thyroid gland and its branches also provide oxygenated blood to the superior parathyroid glands. The carotid artery and superior thyroid artery do not directly supply blood to the superior parathyroid glands.

TSH levels are not useful in establishing the severity of hypothyroidism in a patient who has already been diagnosed with the condition. TSH levels are typically used to diagnose hypothyroidism and monitor the effectiveness of treatment. In a patient who has already been diagnosed, other factors such as symptoms and clinical presentation would be more useful in determining the severity of the disease. Therefore, TSH levels would not be necessary in this scenario.

Age is an important prognostic factor in patients with thyroid cancer. This means that the age of the patient can provide valuable information about the likely outcome of the disease. Older patients tend to have a worse prognosis compared to younger patients. This could be due to various factors such as the presence of other comorbidities in older individuals or the aggressiveness of the cancer in older age groups. Therefore, age is an important consideration when assessing the prognosis and determining the appropriate treatment for patients with thyroid cancer.

Methimazole and PTU may lead to remission of Graves' disease by exerting an immunosuppressive action. This means that these medications can suppress the overactive immune response that is responsible for the production of antibodies that stimulate the thyroid gland to produce excessive amounts of thyroid hormone. By suppressing the immune system, these medications can help to reduce the production of thyroid hormone and bring it back to normal levels, leading to remission of the disease.

Purified thyroglobulin is not administered to a patient with thyroid storm because its purpose is to bind excess free T4, which is not a characteristic of thyroid storm. Thyroid storm is a life-threatening condition caused by excessive release of thyroid hormones. The treatment for thyroid storm includes supportive measures to maintain adequate CNS and CVS function, propanolol to control heart rate and reduce symptoms, high doses of glucocorticoids to inhibit the production of thyroid hormones, and inorganic iodine to inhibit the release of thyroid hormones.

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