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Surgery class test Q/A Thyroid


1.     location of thyroid gland?

a :- it is present in front of neck, with it’s 2 lobes on either side of trachea, connected with  isthumus.

2.     position of the patient while examining the thyroid?

a :- let the patient sit on the stool, with the neck slightly hyperextened and inspect the thyroid from the front, asking the patient to swallow makes the thyroid more prominent.

3.     how would you examine if the neck is short and fat?

a :- ask the patient to clasp the head against the occiput an then push the hand backward against the resistance clasp hand.

4.     what is pizillo’s method?

a :- ask the patient to clasp the head against the occiput and then push the hand backward against the resistant clasp hand.

5.     what should be noted in order to inspect the thyroid gland?

a :- (a) size and shape.       (b) location.

6.     where does thyroid swelling lies in relation to sternocleidomastoid?

a :- it can be one side of midline or else on midline or extent on both the sides of midline.

7.     extension of thyroid gland?

a :- deep to sternocleidomastoid and it is demonstrated by contraction of sternoceidomastoid.

8.     which point should be noted while examining the surface of the swelling?

a :- (a) smooth.

       (b) nodular.

       (c) bosselated.

9.     which type of surface is seen in simple, single nodular goitre?

a :- smooth

10. which type of surface is seen in multinodular goitre?

a :- (a) nodular.

       (b) bosselated.

11. what should be noted while examining the skin over the thyroid?

a :- (a) redness and oedema.

       (b) scars of previous surgery.

       (c) sinuses.

        (d) dilated veins.

12. why does the thyroid swelling moves upwards during deglutition?

a :_ it is enclosed in pretracheal fascia which is fix to thyroid cartilage, so when the superior constrictors of larynx pull the thyroid cartilage while deglutition also moves up and down.

13. in which other condition the swelling moves up on deglutition?

a :- (a) thyroid.

       (b) pretracheal lymphnode.

       (c) thyroglossal cyst.

       (d) subhyoid bursa.

       (e) extrinsic carcinoma of larynx.

14. why does the swelling on deglutition does not moves?   

 a:- a swelling which is not attach to the pretrachial fascia like lipoma will not move upward during deglutition.

15. example of swelling which does not moves?      

 a :- lipoma

16. what is the diagnostic sign to detect the midline swelling?

a :- if the swelling is a nodule close to the midline also test for its upward movement by protrusion of tongue & removing the tongue in & out.

17. in which case there is upward movement of the swelling on protrusion of the tongue because of connection with foramen caecum of tongue?   

 a :- thyroglossal cyst.

18. which other condition can be detected from the protrusion of the tongue?

  a :- thyroglossal fistula

19. on inspection what point should be taken into consideration on upward movement? 

  a :- (a) deglutition (b) prutrision of tongue 

20. what is the standard method for palpation of thyroid gland?

  a:- stand behind the patient, place the hand around the neck, the thubps around the occiput & tip of the other fingers over the front of the neck.

21. how is the flexion of the neck adjusted in the standard method?

  a:- the flexion of the neck by the grip between the thumbs over the occiput and the index finger under the skin.

22. what is to be suspected if the trachial ring in suprasturnal notch is not palpable?  

  a:- retrosternal extension should be suspected.

23. which method is used for palpation of deep surface of thyroid? 

  a :- lahey’s method.

24. which method is used for palpation of small nodule in the thyroid?    

 a :- crile’s method.

25. what is crile’s method?

  a :-  keep a thumb over the lob to be examined & ask the patient to swallow feel for small nodules on the surface as the glands moves the up and down.

26. what is to be taken into considerartion if entire lobe or gland is enlarged? 

 a:-  (a)surface = smooth,bosselated , ( b ) consistency= soft,firm,hard and variable. ( c) retrosternal extension.

27. which goitre is soft in nature?  

 a :- colloid goitre.

28. which goitre is firm in nature?

  a:- multinodular goitre.

29. which swelling is hard?

 a:- carcinoma and ridal’s thyroiditis.

30. the lower border during deglutition should be palpated very carefully for?     a:- retrosternal extension.

31. what does it rule out, if there is palpation of the trachial ring?  

 a :- retrosternal extension

32. what should be noted if there is single nodule?

 a:- (a) location = lobe / isthumus. (b) size (c) consistency = soft & firm

33. how does the cyst in thyroid felt?    a:-firm

34. how is a solid swelling (adenoma) in nature?  

a :- soft on feeling

35. where does the isthamus of thyroid gland palpated?  

 a:- on 2nd,3rd,4th, tracheal ring

36. what is the diagnostic of primary toxic goitre?

 a:- keep your hand very gently on the each other side & try to feel the palpable thrill over the  upper pole ,aching to the feel of the paring cat , is the diagnostic primery toxic goitre .

37. what does the fixity in any dirrection suggest?

a :- malignancy or thyroiditis.

38. what is to be suggested on palpation of thyroid swelling?

a:- (a) trachea – deviation from midline by kocher’s test

      (b) carotids – berry’s sign.

39. in unilateral affections, what is the position of the trachea?

a:- trachea can be felt along its length and displacements to the opp side can be easily appreciated.

40. in bilateral goitre, how can trachea  be palpated?

a:- trachea is difficult to feel so note the position of the larynx and the position of the trachea at suprasternal notch to get an appropiate idea of position of trachea.

41. which test is done for the scabbard trachea?

a:- kocher’s test.

42. how is kocher’s test performed?

a:- ask the pt to extend the neck andtake heavy deep breath, to open the mouth now compress swelling on both the sides,apperance of strider on slighest compression of lateral lobes indicates narrowing of trachea.

43. what is scabbard trachea?

a:- trachea is compressed from both side and become the anteroposterior slight like a scrabbard of the sword.

44. in which other condition scabbard trachea is seen?

a:- carcinoma of thyroid.

45. in benign goitre, the carotid artery is displaced backward, so weather pulsation is felt or not?

a:- yes.

46. in which condition carotid artery pulsation is weak or absent?

a:- malignant goitre.

47. what is the cause for obliterated pulse in malignant goitre?

a:- because of malignant infilteration of carotid sheath.

48. what is berry’s sign?

a:-for obliteration of carotid pulsation.

49. name the different method for palpation of throid swelling?

a:- (a) standard method

      (b) lahey’s method

      (c) crile’s method.

50. where is the process of percussion done?

a:- on manubrium sterni.

51. in normal condition how is percussion behind menubrium sterni?

a:- resonant.

52. how is the percussion in retrosternal goitre?

a:- dull.

53. what should be looked for after examination of thryoid?

a:- (a) sign of thyrotoxicosis.

      (b) sign of myxodema

       (c) sign of retrosternal extension.

       (d) sign of metastasis.

54. what are the signs of thyrotoxicosis?

a:- (a) eye signs

      (b) tremors

      (c) tachycardia

      (d) bruit, thrill.

      (e) warm, moist skin

      (f) pretibial myxoedema.

55. what should be looked for exopthalamus in thyrotoxicosis?

a:- (a) lid retraction, lid lag & infrequent blinking.

      (b) actual buldge ( naffzigers’s sign)

       (c) sclera seen inferiorly.

       (d) absence of wrinkling and inability to converge.

56. which is the earliest sign to appear in thyrotoxicosis?

a:- lid retraction.


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