Exam 16: Thyroid and Parathyroid Surgery

Substernal or intrathoracic thyroidectomy is indicated for goiters that are encroaching into the substernal or intrathoracic regions,causing tracheal or esophageal obstruction.Access to the substernal compartment is typically facilitated by:

A minimally invasive video-assisted thyroidectomy (MIVAT)procedure relies on Miccoli instruments added to the standard thyroid or neck dissection setup,a 30-degree endoscope,and an ultrasonic (harmonic)scalpel with scissors to ligate and divide the vessels.An important risk-reduction strategy for any minimally invasive procedure would be to:

A 62-year-old woman with a 4-year history of Graves' disease has not responded to medical therapy.She is scheduled for a subtotal thyroidectomy.Which condition,a complication of Graves' disease,is her probable indication for a subtotal thyroidectomy?

Hypothyroidism results from undersecretion of thyroid hormone.Select the set of symptoms that is most commonly associated with hypothyroidism.

A number of symptoms and signs are well-established manifestations of thyroid dysfunction.The American Association of Clinical Endocrinologists (AACE)has established practice guidelines for the diagnostic evaluation and screening of hyperthyroidism and hypothyroidism.The AACE recommends the ___________ as the single best screening test.A history of ___________ are symptoms of concern,and patients with ___________ require MRI or CT imaging,because this may be indicative of metastasis.Select the clinical triad to complete this diagnostic screening guideline.