Read the attached medical report and answer the following qu

Read the attached medical report, and answer the following questions:

Thyroid Cancer Surgery Discharge Summary

Discharge Diagnosis: Follicular thyroid cancer.

Hospital Course: The patient, a 52-year-old female, came into the same-day surgery department on Friday, May 31, 2011. She underwent an uneventful left thyroid lobectomy, and intraoperatively her frozen section diagnosis was follicular adenoma. She did well postoperatively and was subsequently prepared for discharge. However, the pathology demonstrated that she had a moderately well-differentiated follicular cancer. A completion thyroidectomy was then planned, and she was returned to the operating room. The contralateral lobe was then removed. Parathyroid glands were well identified as were the recurrent laryngeal nerves bilaterally, and the procedure was well tolerated.

Postoperatively, her calcium level was 7.9, with a preoperative calcium of 8.5. She had no Chvostek or Trousseau sign on postoperative examination and felt no irritability. She had some very mild hoarseness after the second operation but good phonation and was able to cough well. She was instructed on postoperative wound care, and it was discussed with her that she should have radioiodine ablation in several weeks when she becomes hypothyroid.

Plans are to discharge her home on oral Vicodin for pain and have her return to the office later in the week. Additional plans for outpatient ablation will be forthcoming.

Questions:

1.Please define the following:

lobectomy

intraoperative

postoperative

contralateral

bilateral

2. What is Thyroid Follicular Adenoma? How does it differ from Follicular Cancer?
3. What does \"well differentiated\" mean in this context?
4. Please define Chvostek sign and Trousseau sign.
5. Why are the surgeons concerned about her phonation?
6. Please describe radioiodine ablation. What is it and why is it used?

Solution

1. Lobectomy: It is the process where a lobe of an organ like thyroid is surgically removed.

Intraoperative: It is a process occurring during the course of the surgical operation.

Postoperative: It is a process occurring after the surgical operation.

Bilateral: It is related to the two sides or tumour affecting the two sides

2. Thyroid follicular adenoma is a benign form or tumour of the thyroid gland, while follicular cancer is a metastatic version of cancer which can spread to different locations from the primary site.

3. Well differentiated in this context mean that the cancerous cells resemble close to the normal thyroid cells.

4. Chvostek sign is a clinical sign of existing nerve hyperexcitability due to hypocalcemia or twitching of the facial muscles in response to the excitability of facial nerve.

Trousseau sign is a latent tetany caused when a sphygmanometer cuff is applied to the upper arm and inflated. It is caused within 4 minutes for this activity.

5. Phonation is the production of speech sounds from the larynx. The operation involves the removal of the thyroid gland which is close to the larynx and its associated nerves.

6. Radioiodine ablation is a procedure where the radioactive form of iodine is used to either scan or destroy the thyroid cells. RAI ablation treats hyperthyroidism and treatment of thyroid cancers.