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Y2 Endocrine > Thyroid Nodules > Flashcards

Thyroid Nodules Flashcards

1
Q

what are the four types of thyroid carcinoma?

A

papillary
follicular
medullary
anapaestic

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2
Q

are most solitary thyroid nodules benign or malignant?

A

benign

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3
Q

what investigations are done for a solitary thyroid nodule?

A

TSH

USS FNA

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4
Q

on USS-FNA of a thyroid nodule, what does thy 1 mean?

A

inadequate sample

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5
Q

on USS-FNA of a thyroid nodule, what does thy 2/U2 mean?

A

benign

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6
Q

on USS-FNA of a thyroid nodule, what does thy 3/U3 mean?

A

atypical

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7
Q

on USS-FNA of a thyroid nodule, what does thy 4/U4 mean?

A

probably malignant

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8
Q

on USS-FNA of a thyroid nodule, what does thy 5/U5 mean?

A

malignant

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9
Q

what makes a DTC low risk?

A

age <50

tumour <4cm

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10
Q

how is a DTC managed in the low risk group?

A

thyroid lobectomy

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11
Q

what makes a DTC high risk?

A

T3 or greater

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12
Q

how is a DTC managed in the high risk group?

A

total thyroidectomy

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13
Q

what staging systems can be used to predict the outcome of a DTC?

A

AMES

TNM

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14
Q

what does it mean if a DTC is T1?

A

tumour size less than 2cm

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15
Q

what does it mean if a DTC is T2?

A

tumour size 2-4cm

limited to the thyroid

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16
Q

what does it mean if a DTC is T3

A

tumour size >4cm

limited to the thyroid/minimal extension

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17
Q

what does it mean if a DTC is T4a?

A

moderately advanced

any size extending beyond the thyroid capsule

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18
Q

what does it mean if a DTC is T4b?

A

very advanced disease

19
Q

what does it mean if a DTC is N0?

A

no lymph node mets

20
Q

what does it mean if a DTC is N1?

A

regional lymph node mets

21
Q

what does it mean if a DTC is N1a?

A

metastatis to near lymph nodes

22
Q

what does it mean if a DTC is N1b?

A

mets to further lymph nodes

23
Q

what does it mean if a DTC is M0?

A

no distant mets

24
Q

what does it mean if a DTC is M1?

A

there are distant mets

25
Q

what is the follow up for a DTC?

A

TSH and thyroglobulin measured bi-annually for 5 years then annually for the next 5

26
Q

what two cancers are considered to be DTC’s?

A

papillary

follicular

27
Q

what is a tumour marker for DTC’s?

A

thyroglobulin

28
Q

what are the two types of follicular thyroid carcinomas?

A

minimally invasive

widely invasive

29
Q

how does a follicular thyroid carcinoma spread?

A

haematogenous

30
Q

what type of follicular thyroid carcinoma is more common?

A

minimally invasive

31
Q

how is minimally invasive follicular thyroid carcinoma usually treated?

A

thyroid lobectomy

32
Q

what do patients with thyroid lymphoma usually have a history of?

A

autoimmune hypothyroidism

33
Q

how does thyroid lymphoma present?

A

rapid onset mass in the thyroid

34
Q

what is the typical patient with thyroid lymphoma?

A

female aged 70-80

35
Q

how is a thyroid lymphoma diagnosed?

A

core biopsy for histology

36
Q

what are the three stages of the treatment regime for thyroid lymphoma?

A

steroids
R CHOP chemotherapy
radiotherapy

37
Q

what is medullary thyroid carcinoma?

A

a tumour of the parafollicular cells

38
Q

what can be used as a tumour marker in medullary thyroid carcinoma?

A

calcitonin

39
Q

what are the three types of medullary thyroid carcinoma?

A

sporadic
familial - non MEN
familial - MEN

40
Q

which MEN is most commonly associated with medullary thyroid carcinoma?

A

MEN2a

41
Q

what should be checked if someone has medullary thyroid carcinoma and why?

A

urinary metanephrines and genetics

look for MEN

42
Q

what should be considered if someone has MEN2?

A

prophylactic thyroidectomy as a child

43
Q

what is TSH like in multi nodular goitre?

A

usually normal/slightly supressed

Y2 Endocrine (33 decks)

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