What are the two main types of thyroid nodule?
Solitary thyroid nodule
The vast majority of solitary thyroid nodules are ___.
Who tends to develop thyroid nodules?
What is the most common type of malignant thyroid nodule?
Papillary thyroid carcinoma
Papillary and ___ thyroid carcinomas are malignant epithelial tumours.
papillary and follicular
What is a malignant cancer of the parafollicular cells of the thyroid?
Medullary thyroid carcinoma
Which fascial layer contains the thyroid?
What happens to the thyroid when you swallow?
Moves up and down along with the larynx
Nodules should move up and down as well
Thyroid nodules are usually (painful / painless).
When would a thyroid nodule be painful?
Usually bleeding into a cyst > expansion > nerve compression
What two questions must be asked on history of a thyroid lump?
Family history of thyroid cancer?
helps differentiate between benign and malignant
What two signs must be checked for on examination of a thyroid lump?
Enlarged lymph nodes
papillary spreads via lymph, follicular haematogenously
recurrent laryngeal nerve palsy - can be eroded by cancer
What are two important investigations for someone presenting with a neck lump?
usually normal, suppressed in hypothyroidism, solitary toxic adenoma
Ultrasound - Fine Needle Aspiration
How are thyroid nodules investigated?
Thyroid function test for TSH
Ultrasound-guided fine needle aspiration for biopsy
What classification systems are used to describe thyroid nodules viewed by
a) FNA - Thy 1 to 5
b) Ultrasound - U1 to U5
What else can ultrasound scanning pick up?
What are the two surgical options for solitary thyroid nodules?
When is lobectomy advised?
Low risk group:
Aged < 50, tumour < 4cm
When is total thyroidectomy advised?
High risk patients:
Age > 50, tumour > 4cm, TSH low
What common staging system can be used to stage thyroid cancer?
Following treatment of a thyroid cancer, what is the ideal TSH level?
Lower range of normal
You don't want thyroid to be too metabolically active
What is used as a marker for differentiated thyroid cancer activity after treatment?
Diagnosis of follicular thyroid carcinoma depends on what?
Invasion of thyroid capsule
How does follicular thyroid carcinoma spread?
Most follicular thyroid carcinomas are (invasive / minimally invasive).
What percentage of women are on thyroxine for autoimmune hypothyroidism?
What type of thyroid nodule can occur in women as a conseqeuence of long term thyroxine use?
Thyroid lymphomas have an (insidious / rapid) onset.
How are thyroid lymphomas treated?
Medullary thyroid carcinoma is a malignant cancer of the C cells which produce ___.