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Year 2 MBChB Endocrine > Neck Lumps > Flashcards

Neck Lumps Flashcards

1
Q

What are the two types of goitre + what is the most common cause of goitre?

A

Diffuse
Multinodular
Iodine deficiency

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2
Q

What is the TSH and T3/T4 level in goitre?

A

High TSH

Normal T3/4

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3
Q

What is multi-nodular goitre caused by?

A

Hyperplasia due to long term goitre

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4
Q

What are the 2 risks of multi nodular goitre?

A

Hyperthyroidism

Malignancy

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5
Q

Do a CT scan in MNG to check for what 2 things?

A

Retrosternal extension

Tracheal compression

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6
Q

MNG may have what type of lesion?

A

Dominant nodule

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7
Q

Name 5 tests for thyroid lumps.

A 
US
TSH
FNA
Core biopsy
Laryngoscopy
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8
Q

US scored from U2-U5 with 2 being … and 5 being …?

A

Benign

Malignant

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9
Q

FNA scored from Thy2-Thy5 with 2 being … and 5 being …?

A

Benign

Malignant

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10
Q

Follicular lesions are always scored … on the Thy score?

A

Thy 3

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11
Q

Most common benign thyroid lump?

A

Follicular adenoma

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12
Q

What is a follicular adenoma + solitary/multifocal + functional/non-functional?

A

Neoplastic thyroid follicles with collagen capsule
Solitary
Non-functional

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13
Q

Name the the 2 mutations of the TSHR linked to follicular adenoma.

A

Ras

PIK3CA

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14
Q

Thyroid cancer is associated with … and … and is more common in men/women?

A

Ionising radiation
Iodine deficiency
Women

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15
Q

Name 5 AMES red flags of malignant thyroid disease.

A 
Age < 20 or > 50
Increasing size
> 4 cm
History of radiation
Vocal nerve palsy
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16
Q

Name 4 types of thyroid cancer + what cells they arise from + which is the most common?

A

Papillary, follicular (MOST COMMON)
Follicular, follicular
Medullary, parafollicular
Anaplastic, follicular

17
Q

Are papillary tumours solitary or multifocal + type of spread?

A

Multifocal

Lymph and haematogenous spread

18
Q

2 mutations associated with papillary thyroid tumours?

A

PET/PTC

BRAF

19
Q

Papillary thyroid tumours can be c…. and c…. and are seen with …. bodies?

A

Cystic
Calcified
Psammoma

20
Q

Name 2 causes of papillary thyroid tumours?

A

Ionising radiation

Hashimoto’s thyroiditis

21
Q

What is the prognosis for papillary thyroid tumours?

A

Good

22
Q

What is the treatment for thyroid tumours + non-surgical option if cancer persists?

A

Lobectomy or total thyroidectomy + radioioidine

Thyroid remnant ablation

23
Q

Are follicular carcinomas solitary or multifocal + key mutation + type of spread?

A

Solitary
PAX8-PPAR
Haematogenous

24
Q

What is follicular carcinoma associated with?

A

Iodine deficiency

25
Q

Prognosis of follicular carcinomas depends on?

A

Degree of capsular invasion

26
Q

What do medullary carcinomas secrete?

A

Calcitonin

27
Q

Name 2 paraneoplastic syndromes associated with medullary carcinoma + the hormones?

A 
Diarrhoea = VIP
Cushing's = ACTH
28
Q

Sporadic and familial medullary carcinoma are seen in … people whereas … cases are linked to …?

A

Older

MEN 2

29
Q

Sporadic medullary carcinoma is usually … and familial is ….?

A

Solitary

Bilateral/multicentric

30
Q

Name a type of cell + a deposition molecule associated with medullary carcinoma.

A

Spindle cell

Amyloid

31
Q

Anaplastic carcinoma is seen in what age group with what history?

A

Older

Thyroid cancer

32
Q

What type of care is needed for anaplastic carcinoma + why?

A

Palliative

Poorly differentiated cancer so very aggressive

33
Q

What 2 tests are done post-thyroid surgery and what are they looking for?

A

Serum Ca = Ca < 2 mmol/l

Iodine body scan = cancer cells

34
Q

When does T4 and T3 need to be stopped before an iodine body scan?

A 
T4 = 4 weeks
T3 = 2 weeks

Year 2 MBChB Endocrine (14 decks)

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