9: Differentiated thyroid cancer Flashcards Preview

Endocrine Week 3 2017/18 > 9: Differentiated thyroid cancer > Flashcards

Flashcards in 9: Differentiated thyroid cancer Deck (41)
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1

Rank the types of thyroid cancer from most common to least common.

Papillary (absolutely most common)

Follicular

Medullary (C cells)

Anaplastic (killer)

2

Papillary and follicular thyroid cancers are described as ___.

differentiated

3

Differentiated thyroid cancers secrete ___ and take up ___.

secrete thyroglobulin (used as a tumour marker)

take up iodine (so iodine can be used to both investigate and kill the cancer)

4

Which hormone drives papillary and follicular thyroid cancer?

TSH

5

Differentiated thyroid cancers have a (good / bad) prognosis.

good prognosis

6

Thyroid cancer is more common in (males / females).

females

7

Thyroid cancer is strongly associated with exposure to what?

Radiation

8

Thyroid cancer incidence increases following what type of accidents?

Nuclear incidents

e.g Chernobyl, Fukushima

www.theguardian.com/world/2014/mar/09/fukushima-children-debate-thyroid-cancer-japan-disaster-nuclear-radiation

9

How long does it take for thyroid cancer to develop following nuclear incidents?

4 years - several decades

10

What is found on thyroid examination in the majority of thyroid cancers?

Palpable nodules

11

Thyroid cancer is a chance finding following what procedure?

Thyroidectomy

for say hyperthyroidism secondary to Graves disease

12

What is the most common type of thyroid cancer?

Papillary

13

Papillary thyroid cancer spreads via which system?

Lymphatic system

14

Papillary thyroid cancer is associated with what type of thyroiditis?

Hashimoto's thyroiditis

15

Follicular thyroid cancer tends to spread how?

Haematogenously

16

How are suspected thyroid cancers investigated?

Ultrasound-guided FNA

17

How is thyroid cancer initially treated?

Surgery

18

What are the surgical options for treating thyroid cancer?

Lobectomy (including the isthmus)

Sub-total thyroidectomy

Total thyroidectomy

19

Why isn't lobectomy commonly carried out anymore?

Leaves half the thyroid intact, skewing thyroid function tests, drug doses etc.

20

Depending on the risk calculated following surgery, what treatment is added on for thyroid cancer?

Thyroid remnant ablation (TRA)

using radioiodine

21

Which risk stratification tool is used post-op in thyroid cancer?

AMES system

Age, Metastases, Extent of primary tumour, Size of primary tumour

22

The AMES system divides post-op thyroid cancer patients into which two groups?

Low risk (cancer is/was confined to the thyroid)

High risk (spread outwith the thyroid)

23

Which group of patients receive radioactive iodine treatment post-op?

High risk patients

24

In which type of cancer would lymph node surgery be considered in addition to surgery and TRA?

Papillary

because it tends to spread lymphatically

25

Why can patients become hypocalcaemic following thyroid surgery?

Removal of parathyroid glands

26

Following thyroid surgery, what drug are patients discharged with?

Thyroxine tablets

Calcium / recombinant PTH if parathyroids removed

27

What test is carried out 3-6 months post-op to detect remnants of thyroid cancer?

Whole body iodine scanning

to check for metabolically active cells, i.e cancer

28

What needs to be elevated before a patient recieves a whole body iodine scan?

TSH

to stimulate the metabolism of the cancer cells so they show up on the scan

29

How are a patient's TSH levels raised prior to their whole body iodine scan?

Stop taking their thyroxine for 2-4 weeks (produces hypothyroid symptoms)

rhTSH injections (don't need to stop thyroxine, but very expensive)

30

If thyroid cancer is still active following surgery, what treatment is given to patients?

Thyroid remnant ablation

using radioactive iodine