clinical thyroid disease - thyroid tumours and goitre Flashcards
What are physiological causes of goitre
Puberty
Pregnancy
What are the autoimmune causes of goitre
Grave’s disease - hyperthyroidism
Hashimoto’s disease - Hypothyroidism
What are the less common causes of goitre
Thyroiditis
Iodine deficiency
Dyshormonogenesis
Goitrogens
What are goitrogens
Hormones which interfere with the function of the thyroid gland
What are the different types of goitre
Multinodular
Diffuse
Cysts
Tumours - adenoma, carcinoma and lymphoma
Sarcoidosis and TB
What does a solitary nodule on the thyroid usually mean
Malignancy
Who is at risk of thyroid malignancy
Children
Adults less than 30 or over 60
Previous radiotherapy in the head and neck to destroy cancer cells
Large dominant nodule in multi nodular goitre
What is head and neck irradiation
Radiotherapy to head and neck to destroy cancer cells
What investigations are done when a solitary thyroid nodule
TFT - thyroid function test
Ultrasound - good for looking if it is benign or malignant
Fine needle aspiration
What is a papillary thyroid cancer
The most common type which is multifocal and spread to lymph nodes
Good prognosis
What is a follicular thyroid cancer
Single lesion usually - metastases to lung and bone
Good prognosis if resectable
What is the management for thyroid cancer
Near total thyroidectomy
High dose radioiodine
Suppresive doses of thyroxine given longterm
What is the follow up to thyroid cancer treatment
Thyroglobulin - if it is raised after thyroid gland has been removed or suppressed, means that there is probable suspicion of a thyroid tumour
What is anaplastic thyroid cancer
Aggressive and locally invasive with a poor prognosis and doesn’t respond to radioiodine
Less common
What is lymphoma thyroid cancer
Rare - can come from hashimotos thyroiditis
External radiotherapy combined with chemotherapy is helpful
