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Flashcards in Endocrine (NMS) Deck (17):
1

What type of thyroid cancer is most commonly seen in someone with a history of neck radiation?

Papillary

2

What is first step in thyroid nodule evaluation?

FNA

3

Psammoma bodies

Associated with papillary carcinoma

4

What is the most type of thyroid cancer?

Papillary carcinoma. Better prognosis

5

Amyloid deposits are associated with what type of thyroid cancer?

Medullary thyroid cancer; highly malignant. Hyperplasia of parafollicular C cells -> high calcitonin.

6

Serious complications of thyroid surgery

Injury to recurrent laryngeal nerve. Devascularization of all 4 parathyroid glands -> hypocalcemia

7

Treatment of papillary cancer

If had prior radiation -> total thyroidectomy. If no previous radiation to neck, can do total thyroidectomy or lobectomy/isthmusectomy. Advantage of total is that thyroglobulin can be used as tumor marker thereafter

8

Treatment of follicular cancer

Lobectomy/isthmusectomy for well-circumbscribed lesion. If > 4cm microinvasive OR > 1 cm invasive -> total thyroidectomy

9

Papillary cancer mets via

Lymph nodes

10

Follicular cancer mets via

Hematogenous

11

Adjuvant post-op tx for papillary and follicular cancer

TSH suppression with thyroid hormone; possibly iodine ablation. NB: this is not used for medullary b/c that is a problem with parafollicular cells

12

Clear indications for surgery in asymptomatic hyperPTH due to parathyroid adenoma

Serum Ca > 11.5 mg/dl, age

13

Surgical treatment of secondary or tertiary hyperPTH

Usually medical management alone unless *bone pain, fractures, intractable pruritus, or soft tissue calcium deposits*. Then you take out all but 50 mg of parathyroid and implant that in the forearm

14

MEN1

parathyroid hyperplasia, pancreatic tumors, pituitary tumors

15

MEN2A

parathyroid hyperplasia, pheochromocytoma, medullary thyroid carcinoma

16

MEN2B

Medullary thyroid carcinoma, pheochromocytoma, mucosal neuromas/ Marfanoid habitus

17

Workup of adrenal mass

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