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

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

A

Papillary

2
Q

What is first step in thyroid nodule evaluation?

A

FNA

3
Q

Psammoma bodies

A

Associated with papillary carcinoma

4
Q

What is the most type of thyroid cancer?

A

Papillary carcinoma. Better prognosis

5
Q

Amyloid deposits are associated with what type of thyroid cancer?

A

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

6
Q

Serious complications of thyroid surgery

A

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

7
Q

Treatment of papillary cancer

A

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
Q

Treatment of follicular cancer

A

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

9
Q

Papillary cancer mets via

A

Lymph nodes

10
Q

Follicular cancer mets via

A

Hematogenous

11
Q

Adjuvant post-op tx for papillary and follicular cancer

A

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
Q

Clear indications for surgery in asymptomatic hyperPTH due to parathyroid adenoma

A

Serum Ca > 11.5 mg/dl, age

13
Q

Surgical treatment of secondary or tertiary hyperPTH

A

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
Q

MEN1

A

parathyroid hyperplasia, pancreatic tumors, pituitary tumors

15
Q

MEN2A

A

parathyroid hyperplasia, pheochromocytoma, medullary thyroid carcinoma

16
Q

MEN2B

A

Medullary thyroid carcinoma, pheochromocytoma, mucosal neuromas/ Marfanoid habitus

17
Q

Workup of adrenal mass

A