EXAM #1: THYROID CANCER Flashcards Preview

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Flashcards in EXAM #1: THYROID CANCER Deck (39):
1

What is the difference between a tyroglossal duct cyst and a cervical cyst?

Midline= thyroglossal duct cyst
Lateral= cervical cyst

2

Where does the superior thyroid artery come from?

External carotid artery

3

Where does the inferior thyroid artery come from?

Thyrocervical trunk

4

What is a potential complication of a tracheostomy that results in excessive bleeding?

Transsection of a "Thyroid ima artery" that runs along the anterior trachea

5

Where does the Inferior thyroid vein drain?

Brachiaocephalic

6

Where do the superior and middle thyroid veins drain?

Internal jugular vein

7

What nerve do you need to be especially conscious of when performing a thyroidectomy?

Recurrent laryngeal nerve of the vagus

*Most common is Injury to the external branch of the superior laryngeal nerve--not a big deal. Most dreaded is injury to the recurrent laryngeal bilaterally.

8

What does the recurrent laryngeal nerve innervate?

All intrinsic muscles of the larynx EXCEPT the cricothyroid muscle

9

Where does the recurrent laryngeal nerve lie?

tracheoesophageal groove

10

What is the differential diagnosis for a thyroid nodule?

1) Cyst
2) Thyroid adenoma
3) Infection/ thyroiditis
4) Developmental abnormality
5) Carcinoma
6) Thyroid lymphoma

*Note that most are NOT malignant

11

What is an important historical feature to ask patients about when taking a thyroid related history?

Radiation exposure

12

What is the most reliable and cost effective method for diagnosing thyroid nodules? When is this absolutely indicated?

FNA

*Note that this is indicated for any nodule greater than 1 cm; less than 1 cm is less clear

13

What information can you discern from a thyroid US?

1) Solid vs. cystic
2) Homogenous vs. heterogenous

14

If a radionuclear scan of the thyroid is performed, which is more likely to be malignant--hot or cold nodule?

Cold nodule

15

What are the differentiated thyroid cancers? How are these followed and treated?

1) Papillary
2) Follicular
3) Hurthle Cell

*Followed with thyroglobulin and treated with radioactive iodine

16

What is the c-cell cancer?

Medullary Thyroid Cacner

17

What is pathognomonic for papillary thyroid cancer?

Psammoma bodies

18

What is Follicular Thyroid Cancer?

Neoplastic proliferation of thyroid follicles that invades the capsule

19

How is follicular thyroid cancer spread?

Hematogenously

20

Where does follicular thyroid cancer commonly metastasize?

- Bone
- Lung
- Liver
- CNS

21

What is Hurtle Cell Cancer?

Variant of Follicular Thyroid Cancer

*Difficult to determine if benign or malignant via FNA

22

What is Medullary Thyroid Cancer?

Malignant neuroendocrine tumor of parafollocular C-cells

23

What are the markers for Medullary Thyroid Cancer?

Calcitonin
CEA

24

What do you need to screen for in patients with Medullary Thyroid Cancer?

1) Pheochromocytoma
2) Hyperparathyroidism

25

What syndromes are associated with Medullary Thyroid Cancer?

MEN 2A and 2B

26

Is medullary thyroid cancer response to radioactive iodine?

NO

27

What do you need to measure after surgery for medullary thyroid cancer?

Calcitonin

28

What are the clinical features of anaplastic thyroid cancer?

- Rapidly enlarging
- Painful
- Symptomatic

29

What is the primary treatment for anaplastic thyroid cancer?

Chemoradiation

30

What is Thyroid Lymphoma?

Rare lymphoma that develops from the thyroid gland

31

What is the treatment for thyroid lymphoma?

Chemoradiation

32

If a thyroid tumor is less than 1 cm in size, what surgical procedure should be performed?

Lobectomy

33

What stage are all anaplastic carcinomas considered?

Stage IV--worst prognosis

34

What are the best relative 5-year survival rates for the thyroid cancers?

1) Papillary
2) Follicular
3) Medullary

35

When is lymph node dissection warranted?

Grossly positive nodes on physical exam or imaging--no consensus otherwise

36

What are the post-surgical complications of a thyroidectomy?

1) Hematoma
2) Nerve injury
3) Hypocalcemia

37

What is Chovstek's sign?

Tapping on the cheek causes spasm

38

What is Troussseau's sign?

Carpopedal spasm with BP cuff

39

Should you give a patient thyroid hormone after thyroid surgery?

NO--send to an Endocrinologist