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Endocrine > EXAM #1: THYROID CANCER > Flashcards

EXAM #1: THYROID CANCER Flashcards

1
Q

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

A 
Midline= thyroglossal duct cyst 
Lateral= cervical cyst
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2
Q

Where does the superior thyroid artery come from?

A

External carotid artery

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3
Q

Where does the inferior thyroid artery come from?

A

Thyrocervical trunk

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4
Q

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

A

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

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5
Q

Where does the Inferior thyroid vein drain?

A

Brachiaocephalic

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6
Q

Where do the superior and middle thyroid veins drain?

A

Internal jugular vein

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7
Q

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

A

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.

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8
Q

What does the recurrent laryngeal nerve innervate?

A

All intrinsic muscles of the larynx EXCEPT the cricothyroid muscle

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9
Q

Where does the recurrent laryngeal nerve lie?

A

tracheoesophageal groove

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10
Q

What is the differential diagnosis for a thyroid nodule?

A

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

*Note that most are NOT malignant

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11
Q

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

A

Radiation exposure

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12
Q

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

A

FNA

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

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13
Q

What information can you discern from a thyroid US?

A

1) Solid vs. cystic

2) Homogenous vs. heterogenous

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14
Q

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

A

Cold nodule

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15
Q

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

A

1) Papillary
2) Follicular
3) Hurthle Cell

*Followed with thyroglobulin and treated with radioactive iodine

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16
Q

What is the c-cell cancer?

A

Medullary Thyroid Cacner

17
Q

What is pathognomonic for papillary thyroid cancer?

A

Psammoma bodies

18
Q

What is Follicular Thyroid Cancer?

A

Neoplastic proliferation of thyroid follicles that invades the capsule

19
Q

How is follicular thyroid cancer spread?

A

Hematogenously

20
Q

Where does follicular thyroid cancer commonly metastasize?

A
  • Bone
  • Lung
  • Liver
  • CNS
21
Q

What is Hurtle Cell Cancer?

A

Variant of Follicular Thyroid Cancer

*Difficult to determine if benign or malignant via FNA

22
Q

What is Medullary Thyroid Cancer?

A

Malignant neuroendocrine tumor of parafollocular C-cells

23
Q

What are the markers for Medullary Thyroid Cancer?

A

Calcitonin

CEA

24
Q

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

A

1) Pheochromocytoma

2) Hyperparathyroidism

25
Q

What syndromes are associated with Medullary Thyroid Cancer?

A

MEN 2A and 2B

26
Q

Is medullary thyroid cancer response to radioactive iodine?

A

NO

27
Q

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

A

Calcitonin

28
Q

What are the clinical features of anaplastic thyroid cancer?

A
  • Rapidly enlarging
  • Painful
  • Symptomatic
29
Q

What is the primary treatment for anaplastic thyroid cancer?

A

Chemoradiation

30
Q

What is Thyroid Lymphoma?

A

Rare lymphoma that develops from the thyroid gland

31
Q

What is the treatment for thyroid lymphoma?

A

Chemoradiation

32
Q

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

A

Lobectomy

33
Q

What stage are all anaplastic carcinomas considered?

A

Stage IV–worst prognosis

34
Q

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

A

1) Papillary
2) Follicular
3) Medullary

35
Q

When is lymph node dissection warranted?

A

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

36
Q

What are the post-surgical complications of a thyroidectomy?

A

1) Hematoma
2) Nerve injury
3) Hypocalcemia

37
Q

What is Chovstek’s sign?

A

Tapping on the cheek causes spasm

38
Q

What is Troussseau’s sign?

A

Carpopedal spasm with BP cuff

39
Q

Should you give a patient thyroid hormone after thyroid surgery?

A

NO–send to an Endocrinologist

Endocrine (34 decks)

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