Feb5 M1-Thyroid Nodules Flashcards Preview

Bloc E - GI & Metabolism > Feb5 M1-Thyroid Nodules > Flashcards

Flashcards in Feb5 M1-Thyroid Nodules Deck (24)
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1
Q

thyroid cancer most common in who

A

women between 20 and 50 yrs of age

2
Q

when to workup thyroid nodules (ultrasound and biopsy) EXAM (2)

A
  1. size ­­above 1.5 cm

2. size less than 1.5 cm but family history or been exposed to radiation

3
Q

thyroid nodule workup: what is done EXAM (3)

A

ultrasound, ultrasound guided biopsy, molecular testing eventually

4
Q

treatment of thyroid cancer EXAM (2)

A
  1. surgery

2. consider radioactive iodine if aggressive mass

5
Q

2 things to be careful about in thyroid surgery

A
  1. don’t hit recurrent laryngeal nerve

2. don’t remove parathyroid glands (will be fine with one of 4 though)

6
Q

epi charact of thryoid cancer that’s important

A

cancer with most rapidly increasing incidence rate

7
Q

ddx of thyroid mass and %

A
  • benign (95%): adenoma or multinodular goitre

- malignant (5%)

8
Q

history and physical in thyroid nodule patient

A

family history, weight loss, trouble swallowing, hoarse voice, exposure to radiation

9
Q

most common benign thyroid tumor

A

adenoma

10
Q

most common malignant thyroid cancer and % of malignant thyroid cancers it represents EXAM

A

papillary thyroid CA. 80%.

11
Q

2nd most common thyroid malignant cancer and other name for it

A

follicular thyroid CA. Also clled Hurthle cell CA.

12
Q

3rd most common thyroid malignant cancer and associated with what

A

medullary thyroid carcinoma.

associated with MEN syndrome Type 2A and type 2B (multiple endocrine neoplasia)

13
Q

4th most common thyroid malignant cancer and characteristics

A

anaplastic carcinoma. very aggressive. cells go crazy, it’s a mush.

14
Q

other things than 4 first carcinomas on thyroid nodule ddx

A

lymphoma, metastasis

+TB as general internal med differential

15
Q

things that differentiate carcinoma from adenoma

A

CA has angioinvasion (vessels) + extracapsular spread (not enclosed in a capsule)

16
Q

prognoses of the diff thyroid CAs

A

papillary: good
follicular: good
medullary: sometimes good sometimes bad
anaplastic: very bad. no one survives

17
Q

marker of medullary carcinoma

A

calcitonin levels (from parafollicular or C cells)

18
Q

ultrasound cancer vs not cancer in thyroid

A

black=cancer
white=not cancer
grey=not sure

19
Q

problem with biopsies

A

20% are indeterminate (can’t know if it’s cancer)

20
Q

proportion of grey on US that turns out to be thyroid cancer

A

33%

21
Q

2 treatment options (2 methods) if couldn’t know if it’s thyroid cancer + how changed today

A
  1. surgery just in case
  2. US + biopsy every 6 months
    Now have molecular testing for genes
22
Q

most common and most aggressive mutation in thyroid cancer + its kind of thyroid cancer

A

BRAF. in papillary thyroid cancer

23
Q

treatment of thyroid CA with BRAF mutation (papillary)

A

surgery + radiation bc it’s aggressive (malignant)

24
Q

mutations found in more than 70% of thyroid CAs

A

BRAF and RAS point mutations

RET/PTC rearrangements

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