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ACR 2: Fatigue > Hypothyroidism > Flashcards

Flashcards in Hypothyroidism Deck (13)
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1

Are most thyroid nodules are benign or cancerous?

Benign ~70%

2

what are the most common types of noncancerous thyroid nodules?

how does it show up on a

benign adenoma

3

what is the most common cause of multiple nodules

Hashimoto's

4

4 types of thyroid CA

who is at greatest risk?

Papillary: most common, most curable
Follicular: similar to papillary
Medullary (↑calcitonin levels, 60-70% cure rate)
Anaplastic (lethal form)

(<30 & >60 y.o. greatest risk)

5

Risk for thyroid CA

Radiation exposure during childhood

Rapid growth of a nodule

hoarseness, vocal cord paralysis, dysphagia

FHx of thyroid CA or multiple endocrine neoplasia syndrome

6

what PE exams would you perform on a thyroid nodule?

Gland: size, consistency, number
Solitary, hard, irregular and fixed = malignant

Lymph nodes: same side

7

What are the guidelines for thyroid biopsy

Biopsy nodules > 1-1.5cm

↑risk hx: biopsy any thyroid nodule > 5 mm in diameter w/ suspicious features

Enlarged cervical lymph nodes

8

What may be included in a thyroid nodule workup?

TSH
US
Biopsy
RAIU

9

What are thyroid CA features?

Microcalcifications
hypoechoic
infiltrative margins
↑vascularity

10

What are biopsy indications

Biopsy nodules > 1-1.5cm

↑risk hx: biopsy any thyroid nodule > 5 mm in diameter w/ suspicious features

Enlarged cervical lymph nodes

11

What TSH value indicates RAIU should be performed?

low TSH

12

what do the following RAIU results mean?

Hot = More likely to be autonomous → Rarely CA

Warm = Taking up iodine

Cold = Does not take up iodine

13

Tx: After bx...

CA: Thyroidectomy

Benign: Monitor at least annually w/ US and TSH testing

Symptomatic: Consider thyroidectomy