Thyroid

Question 1

what is the most common form of thyroid cancer

Answer 1

papillary

Question 2

what are the types of differentiated cancer

Answer 2

papillary and follicular

Question 3

what are differentiated thyroid cancers driven by

Answer 3

TSH

Question 4

what do differentiated thyroid cancers do

Answer 4

most take up iodine and secrete thyroiglobulin

Question 5

what is the greatest risk for thyroid cancre

Answer 5

neck irradiation

Question 6

how does papillary thyroid cancer spread

Answer 6

via lymphatics

haematogenous spread to lungs, bone, liver and brain

Question 7

what is papillary thyroid cancer associated with

Answer 7

hashimotos thyroiditis

Question 8

what increases the incidence of follicular thyroid cancer

Answer 8

iodine deficient areas

Question 9

how does follicular cancer spread

Answer 9

haematogenous

v rare for lymphatic spread

Question 10

How are potential cancers investigated

Answer 10

ultrasound guided FNA

Question 11

what does cAMP do to T3 and T4

Answer 11

INCREASES PRODUCTION AND RELEASE OF t3 AND t4

Question 12

HLA associated with hasmimotos thyroiditis

Answer 12

DR3 and DR5

Question 13

which cells may indicate destruction of thyroid epithelium

Answer 13

CD8 cells

Question 14

genes involved in hashimotos thyroiditis

Answer 14

CTLA-4 a negative regulator of Tcell response

PTPN-22 which inhibits T cell function

Question 15

what are you at increased risk of with Hashimotos thyroiditis

Answer 15

B cell NHL

Question 16

what makes it a follicular carcinoma rather than a follicular adenoma

Answer 16

vascular or capsular invasion makes it a carcinoma

Question 17

what does a sporadic case of medullary thyroid cancer look like

Answer 17

sporadic cases are a solitary nodule

Question 18

familial cases of medullary thyroid cancer

Answer 18

bilateral/multicentric, C cell hyperplasia

Question 19

cells in medullary throid cancer

Answer 19

composed of spindle or polygonal cells, arranged in nests, trabeculae or follicles

Question 20

MTC associated with deposition of what

Answer 20

amyloid deposition

Question 21

other features of sporadic cases of MTC

Answer 21

neck mass with local effecs -dysphagia, hoarseness, airway compromise
paraneoplastic syndrome-diarrhoea-VIP production
Cushings ACTH production

Question 22

parathyroid is composed of what type of cells

Answer 22

chief cells

Question 23

what are the chief cells of the parathyroid supported by

Answer 23

oxyphil cells

Question 24

what are some cardia problems associated with hypothyroidism

Answer 24

reduced heart rate
cardiac dilatation
pericardial effusion
worsening of heart failure

Question 25

respiratory symptoms associated with hypo

Answer 25

depp hoarse voice macroglossia obstructive sleep apnoea

Question 26

what is carpal tunnel associated with

Answer 26

hypothyroidism

Question 27

how does hypothyroid affect prolactin

Answer 27

hyperprolactinaemia, increased TRH causes increased prolactin secretion

Question 28

laboratory results in hypothyroidism

Answer 28

``` macrocytosis-rule out a concurrent vitamin B12 deficiency increase in CK increase in LDL cholesterol hyPOnatreamia hyPERprolacitnaemia increase in TSH and decrease in T3.T4 ```