Thyroid Nodules

Question 1

what are the four types of thyroid carcinoma?

Answer 1

papillary
follicular
medullary
anapaestic

Question 2

are most solitary thyroid nodules benign or malignant?

Answer 2

benign

Question 3

what investigations are done for a solitary thyroid nodule?

Answer 3

TSH

USS FNA

Question 4

on USS-FNA of a thyroid nodule, what does thy 1 mean?

Answer 4

inadequate sample

Question 5

on USS-FNA of a thyroid nodule, what does thy 2/U2 mean?

Answer 5

benign

Question 6

on USS-FNA of a thyroid nodule, what does thy 3/U3 mean?

Answer 6

atypical

Question 7

on USS-FNA of a thyroid nodule, what does thy 4/U4 mean?

Answer 7

probably malignant

Question 8

on USS-FNA of a thyroid nodule, what does thy 5/U5 mean?

Answer 8

malignant

Question 9

what makes a DTC low risk?

Answer 9

age <50

tumour <4cm

Question 10

how is a DTC managed in the low risk group?

Answer 10

thyroid lobectomy

Question 11

what makes a DTC high risk?

Answer 11

T3 or greater

Question 12

how is a DTC managed in the high risk group?

Answer 12

total thyroidectomy

Question 13

what staging systems can be used to predict the outcome of a DTC?

Answer 13

AMES

TNM

Question 14

what does it mean if a DTC is T1?

Answer 14

tumour size less than 2cm

Question 15

what does it mean if a DTC is T2?

Answer 15

tumour size 2-4cm

limited to the thyroid

Question 16

what does it mean if a DTC is T3

Answer 16

tumour size >4cm

limited to the thyroid/minimal extension

Question 17

what does it mean if a DTC is T4a?

Answer 17

moderately advanced

any size extending beyond the thyroid capsule

Question 18

what does it mean if a DTC is T4b?

Answer 18

very advanced disease

Question 19

what does it mean if a DTC is N0?

Answer 19

no lymph node mets

Question 20

what does it mean if a DTC is N1?

Answer 20

regional lymph node mets

Question 21

what does it mean if a DTC is N1a?

Answer 21

metastatis to near lymph nodes

Question 22

what does it mean if a DTC is N1b?

Answer 22

mets to further lymph nodes

Question 23

what does it mean if a DTC is M0?

Answer 23

no distant mets

Question 24

what does it mean if a DTC is M1?

Answer 24

there are distant mets

Question 25

what is the follow up for a DTC?

Answer 25

TSH and thyroglobulin measured bi-annually for 5 years then annually for the next 5

Question 26

what two cancers are considered to be DTC's?

Answer 26

papillary | follicular

Question 27

what is a tumour marker for DTC's?

Answer 27

thyroglobulin

Question 28

what are the two types of follicular thyroid carcinomas?

Answer 28

minimally invasive | widely invasive

Question 29

how does a follicular thyroid carcinoma spread?

Answer 29

haematogenous

Question 30

what type of follicular thyroid carcinoma is more common?

Answer 30

minimally invasive

Question 31

how is minimally invasive follicular thyroid carcinoma usually treated?

Answer 31

thyroid lobectomy

Question 32

what do patients with thyroid lymphoma usually have a history of?

Answer 32

autoimmune hypothyroidism

Question 33

how does thyroid lymphoma present?

Answer 33

rapid onset mass in the thyroid

Question 34

what is the typical patient with thyroid lymphoma?

Answer 34

female aged 70-80

Question 35

how is a thyroid lymphoma diagnosed?

Answer 35

core biopsy for histology

Question 36

what are the three stages of the treatment regime for thyroid lymphoma?

Answer 36

steroids R CHOP chemotherapy radiotherapy

Question 37

what is medullary thyroid carcinoma?

Answer 37

a tumour of the parafollicular cells

Question 38

what can be used as a tumour marker in medullary thyroid carcinoma?

Answer 38

calcitonin

Question 39

what are the three types of medullary thyroid carcinoma?

Answer 39

sporadic familial - non MEN familial - MEN

Question 40

which MEN is most commonly associated with medullary thyroid carcinoma?

Answer 40

MEN2a

Question 41

what should be checked if someone has medullary thyroid carcinoma and why?

Answer 41

urinary metanephrines and genetics look for MEN

Question 42

what should be considered if someone has MEN2?

Answer 42

prophylactic thyroidectomy as a child

Question 43

what is TSH like in multi nodular goitre?

Answer 43

usually normal/slightly supressed