Flashcards in Thyroid Nodules Deck (23)
when should you do FNA for thyroid?
increase blood flow on doppler
more than 1cm size
past radiation exposure
what thyroid cancer do you get with radiation?
follicular thyroid cancers
possible outcomes of thyroid FNA?
3-follicular lesion, undetermined significance (5-10% malignant)
4- follicular neoplasm (20-30% malignant)
5 - suspicious for malignancy (50-75% of malignancy)
if you have category 4 follicular neoplasm of thyroid: what to do after?
check TSH levels
low - non functioning: surg, high functioning: observe
normal - surgery
after dx of thyroid malignancy, what to do?
ultrasound to stage it
if lymph node positive, you do FNA
lymph node for thyroid after FNA, request for what?
CT of thyroid, what not to give? why?
don't give contrast
may saturate thyroid cells, may need radiopharma
when do total thyroidectomy?
when do hemi-thyroidectomy?
multifocal and bilateral type of thyroid cancer?
papillary thyroid carcinoma
most common place for thyroid mets?
level 6 and 7, para tracheal or central lymphnodes
adjunctive Rx of thyroid cancer
thyroxine (aim to suppress TSH
long term TSH suppression risks?
survival rate for thyroid cancers?
98% at 20 years
what to ask history of someone with thyroid lump?
when operate if someone with multi-nodular goitres?
operate if symptomatic
if big or increasing in size
what is a significant change in thyroid nodule size?
increase volume by 50%
>20% in nodule dimension
hyperthyroid/thyrotoxicosis in someone with a single nodule?
toxic nodule nuclear medicine scan see what?
nodule: increase uptake
suppressed other parts of thyroid
grave's disease nuclear medicine scan see what?
diffuse uptake of thyroid
treatment options for toxic nodule? recommended
radioactive iodine (recommended)
med treatments for toxic thyroid nodule? cure?
not cure, good useful as short term measure