Thyroid Nodules Flashcards Preview

Jason's MD2 ED/Amb Rotation > Thyroid Nodules > Flashcards

Flashcards in Thyroid Nodules Deck (23):
1

when should you do FNA for thyroid?

increase blood flow on doppler
fhx
more than 1cm size
microcalcifications
past radiation exposure
hoarse voice

2

what thyroid cancer do you get with radiation?

follicular thyroid cancers

3

possible outcomes of thyroid FNA?

0
1-non-diagnostic
2-benign
3-follicular lesion, undetermined significance (5-10% malignant)
4- follicular neoplasm (20-30% malignant)
5 - suspicious for malignancy (50-75% of malignancy)
6- malignant

4

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

5

after dx of thyroid malignancy, what to do?

examine neck
ultrasound to stage it

if lymph node positive, you do FNA

6

lymph node for thyroid after FNA, request for what?

cytology
thyroglobulin

7

CT of thyroid, what not to give? why?

don't give contrast

may saturate thyroid cells, may need radiopharma

8

when do total thyroidectomy?

>1cm nodule

9

when do hemi-thyroidectomy?

10

multifocal and bilateral type of thyroid cancer?

papillary thyroid carcinoma

11

most common place for thyroid mets?

level 6 and 7, para tracheal or central lymphnodes

12

adjunctive Rx of thyroid cancer

radioactive iodine
thyroxine (aim to suppress TSH

13

long term TSH suppression risks?

osteoporosis
arrythmias/AF

14

survival rate for thyroid cancers?

98% at 20 years

15

what to ask history of someone with thyroid lump?

pressure symptoms
dysphagia
pain
breathing difficulties

16

when operate if someone with multi-nodular goitres?

operate if symptomatic
if cancer
if big or increasing in size
retrosternal extension

17

what is a significant change in thyroid nodule size?

increase volume by 50%
>20% in nodule dimension

18

hyperthyroid/thyrotoxicosis in someone with a single nodule?

Grave's
toxic nodule

19

toxic nodule nuclear medicine scan see what?

nodule: increase uptake
suppressed other parts of thyroid

20

grave's disease nuclear medicine scan see what?

diffuse uptake of thyroid

21

treatment options for toxic nodule? recommended

meds
surg
radioactive iodine (recommended)

22

med treatments for toxic thyroid nodule? cure?

carbimazole
propylthiouracil

not cure, good useful as short term measure

23

if you get an abnormal thyroid function? what tests to do next?

TFT repeat
anti-thyroid antibodies
thyroid ultrasound

AntiTPO
antithyroid globulin