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Flashcards in Thyroid Nodules Deck (22)
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1

What are the two main classifications of nodule?

Solitary Thyroid Nodule
Multinodular goitre

2

The vast majority of Solitary Thyroid Nodules are benign. TRUE/FALSE?

TRUE

3

What benign pathologies can present as a solitary thyroid nodules?

Cyst
Colloid Nodule
Benign Follicular adenoma
Hyperplastic Nodule

4

5% of solitary thyroid nodules are malignant. Give examples of what pathologies could cause this

PAPILLARY THYROID CARCINOMA – 80%
Follicular Thyroid Carcinoma
Medullary Thyroid Carcinoma

5

If a solitary nodule moves on swallowing where is it sitting?

Invested in Pre-tracheal fascia

6

If a patient presents with a painful solitary nodule, what is thought to cause this?

intra thyroidal into a cyst

7

What should be asked about in the patients history to determine possible causes of the solitary nodule?

- Previous Neck irradiation
- FHx of thyroid Cancer

8

What should be checked on examination of a solitary thyroid nodule?

- Neck nodes
- Hoarseness

9

What investigations are carried out on investigation of a solitary thyroid nodule?

- TSH
- Ultrasound +/- Fine Needle Aspiration

10

How are US/FNA tests graded with regards to thyroid cancer?

Thy1 – inadequate U1
Thy2 – Benign U2
Thy 3 (a/f) – Atypical U3
Thy4 – Prob malignant U4
Thy 5 – malignant U5

11

How are differentiated thyroid cancers treated?

If low risk (<4cm) => Lobectomy

If high risk => total thyroidectomy +/- radioactive iodine

12

What are the two types of differentiated thyroid cancer?

Papillary
Follicular

13

How do follicular thyroid carcinomas spread?

Haematogeneous spread

14

Most follicular thyroid carcinomas are minimally invasive. TRUE/FALSE?

TRUE

15

How is a thyroid lymphoma usually investigated and treated?

Ix = Core Biopsy

Tx =
- Steroids
- Chemotherapy
- Radiotherapy

16

Where does a medullary thyroid carcinoma originate and what does it secrete?

tumour of the parafollicular cells
secrete CALCITONIN

17

If a fine needle aspiration shows evidence of amyloid or Calcitonin positive stains, this indicates a Medullary Thyroid Carcinoma. TRUE/FALSE?

TRUE

18

What investigations can be carried out for a Multinodular Goitre?

TSH levels
CT Scan

19

What are TSH levels usually like in a multinodular goitre?

normal or slightly suppressed

20

What can a CT Scan show in multinodular goitre?

Retrosternal Extension
Tracheal Compression

21

What treatment can be given if doctors are concerned about a multinodular goitre?

Radioactive Iodine if significantly hyperthyroid
Surgery if structural problem

22

Who should be offered surgery for a multinodular goitre?

- Lifestyle interfering symptoms
- Possibility of cancer
- Significant tracheal compression (?<7 mm)
- Tracheal Flow Loops