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endo II exam1 > thyroid part III > Flashcards

thyroid part III Flashcards

1
Q

follicular carcinomas are more prevalent where

A

dietary iodine deficiency areas like mountains

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2
Q

peak incidence of follicular carcinomas

A

between 40 and 60

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3
Q

morphology of follicular carcinomas

A

single nodules that are well circumscribed or widely infiltrative
gray- tan to pink on cut section
large colloid filled follicles

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4
Q

diference of adenoma vs carcinoma of follicular thyroid

A

adenoma has thin capsule

carcinoma has thick capsule with invasion

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5
Q

what type of spread is common with follicular carcinoma

A

vascular dissemination with mets to bone lungs and liver

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6
Q

how will follicular carcinoma appear on scintigram

A

cold nodules but some that are hyperfunctional may appear warm

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7
Q

prognosis of follicular carcinoma

A

depends on extent of invasion and stage

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8
Q

Tx follicular carcinoma

A

total thyroidectomy with administration of radioactive iodine which is used to identify mets and ablate them

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9
Q

why are patients with follicular carcinomas treated with thyroid hormone post surgery

A

to suppress endogenous TSH levels

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10
Q

how do we monitor the tumor recurrence in follicular carcinomas

A

thyroglobulin levels

should be barely detectable in patient free of the disease

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11
Q

Prognosis of anaplastic carcinomas of thyroid

A

100% mortality
undifferentiated tumors
usually mean age 65

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12
Q

what should you ask in Hx of patient Dx with anaplastic carcinoma of thyroid

A

Hx of well differentiated thyroid carcinoma because 25% have had this

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13
Q

micro morphology of anaplastic carcinoma of thyroid

A

pleomorphic giant cells
spindle cells
mixed of both types

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14
Q

epithelial marker for anaplastic carcinoma of thyroid

A

cytokeratin

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15
Q

presentation and course of anaplastic carcinoma

A

rapidly enlarging bulky neck mass that usually spread beyond thyroid capsule into adjacent neck structures or mets to lungs

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16
Q

Sx of anaplastic carcinoma

A

dyspnea, dysphagia, hoarseness and cough

17
Q

avg life span once Dx with anaplastic carcinoma of thyroid

A

less than 1 year

18
Q

what are medullary carcinomas of thyroid

A

neuroendocrine neoplasms derived from parafollicular cells or C cells

19
Q

what do medullary carcinomas secrete and why is this important

A

calcitonin!! used to Dx and follow-up

20
Q

majority of medullary carcinomas arise how

A

sporadically and the remainder in MEN 2A or 2B or familial medullary thyroid carcinoma

21
Q

difference morph of sporadic medullary carcinoma vs familial

A

sporadic are solitary nodules

familial are b/l and multicentricity

22
Q

what is a key feature morphologically of medullary carcinomas of thyroid

A

deposition of amyloid from the calcitonin molecules

23
Q

dense core granules

A

derived from endocrine system

24
Q

clincal presentation of sporadic medullary carcinoma

A

mass in neck sometimes with dysphagia or hoarseness

sometimes paraneoplastic syndrome (secretion of a peptide hormone)

25
Q

is hypocalcemia a prominent feature of medullary carcinomas

A

no even though high calcitonin

26
Q

biomarker for medullary carcinoma

A

carcinoembryonic antigen CEA from neoplastic cells

27
Q

which type of medullary carcinoma is more aggressive

A

MEN2B associated

28
Q

Patient has MEN2 with RET mutation, though asymptomatic what is recommended

A

prophylactic thyroidectomy to prevent development of medullary carcinoma

29
Q

PAX8PPARG fusion gene

A

follicular carcinoma

30
Q

RAS or PI-3K actication

A

follicular carcinoma

31
Q

chrom translocation RET oncogene

A

papillary carcinoma

32
Q

mutaitons in RET

A

medullary carcinoma

endo II exam1 (14 decks)

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