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Endocrine > Cancer + Goitres > Flashcards

Cancer + Goitres Flashcards

1
Q

Types of thyroid cancer + characteristics

A 
Papillary carcinoma (60%) - younger patients, spreads to lymph + lung 
Follicular carcinoma (<25%) - middle age, spreads to bone + lung

Undifferentiated (more aggressive):
Medullary (5%) - may produce calcitonin
Lymphoma (5%) = presents with stridor/ dysphagia
Anaplastic - rare -elderly

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2
Q

RF for thyroid cancer

A 
Low iodine consumption 
Thyroid disease 
Exposure to radiation 
White + asian 
Breast cancer 
Drugs = lithium, amiodarone, B blockers, sulphonylureas
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3
Q

Red flag symptoms for thyroid cancer

A 
Lump in throat 
Cough, hoarseness 
Difficulty swallowing 
Swollen lymph nodes 
Asymmetry 
Stridor
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4
Q

Investigations for thyroid cancer

A

USS
CXR with thoracic inlet view for mets
Radionucleotide scans
Fine needle aspiration + cytology

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5
Q

Management of thyroid cancer based on type

A 
Papillary = total thyroidectomy + node excision + radioiodine + thyroxine 
Follicular = total thyroidectomy + T4 suppression + radioiodine 
Medullary = thyroidectomy + node clearance 
Lymphoma = chemoradiotherapy, surgery 
Anaplastic = excision + radiotherapy
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6
Q

Causes of neck lumps

A

Skin infections, lymphadenopathy, tumours, salivary gland lumps, thyroglossal cysts

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7
Q

Complications of thyroid cancer

A

Tracheal compression
Laryngeal nerve palsy
Hypoparathyroidism

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8
Q

What is a goitre + what are the causes?

A 
Swelling of thyroid gland 
Iodine deficiency 
Hashimotos
Graves 
Lithium 
Amiodarone 
Pregnancy + menopause
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9
Q

RF for goitres

A

Smoking
fam hx
RT

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10
Q

What is the difference between a toxic + non-toxic goitre?

A

Toxic = abnormal LFTs

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11
Q

Investigations for goitres

A

TFT
US
FNA
CT + MRI to detect lymphatic spread

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12
Q

Management of toxic goitre

A

BB

Carbimazole, radioiodine or surgery

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13
Q

What is the pathology of a phaeochromocytoma?

A

Tumour that secretes catecholamines causing arrhythmias + HTN
Derived from chromaffin cells, in adrenal medulla

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14
Q

Causes of phaeochromocytoma?

A

Germline mutations

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15
Q

Symptoms of phaeochromocytoma

A

Headache
Profuse sweating
Palpitations
Tremor

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16
Q

Signs on examination of phaeochromocytoma

A

HTN
Postural hypotension
Tremor

17
Q

Investigations + results for phaeochromocytoma

A 
High blood glucose
High calcium 
High Hb 
High plasma catecholamines 
24hr creatinine collection 
CT for staging 
Biopsy - using PASS system
18
Q

RF for hypertensive crisis in phaeochromocytoma

A 
Induction of anaesthesia 
Opiates
Dopamine antagonists 
Decongestants - pseudoephedrine 
TCAs + cocaine 
X ray contrast media 
Childbirth
19
Q

Management of phaeochromocytoma

A

Surgery

Alpha + beta blockers prior to surgery to control BP

Endocrine (6 decks)

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