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Additional CSO Cards > Chapter 25: Thyroid Cancer > Flashcards

Chapter 25: Thyroid Cancer Flashcards

1
Q

The thyroid produces these 2 hormones

A
  1. Thyroid hormone
  2. Calcitonin
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2
Q

What are 3 things that thyroid hormone helps regulate?

A
  1. Weight
  2. Heart rate
  3. Body temperature
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3
Q

What does calcitonin do?

A

Maintain normal calcium levels

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4
Q

What is the lifetime risk for thyroid cancer? And survival rate?

A

1.2% (98.3%)

Increased technology for earlier diagnosis has contributed to increased incidence

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5
Q

What are 5 risk factors for thyroid cancer?

A
  1. Exposure to radiation (especially earlier in infancy/childhood) - best established factor
  2. Genetics (20-25% cases)
  3. Female age 25-65
  4. Family/personal hx of benign thyroid conditions (i.e. goitor)
  5. Obesity in FEMALES - no correlation established with males
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6
Q

Most widely known dietary risk factor for thyroid cancer

A

Iodine intake (both chronically deficient and high intake i.e. with supplements)

Follicular (deficient)
Papillary (excess)

F = fail, deFicient

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7
Q

Link between fish intake and thyroid cancer?

A

Inconsistent, no established association

May be protective in areas where the soil, ground water, drinking water are low in iodine

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8
Q

__________ contain goitrogens

A

Cruciferous vegetables

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9
Q

What are goitrogens?

A

Goiter-producing compounds. shown to induce thyroid cancer in animals but not humans

Likely that unfavorable benefits of goitrogens are outweighed by the protective benefits of other plant constituents

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10
Q

Early thyroid cancer is often asymptomatic, but as cancer grows symptoms such as ________ can develop

A
  1. Difficulty swallowing
  2. Enlarged neck
  3. Neck pain
  4. Difficulty breathing
  5. Coguh
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11
Q

These are the 2 main types of thyroid cells

A
  1. Follicular
  2. Parafollicular
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12
Q

Thyroid cancers are staged from 1-4, but ______ thyroid cancer is always considered stage 4

Thyroid cancer is also considered “differentiated” or
undifferentiated”

A

Anaplastic

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13
Q

_________ cells are AKA “C” cells

A

Parafollicular
“C” cells produce calcitonin

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14
Q

Role of thyroid/parathyroid hormones

A
  1. Calcitonin - lowers blood calcium
  2. Parathyroid hormone - increased blood calcium
  3. Thyroid hormone - regulates heart rate, body temperature, weight
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15
Q

Function of follicular cells

A

Produce and store thyroid hormone

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15
Q

The ___________ is 4 small glands located on the back of the thyroid

A

Parathyroid

16
Q

Function of parafollicular cells

A

Produce calcitonin

17
Q

What are the 4 main types of thyroid cancer?

A
  1. Anaplastic thyroid carcinoma
  2. Follicular thyroid carcinoma
  3. Medullary thyroid carcinoma
  4. Papillary thyroid carcinoma
18
Q

Discuss anaplastic thyroid cancer

A

Always stage 4. Most undifferentiated. Very aggressive and typically fatal. Originates in follicular cells

19
Q

Discuss medullary thyroid cancer

A

Less differentiated and somewhat aggressive. Originates in the C cells. More likely to spread. Releases high levels of calcitonin & CEA

*only that arises in C cells

20
Q

Rank thyroid cancers from most aggressive to least aggressive

A
  1. Anaplastic
  2. Medullary
  3. Follicular
  4. Papillary

(Avoid My..)

21
Q

Describe follicular thyroid cancer

A

Differentiated, originates in follicular cells. More aggressive and more likely to recur than papillary.

22
Q

Describe papillary thyroid cancer

A

Differentiated. Most common, slow growing. Best prognosis.

23
Q

Thyroid surgery can damage the __________ nerve, which may compromise ________ function

A

Laryngeal
Swallowing

*may also be d/t the compression of the thyroid glad

24
Q

Surgery is typically the treatment of choice but not in _________ thyroid cancer

A

Anaplastic, rarely indicated d/t advanced disease

25
Q

Where is thyroid stimulating hormone (TSH) produced?

A

Pituitary gland

26
Q

When may chemotherapy be used for thyroid cancer?

A

Metastatic disease, almost as a last option

If radioactive iodine therapy, radiation, and TSH-suppressive therapy don’t work

Typically rare in anaplastic thyroid cancer though d/t the aggressive nature

27
Q

Post total thyroidectomy, thyroid hormone replacement is usually provided while __________ suppressors may be given

A

Thyroid stimulating hormone

28
Q

What is the type of radioactive substance called used for thyroid cancer?

A

Iodine 131

29
Q

Is radioactive iodine (RAI) done pre or post-op

A

Post-op in high risk cases

30
Q

T/F: Only thyroid cells take up radioactive iodine, thus no other tissues are formed

A

True

*a non-destructive form can be used for detection

31
Q

When is radiation (radiotherapy used) with thyroid cancer?

A

When surgery and RAI are ineffective

32
Q

Goal of low iodine therapy

A

To deplete whole-body iodine stores before scans or therapy to optimize RAI uptake in thyroid cells

*urinary iodine can be used to assess iodine status (low in urine, low in diet)

33
Q

Recommended Iodine restriction _________ /day

Recommended duration for low iodine diet prior to RAI

A

</= 50 mcg/day

1-2 weeks

33
Q

Is sea salt restricted on a low iodine diet?

A

No, this is a common misconception. Only contains trace levels of iodine

34
Q

On low iodine diet, avoid creams or lotions made from ______

A

seaweed

35
Q

Name 7 items to avoid with low iodine diet

A
  1. Iodized salt
  2. ALL seafood/sea products
  3. Dairy products
  4. Egg yolks
  5. Erythrosine (red dye)
  6. Iodate dough conditioners
  7. Chocolate (bc of the milk)
36
Q

What to do about EN/PN patients requiring low iodine diet?

A

PN - all good, trace element products typically don’t contain iodine

EN - no formulas suitable, must puree food products acceptable on a low iodine diet

Additional CSO Cards (26 decks)

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