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Y2 Endocrine > Differentiated Thyroid Cancer > Flashcards

Differentiated Thyroid Cancer Flashcards

1
Q

what types of thyroid cancer are differentiated (DTC)?

A

follicular

papillary

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2
Q

what substance do DTCs take up?

A

iodine

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3
Q

what do DTCs secrete that can be used as a tumour marker?

A

thyroglobulin

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4
Q

what drives DTCs?

A

TSH

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5
Q

which sex is more commonly affected by DTCs?

A

females

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6
Q

what is a risk factor for DTCs?

A

exposure to radiation

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7
Q

how do the majority of patients with DTCs present?

A

palpable nodules in the neck

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8
Q

what is the most common type of DTC?

A

papillary thyroid cancer

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9
Q

how does papillary thyroid cancer tend to spread?

A

lymphatics

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10
Q

where can papillary thyroid cancer spread via the haematogenous route?

A

lungs
bones
liver
brain

this is less common than lymphatic spread

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11
Q

what condition does papillary thyroid cancer have a small association with?

A

hashimoto’s thyroiditis

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12
Q

where is incidence of follicular thyroid cancer higher?

A

regions of relative iodine deficiency

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13
Q

how does follicular thyroid cancer tend to spread?

A

hematogenously

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14
Q

what is the investigation of choice for a DTC presenting as a thyroid lesion?

A

USS guided FNA

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15
Q

what is the investigation of choice for a DTC presenting as an enlarged neck node?

A

excision biopsy of the lymph node

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16
Q

what is the treatment of choice for a DTC?

A

surgery

17
Q

what are the three most common surgical options for a DTC?

A

hemi thyroidectomy
sub total thyroidectomy
total thyroidectomy

18
Q

what are the indications for hemi thyroidectomy in DTC?

A

papillary microcarcinoma
minimally invasive follicular carcinoma
AMES low risk group

19
Q

what four things are assessed in the AMES risk assessment for DTC?

A

age
metastases
extent or primary tumour
size of primary tumour

20
Q

what post-operative care is done following thyroid surgery for a DTC?

A

check calcium within 24 hours
replace calcium if <2
IV calcium if <1.8/symptomatic

discharge patient on T3 or T4

Y2 Endocrine (33 decks)

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