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Endocrine > Differentiated Thyroid cancer > Flashcards

Differentiated Thyroid cancer Flashcards

1
Q

What is the most common type of thyroid cancer?

A

Papillary

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2
Q

What is the second most common type?

A

Follicular

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3
Q

What do medullary cancers secrete?

A

Calcitonin

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4
Q

What is the most aggressive thyroid cancer?

A

Anaplastic.

Few months.

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5
Q

What drives differentiated thyroid cancers?

A

TSH

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6
Q

What do DTC secrete and take up?

A

Secrete thyroglobulin

Take up iodine

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7
Q

What does thyroglobulin do?

A

Contains T3/4

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8
Q

What is the pattern with men of developing thyroid cancer?

A

Risk gradually increases with age

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9
Q

How do DTC present?

A

Palpable nodules

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10
Q

Where would local metastasis be?

A

Cervical lymph nodes

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11
Q

Where else is important to examine for nodes?

A

Groin

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12
Q

How does papillary spread?

A

Lymphatics ++

Haematogenously - liver, bones, brain and lungs

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13
Q

What thyroid condition is papillary TC associated with?

A

Hashimoto’s thyroiditis

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14
Q

What is the prognosis for papillary or follicular?

A

95% at 10 years

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15
Q

What investigations are involved?

A

USS-FNA
Excisional biopsy
NOT MRI/CT

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16
Q

How are patient’s risk defined in NW?

A

Age
Metastases
Extent of primary tumour
Size of primary tumour

AMES low or high

17
Q

What is the best surgical option for high AMES patients?

A

Total thyroidectomy

18
Q

Why might calcium levels be low after a thyroidectomy?

A

Inadvertent removal of parathyroids

19
Q

What are the dangers of hypocalcaemia?

A

Long QT syndrome
Tetany
seizures

20
Q

When is whole body iodine scanning used?

A

High AMES with previous total thyroidectomy

21
Q

When is whole body iodine scanning done?

A

3-6 months after thyroidectomy

22
Q

Which medications need to be stopped before the scan?

A

T3/4 so biochemically is hypothyroid

Purpose is to raise TSH

23
Q

What is given prior to the body scan?

A

Iodine as a capsule.

24
Q

Where should iodine be rich on the scan?

A

Salivary glands
Stomach
Bladder

25
Q

What is an absolute contra-indication to radioablation?

A

Pregnancy

26
Q

When is discharged allowed?

A

When geiger count is less than 500

27
Q

Describe the T3/4 and TSH balance required post surgery

A

TSH needs to be low due the cancers being TSH driven so T3/4 is high

28
Q

Why should thyroglobulin be undetectable?

A

All thryoid cells removed so not being produced

29
Q

What is the minute risk with total radioablation?

A

Increased risk of acute myeloid leukaemia

30
Q

What is the follow up plan for DTC?

A

3 monthly for 2 years

6 monthly for 5 years

Endocrine (20 decks)

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