Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 2 > Differentiated thyroid cancer > Flashcards

Differentiated thyroid cancer Flashcards

1
Q

What are they types of differentiated thyroid cancer (DTC)?

A

Papillary and follicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which substance drives DTC?

A

Thyroid stimulating hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What do DTCs take up and secrete?

A

Take up: Iodine and secrete: thyroglobulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the demographics of DTC?

A

Commoner in females (risk increases until middle age then plateaus) than males (risk increases with age), uncommon in children, lower incidence in black people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the epidemiology of DTC?

A

Strong associations with radiation, weak associations with adenoma, chronic elevation of TSH and increasing number of children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does DTC present?

A

Palpable nodes

Less commonly local of disseminated metastases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the commonest type of thyroid cancer?

A

Papillary (followed by follicular)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does papillary thyroid cancer tend to spread and to where?

A

Lymphatics to cervical nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does follicular thyroid cancer tend to spread and to where?

A

Haematogenously to brain, bones, liver and brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What pathology is papillary cancer associated with?

A

Hashimoto’s thyroiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What deficiency is follicular cancer associated with?

A

Iodine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the prognosis of DTC?

A

Very, very good

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How are suspected DTCs investigated?

A

Ultrasound guided FNA +/- excision biopsy of lymph nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How are suspected DTCs investigated if there is vocal cord palsy?

A

Pre-operative laryngoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the clinical predictors of DTC cancer?

A 
Nodule aged 50
Male
Increasing size
>4cm diameter
History of irradiation
Vocal cord palsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is DTC treated?

A

Surgically - lobectomy + isthmusectomy OR sub-total thyroidectomy OR total thyroidectomy

17
Q

What is the risk scoring system for DTC?

A

A - age
M - metastases
E - extent of tumour
S - size of tumour

18
Q

When is a lobectomy with isthmusectomy used?

A

Microcarcinomas (

19
Q

When are sub total or total thyroidectomys used?

A 
Extra-thryoidal spread
Bilateral/multifocal involvement
Distant metastases
Nodal involvement
High risk AMES
20
Q

How is lymph node surgery used in DTC?

A

Papillary - central compartment clearance with biopsy of lateral nodes
Follicular - central compartment clearance

21
Q

What must be checked following thyroid surgery?

A

Calcium

22
Q

How is a calcium deficiency treated post-thyroid surgery?

A

Replacement if calcium below 2 mmol/l

IV replacement if calcium below 1.8 mmol/l

23
Q

What medication must a patient be given following thyroid surgery?

A

T3 or T4 (commonly T4)

24
Q

When and why is whole body iodine scanning used?

A

3-6 months after subtotal or total thyroid surgery to check that all the thyroid tissue has been cleared

25
Q

What must be stopped prior to whole body iodine scanning?

A

T3 - 2 weeks prior

T4 - 4 weeks prior

26
Q

When might a patient undergo thyroid remnant ablation?

A

If uptake of iodine on a full body iodine scan is more than >0.1% of the ingested dose

27
Q

How is thyroid remnant ablation carried out?

A

Administration of I-131 with extensive radiation precautions

28
Q

What are the side effects of thyroid remnant ablation?

A

Sialadenitis (salivary gland inflammation) and/or sore throat

29
Q

What level should TSH and free T4 ideally be below following treatment for DTC?

A

TSH below 0.1mU/l

Free T4 below 25

30
Q

Which substance can be used as a tumour marker (i.e a marker of recurrence)?

A

Thyroglobulin

31
Q

What are the long term affects of thyroid remnant ablation?

A

Small increase in acute myeloid leukemia

32
Q

How can recurrent disease be detected?

A

Rising thyroglobulin

Imaging (whole body thyroid uptake scan, PET)

Year 2 (72 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions