Digestion & Metabolism 2: Thyroid & Pancreas Sx Flashcards
MOST thyroid tumors we detect are ___ ___
usually come from ___ ___ CELLS or ____ CELLS
usually has ___ presentation
rate of METASTASIS is ___
MALIGNANT CARCINOMAS
usually come from THYROID FOLLICULAR CELLS or MEDULLARY CELLS
usually has BILATERAL presentation
rate of METASTASIS is HIGH (LNs & LUNGS)
TRUE/FALSE
ECTOPIC thyroid tumors are POSSIBLE
usually these around found between MEDIASTINUM & NECK
TRUE
MOST thyroid tumors are _____, BUT if they ARE ____, then shows signs of ____, which include… (2)
MOST thyroid tumors are NONFUNCTIONAL, BUT if they ARE FUNCTIONAL, then shows signs of HYPERTHYROIDISM, which include…
- PU/PD
- WEIGHT LOSS
TRUE/FALSE
THYROID tumors are NOT usually an INCIDENTAL finding
FALSE, they are!
THYROID tumors usually found as a ___ ___ MASS
what is MOST important for GOOD PROGNOSIS?
VENTRAL CERVICAL MASS
MOST important for good prognosis = EARLY DETECTION
FELINE HYPERTHYROIDISM tends to have ____ MASSES, while CANINE HYPERTHYROIDISM tends to have ___ THYROID ____
BENIGN, MALIGNANT THYROID CARCINOMA
POSSIBLE clinical signs of THYROID TUMOR? (4)
- COUGH
- INCREASED RR/RE
- DYSPHAGIA
- CHANGE IN VOICE
DIAGNOSTICS for THYROID TUMORS…
4 main?
which 2 can we POTENTIALLY do if CONCURRENT DZ?
4 main?
1. PE to see HOW MOBILE THE TUMOR IS –> palpate both AWAKE & ANESTHETIZED/SEDATED
- CBC/CHEM/UA
- THYROID FUNCTION TESTING
- THORACIC RADS & CT for PULMONARY METS
POTENTIAL?
1. ABDOMINAL US
2. ABDOMINAL CT
what should we prepare PREOPERATIVELY for THYROID TUMOR?
BLOOD TYPE
why do we NOT tend to do FNA on THYROID MASS?
this is usually done WHEN?
usually because HIGHLY VASCULAR TUMORS & likely to have HEMORRHAGE
usually done AFTER IMAGING so that WE DON’T COMPLICATE FINDINGS
LOCAL treatment options for THYROID TUMORS… (2)
each are TREATMENT OF CHOICE especially when…
- THYROIDECTOMY Sx, ESPECIALLY when MOBILE or just VASCULAR INVASION
- RADIATION THERAPY, ESPECIALLY when INVASION OF IMPORTANT SURROUNDING STRUCTURES
SYSTEMIC treatment options for THYROID TUMORS… (2)
list what EACH are GOOD FOR
- CHEMOTHERAPY = good for when HIGH RISK OF METASTATIC DZ; can also use PALLADIA
- I-131 = good for NON-RESECTABLE THYROID TUMORS or RESIDUAL METASTASIS
I-131…
more commonly used in WHAT species?
used for… (2)
has a RISK of….
requires a ____ DOSE
more commonly used in CATS
used for…
1. NON-RESECTABLE THYROID TUMORS
2. GROSS METASTATIC DZ
RISK of MYELOSUPPRESSION
requires a HIGH DOSE
dogs with HYPERTHYROIDISM DO/DO NOT need TREATMENT to induce EUTHYROIDISM PRE-OPERATIVELY for THYROIDECTOMY
vs. in CATS?
DO NOT!!
vs. in CATS, DO NEED TO INDUCE EUTHYROIDISM
ideally we should do an exam of WHAT BEFORE & AFTER THYROIDECTOMY SX?
why? (2)
LARYNGEAL EXAM
why? = to look at THYROID & ensure NORMAL FUNCTION
three general RISKS of THYROIDECTOMY…
what is the MOST COMMON complication?
unfortunately ___ & ___ is possible POST-OP
- BLEEDING
- LARYNGEAL PARALYSIS
- RESPIRATORY SIGNS
MOST COMMON complication = SEROMA/SWELLING
unfortunately RECURRENCE and HYPOTHYROIDISM is possible POST-OP
for HIGHLY METASTATIC but SLOWLY PROGRESSIVE THYROID TUMORS, the prognosis is..
what is the MOST IMPORTANT prognostic indicator?
what is an important prognostic indicator for METS?
MST?
EXCELLENT so long as TREATMENT IS TAKEN
MOBILITY is the MOST IMPORTANT prognostic indicator for RESECTION
if BILATERAL, MUCH MORE LIKELY FOR METS
MST = ~2 years
why can HYPOPARATHYROIDISM occur post-sx for BILATERAL THYROIDECTOMY?
what TREATMENT do they need?
usually REMOVE ALL PARATHYROID TISSUE if this is done!
needs LONG-TERM CALCIUM SUPPLEMENTATION
THYROID TUMORS in CATS…
cats usually presenting with ____ & RARELY show ___
on PE, WHAT is normal?
clinical findings are WIDESPREAD because…
why do we want to make cats EUTHYROID prior to sx?
SURGERY IS COMMONLY/UNCOMMONLY done for CAT THYROID TUMORS
cats usually presenting with HYPERTHYROIDISM & RARELY show MALIGNANCY
on PE, THYROID PALPATION IS NORMAL (not felt)
WIDESPREAD clinical findings because T4 affects MANY ORGANS
want to make CATS EUTHYROID prior to sx because WE WANT TO SEE IF THEY HAVE RENAL DZ
SURGERY DONE UNCOMMONLY
2 types of ENDOCRINE PANCREATIC TUMORS?
which is MOST COMMON?
- INSULINOMA –> MORE COMMON
- GASTRINOMA
GASTRINOMA are the result of NEOPLASTIC ___ ___ that produces EXCESSIVE LEVELS of ___
METASTASIS is _____
DELTA CELLS, GASTRIN
METASTASIS is COMMON
what is the MOST COMMON NON-ENDOCRINE PANCREATIC TUMOR?
tend to have ___ behavior
CARCINOMAS
tend to have AGGRESSIVE behavior
INSULINOMA…
what type of tumor is this?
commonality in DOGS vs. CATS?
usually the result of NEOPLASTIC ___ ___ & causes ____GLYCEMIA
histologically can appear ___, but MAJORITY have ___ behavior by the time we DIAGNOSE; affects what 2 organs?
EXOCRINE PANCREATIC TUMOR
UNCOMMON in DOGS, RARE in CATS
usually the result of NEOPLASTIC BETA CELLS & causes HYPOGLYCEMIA
histologically can appear BENIGN, but MAJORITY have MALIGNANT behavior; affects…
1. LNs
2. LIVER
INSULINOMA…
CLINICAL SIGNS of this depend on what 3 things?
these dogs can look NORMAL if ____ ____
clinical signs? (3)
in SEVERE cases, can cause PERMANENT ___ ____
CLINICAL SIGNS of this depend on what 3 things?
1. DEGREE of hypoglycemia
2. RATE of DECLINE
3. DURATION of hypoglycemia
these dogs can look NORMAL if CHRONIC HYPOGLYCEMIA
clinical signs?
1. ATAXIA
2. SEIZURES
3. WEAKNESS
in SEVERE cases, can cause PERMANENT CNS DYSFUNCTION
how is HYPOGLYCEMIA diagnosed?
HOWEVER, what are 2 MOST COMMON reasons why this might this be INACCURATE?
MEASURE THE GLUCOSE!
ARTIFACTUAL HYPOGLYCEMIA most commonly caused by…
1. UNCENTRIFUGED SAMPLE –> RBCs went THROUGH GLUCOSE
2. used PORTABLE GLUCOSE METER
XYLITOL causes _____ due to INCREASED ____ LEVELS, and this occurs SLOWLY/RAPIDLY
HYPOGLYCEMIA, INSULIN, RAPIDLY
how is INSULINOMA MOST DEFINITIVELY diagnosed?
HYPOGLYCEMIA concurrent with ABNORMAL INSULIN LEVEL
a NORMAL ABDOMINAL ULTRASOUND DOES/DOES NOT RULE OUT INSULINOMA
DOES NOT
if animals have INSULINOMA, we should do WHAT before Sx? how? (2)
MEDICAL MANAGEMENT BEFORE Sx to AVOID HYPOGLYCEMIA, so…
1. GIVE SMALL FREQUENT MEALS prior to ANESTHESIA
2. GIVE PREDNISONE
what is the RECOMMENDED for INSULINOMA Tx?
what 2 things can indicate EXPLORATORY LAPARATOMY?
this is NOT ___, and we should tell CLIENTS this
SURGERY!!
what 2 things can indicate EXPLORATORY LAPARATOMY?
1. HYPOGLYCEMIA
2. CONCURRENT ABNORMAL INSULIN
NOT CURATIVE, we should tell CLIENTS This
