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Endocrine > DTC > Flashcards

DTC Flashcards

1
Q

what varients of thyroid cancer are DTCs?

A

Papillary and follicular

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2
Q

Papillary cancer is most likely to present with?

A

Cervical lymphadenopathy (As the spread is lymphatic)

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3
Q

What is the most common spread with follicular cancer?

A

Haematogenous

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4
Q

In terms of AMES, if a patient has distant metastases and a primary tumour size >5cm what risk are they?

A

High risk

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5
Q

older patients with a intrathyroid papillary lesion are in the AMES high risk? T or F

A

F, low risk

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6
Q

extrathyroidal disease in patients with papillary cancer is a feature of AMES high risk ? T or F

A

T

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7
Q

what will most patients with DTCs present with?

A

Palpable nodules.

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8
Q

1st line investigation for DTC?

A

US guided FNA.

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9
Q

Surgical management options?

A

Lobectomy with isthmusectomy
SUbtotal thyroidectomy
Total thyroidectomy

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10
Q

Thyroid lobectomy with isthmusectomy is done is what circumstances?

A

Papilla

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11
Q

Which patients would have a lobectomy w/ isthmusectomy?

A

Those with

  • Papillary microcarcinoma ( < 1cm diameter)
  • Minimally invasive follicular carcinoma with capsular invasion only
  • a AMES low risk group
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12
Q

What should DTC patients with extra-thyroidal spread/ distnat metastases/ nodal involvement get?

A

Subtotal or total thyroidectomy.

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13
Q

which patients should undergo lymph node clearance?

A

those w/ macroscopic lymph node disease

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14
Q

Post Op patients are monitored for what?

A

Ca levels

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15
Q

If Ca levels falls below 1.8 mmol/l or if patient is symptomatic what is given?

A

IV Ca

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16
Q

At what level is Ca replacement initiated?

A

2 mmol/l

17
Q

Which patients undergo whole body iodine scanning?

A

Those who have had had a subtotal or total thyroidectomy.

18
Q

roughly what happens in whole body iodine scanning?

A

pre scan stopping T3 and T4 or using rhTSH to avoid this
- injections + capsule to make cancer cells “hungry” iodine
- imaging few days later
-

19
Q

What is the aim of Thyroid Remnant ABlation?

A

To suppress TSH for protection

20
Q

Why should thyroglobulin be measured pre-op?

A

Not all subjects secrete Tg.

21
Q

DTC has the best prognosis of all cancers except non-melanoma skin cancer? T or F

A

T

22
Q

Treatment of DTC involves surgery and TRA? T or F?

A

111t

23
Q

Is there a need for life long follow up for DTC patients?

A

Yes to follow up Tg (tumour marker) and TSH

24
Q

does iodine uptake indicate a good prognosis ?

A

Yes

25
Q

Medullary thyroid carcinoma is a cancer of which cells?

A

Parafollicular

26
Q

Parafollicular cells secrete what tumour marker?

A

Calcitonin

Endocrine (9 decks)

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