Brainscape's Knowledge GenomeTM

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


See full index

FRACS exam > Endo > Flashcards

Endo Flashcards

1
Q

At what size do you start getting symptoms tracheal narrowing from goitre

A

Exertions dyspnoea at less than 8mm

Stridor/wheeze at less than 5mm

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

indications for surgery in thyrotoxic nodule or TMNG

A 
6 M's
Malignancy
Medical therapy failure
Massive goitre (compressive symptoms)
Mediastinal extension
Menacing consequences of radioactive iodine - pregnancy, allergey, severe orbitopathy
Mechanical compression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

advice while taking radioactive iodine

A

Takes 3-5 days to pass through system
Takes upto 12 weeks to work

Dependant on the dose
Need to avoid close personal contact - radioactive iodine can be released in saliva, urine, sweat, no sharing saliva, bed, stay away from children for upto 5 days,
no pregnancy for at least 6 months - probably 12 best

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

Treatment of thyroid storm

A 
B blocker
Cooling cares (+ paracetamol) 
Icu
Carbimazole
Iodine
Steroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Amiodarone induced hyperthyroidism types

A

Type 1 - from iodine in amiodaronetype2 from destructive thyroiditis

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

How is the ti rads comprised

A 
Echogenicity
Margins
Shape
Composition (solid v cyst v spongiform)
Echogenic foci (calcs, peripheral calcs, punctuate echogenic foci)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ti rads

A

1- benign (0 points)
2 - benign (2 points)
3 - mildly suspicious - fna greater than 2.5cm and follow 1.5cm
4- moderately suspicious (4-6) fna 1.5cm and follow 1cm
5- highly suspicious - fna 1cm follow 0.5cm

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

What is the implication of negative localisation studies for PHPTH

A

Should do 4 grand exploration
Single gland still most likely
But remember multigland disease/hyperplasia

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

CT differentiation of incidentaloma

A

<10 HU - benign
<4 cm likely benign (90% malignant tumour >4cm)
< -40 HU myelolipoma
Washout - fast washout is consistent with adenoma. Delayed washout >10 mins in phaeo and ACC
Margins
Increased vascularity in phaeo
High intensity T2 on MRI FOR phaeo
Cystic and haemorrhagic changes in phaeo
>20 HU in malignancy and phaeo

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

What is the proportion of incidentaloma that are functional

A

90% non funxtuons

  1. 4 Cushing
  2. 1 phaeo
  3. 6 conns
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is mitotaine used for

A

Adrenocortical carcinoma
Incomplete resection or unresectable
High risk disease

Mitotaine is an adrenolytic agent that suppresses the adrenal Cortex and alters the peripheral metabolism of steroids

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

Commonest sites for neuroendocrine rumours

A 
Small bowel 45%
Rectum 20%
Appendix 16%
Colon 11%
Stomach 7%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the grading of NET

A

G1- mitoses <2, ki67 upto 2%
G2- m 2-20, k 3-20%
G3 - m>20, k >20 (=NEC)

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

Describe staging of NET

A

generally not for tumour <1-2cm and type 1 and 2 gastric NETs
CT CAP
+ somatostatin receptor based imaging “octreoscan” or Dotate PET scan - important to assess if octreotide would work

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

cernea classification

A

1 - nerve passes >1cm above superior lobe (60% of normal sized thyroid, 20% of large goitre)
2a - <1cm of superior lobe (20% of large and normal gland)
b - crosses superior lobe (60% large goitre, 20% small)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

suspicious USS of involved lymph nodes

A 
loss of fatty hilum
calcifications
non compressible
round vs oval
hyperechoic
>8mm size
17
Q

thyroglobulin measurement post total and hemi thyroidectomy

A

total <5ng/ml

hemi <30ng/ml

18
Q

intermediate/high risk categories of thyroid cancer

A 
>4cm
ETE (microscopic) (macroscopic = high risk)
Clinically lymph node involved
Gross residual tumour (high risk)
Node >3cm (high risk)

follicular cancer with >4 foci of vascular invasion + well differentiated + no capsular invasion

Papillary - high risk variant (tall cell, hurthle cell, hobnail, insular)

19
Q

Outline the roles for RAI

A

Used in adjuvant setting- I-131
Ablate residual thyroid tissue
Adjuvant treatment of subclinical mets
Treatment of residual/metastatic disease

Used in diagnostic purposes - I-123
Staging
Assessment of hyperthyroidism

20
Q

Treatment of metastatic thyroid cancer

A

RAI is curative in a minority of patients
Combination of RAI + TSH helps to minimise disease burden
Kinase inhibitors VEGRF targets can be trialled for non-responsive disease -

21
Q

Genetics of papillary vs follicular

A

papillary - MAPK pathway - RET oncogen

follicular - RAS

22
Q

rates of single vs double vs diffuse hyperplasia for HPTP

A

85% vs 5% vs 10%

23
Q

what age to consider MEN2 a possibility with HPTH

A

<30 year old male

24
Q

what type of pet ct for pth adenoma?

A

methionine PET CT

25
Q

cancer syndromes associated with adrenal cortical carcinoma

A

Li Farumeni

MEN1

26
Q

Histology of Adrenal cortical carcinoma

A 
Weiss histological criteria for cancer
Note its difficult to diagnose cancer in the absence of metastatic disease
5 criteria
>6 mitoses/50 HPF, Ki67%
<25% clear tumour cells
abnormal mitoses
necrosis
capsular invasion
27
Q

phaeo associated familial syndromes

A

MEN2
VHL
NF1
Carney triad

28
Q

when to familial test for phaeo/paraganglioma

A

consider for all paraganglioma
bilateral phaeo
family history
unilateral phaeo <45 years old

29
Q

Phaeo triad

A

Headaches, palpitations sweats (+hypertension on examination)

30
Q

Conn’s triad

A

hypokalemia, alkalosis, hypertension

31
Q

PNET characteristic presentations

A

Insulinoma - whipple’s triad - hypoglycemic symptoms (confusion, visual changes, diaphoresis) + recorded hypoglycemia + symptoms settle with sugar intake
Gastrinoma - zollinger-ellison syndrome (PUD + Diarrhoea)
Glucagonoma - necrolytic migratory erythema, diabetes, diarrhoea, VTE, neuropsych
VIPoma - diarrheoa, hypokalemia, hypochlorhydria
Somatostatinoma - steatorrhoea, cholelithiasis

32
Q

how to confirm ZES

A

Fasting serum gastrin level high
Low stomach pH (<2) (ensure not on acid suppression) - if higher pH and not on suppression consider atrophic gastritis/h.pylori
exclude other causes of high gastrin (e.g. retained antrum syndrome)
secretin suppresion test if FSG<10x increased
if >10 FSG then confirms ZES

33
Q

what is the ASVS

A

arterial calcium stimulation with hepatic venous sampling used to help localised insulinoma + gastrinoma

34
Q

carcinoid syndrome

A

flushing diarrhoea wheezing

35
Q

Bethesda + risk of malignancy

A 
1 - non diagnostic
2- benign - 2%
3- atypia of undetermined significant or follicular lesion of undetermined significance - 5-15%
4 -follicular neoplasm - 15-30%
5- Suspicious for malignancy - 60-75%
6- Malignant - 99%

FRACS exam (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions