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Principles and Procedures > Endocrine Tumors > Flashcards

Endocrine Tumors Flashcards

1
Q

What is the function of the endocrine system?

A

Complex Metabolic Functions

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2
Q

What are the 3 primary organs of the endocrine system?

A

Pituitary, Thyroid, and Adrenal

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3
Q

What other 2 structures are also a part of the endocrine system?

A

Parathyroid Gland and Pancreas

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4
Q

What structure controls the endocrine system?

A

Pituitary

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5
Q

What organ directs the pituitary?

A

Hypothalamus

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6
Q

How does the endocrine transport hormones?

A

Hormones are deposited and transported through the blood

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7
Q

What is the function of the endocrine system in terms of looking at the body holistically?

A

Maintain Metabolic Homeostasis

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8
Q

What is the name of the process in which homeostasis is achieved as a result of this process?

A

Negative Feedback Loop

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9
Q

Explain the negative feedback loop

A

In terms of negative feedback, once the body sense there is a high volume of certain hormones then a organ will be limited in creating that hormone

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10
Q

What is a function of the endocrine system that activates bases on external factors?

A

Ability to respond to stresses

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11
Q

Endocrine dysfunction can result in minor or life-threatening situations. True or False?

A

True

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12
Q

What is an example of a situation resulting from endocrine dysfunction?

A

Diabetes, Graves Disease, PCOS

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13
Q

What occurs as a result of neoplastic development in the endocrine system?

A

Metabolic function altering

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14
Q

What results from the metabolic function being altering from neoplastic developments?

A

Paraneoplastic syndromes

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15
Q

Primary Malignancies in the Endocrine System are common. True or False?

A

False, they are rare

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16
Q

What is the most common endocrine malignancy?

A

Thyroid Cancer

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17
Q

What percentage of endocrine tumors are those of the thyroid?

A

Over 90 %

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18
Q

What is the most common histology of thyroid cancer?

A

Papillary

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19
Q

What is the 5-year survival rate for thyroid cancer?

A

98.3%

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20
Q

What event is the most known etiological association to Thyroid Cancer?

A

Exposure to external radiation pre-puberty

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21
Q

History of Goiter has been shown to be related to the cause of thyroid cancer? True or Fales

A

True

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22
Q

What geographical areas have been more prone to the development of thyroid cancer and why?

A

Chernobyl and Marshall Islands. Chernobyl is due to the nuclear reactor disaster that occurred and Marshall Islands are due to the denotation of nuclear arms

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23
Q

Why have those that grew up in the 30s,40s, and 50s shown more occurrence of Thyroid Cancer than other generations?

A

With X-Ray being a new development, there was widespread usage such as in the shoe industry

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24
Q

What are the prognostic factors of Thyroid Cancer?

A

Age, Histological Subtype, Capsular Invasion

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25
Q

In terms of histology and tumor margin, what has the best outcome?

A

Well Differentiated and Tumors confined to the gland

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26
Q

Anatomically the thyroid is separated into?

A

Right and Left lobes

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27
Q

What structure does the thyroid lay anteriorly to?

A

Trachea

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28
Q

What 4 lymphatic chains does the thyroid drain to?

A

Internal Jugular Chain, Anterior Cervical Node, Pre-Wtracheal and Para-tracheal nodes

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29
Q

For Thyroid Cancer, when superior mediastinal nodes are involved, what does the mean?

A

Significant Regional Spread

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30
Q

What are the 7 lymphatics of the neck?

A

Superior Deep Cervical, Inferior Deep Cervical, Submental, Submandibular,, pre-laryngeal, para-tracheal, Pre-tracheal

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31
Q

What two biological components are metabolized by the thyroid?

A

Carbohydrates and Proteins

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32
Q

Most clinical disorders are a result of what two thyroid-related conditions?

A

Hyperthyroidism and Hypothyroidism

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33
Q

Hypothyroidism causes what two disorders?

A

Cretinism and Myxedema

34
Q

What are some symptoms of Cretinism?

A

Appears in infants, Stunted growth, abnormal bone formation, retardation

35
Q

What are some symptoms of Myxedema?

A

Low metabolic rate, Mental Slowness, Weight Gain, peri-orbital edema

36
Q

Hyperthyroidism causes what two disorders?

A

Graves and Goiter

37
Q

What are some symptoms of Grave disease?

A

Elevated Metabolism, abnormal weight, excessive perspiration, exophthalmos

38
Q

What are some symptoms of Goiter?

A

Signs of Enlarged Thyroid, Over stimulation causes enlargement of thyroid cells

39
Q

What is the clinical presentation of Thyroid Cancer?

A

Palpable mass, and 25% exhibit palpable cervical nodes

40
Q

What should be performed on persistently enlarged nodes?

A

Biopsy

41
Q

Why are biopsies so important for thyroid tumors?

A

Give definitive diagnosis

42
Q

What two types of biopsies are performed on thyroid tumors?

A

Fine Needle Aspiration and Core needle biopsy

43
Q

What can a sonograph determine on a thyroid tumor?

A

Solid mass versus cystic mass

44
Q

What can a ct scan determine on a thyroid tumor?

A

Local or Regional Extent

45
Q

What can an MRI determine on a thyroid tumor?

A

Margins and Extent

46
Q

What can radionuclide imaging determine for thyroid malignancy?

A

Evaluate location and function of nodule, detect primary disease and distant mets

47
Q

What radioisotopes are used in radionuclide imaging and what is the meaning behind uptake?

A

Iodine and Technetium, uptake is measured and the more uptake indicates likelihood of malignancy

48
Q

What can nuclear imaging determine in terms of thyroid nodules?

A

Hot, Warm and Cold Nodules

49
Q

What are the 4 types of thyroid histology?

A

Papillary, Follicular, Medullary, Anaplastic

50
Q

What are the most common thyroid histologies?

A

Papillary, Mixed papillary-follicular and Follicular

51
Q

What staging system is used for thyroid cancer?

A

TNM staging

52
Q

What 2 factors are taken into account when staging for thyroid cancer?

A

Histology and age of patient

53
Q

What percentage of patients have positive cervical nodes at dx and does that have an effect on the prognosis?

A

50-70% and there is no worsening of the prognosis

54
Q

Where does papillary/mixed papillary-follicular typically met to?

A

Regional nodes through lymphatics

55
Q

Where does Follicular typically met to?

A

Vascular Channels (Liver, lung, bone and brain)

56
Q

Where does medullary typically met to and the behavior exhibited?

A

indolent or very aggressive and hematogenously/lymphatically

57
Q

Where does anaplastic typically met to and the behavior exhibited?

A

Adjacent structures such as trachea, skin invasion, neck nodes

58
Q

What is the treatment of choice for thyroid cancer?

A

Thyroidectomy, Partial or Total

59
Q

What are the two other treatments utilizing radiation for thyroid cancer?

A

I-131 Radio-ablation, EBRT w/ or w/o I-131

60
Q

What histologies of thyroid cancer are more radioresistant?

A

Papillary and Mixed Papillary-Follicular then follicular

61
Q

What histologies of thyroid cancer are less responsive to radiation therapy?

A

Medullary is less responsive and Anaplastic is not responsive

62
Q

Can EBRT be used with I-131 or Surgery?

A

Alone or with both

63
Q

What is the common dosage for thyroid cancer?

A

6000-7000 cGy (180-200 cGy daily)

64
Q

What structures are included in the thyroid tx field?

A

Entire T-gland, neck, superior mediastinum

65
Q

Why is it important for the neck to be extended for thyroid treatment?

A

To avoid irradiating the mouth or lower portion of the head

66
Q

Pituitary tumors are less aggressive of CNS tumors? True or False.

A

True

67
Q

What portion of the pituitary gland do most tumors occur in?

A

Anterior pituitary gland

68
Q

What is the importance of hormone production in Pituitary tumors?

A

Diagnostic tool and also an indication of any type of response measure

69
Q

What are the two types of pituitary tumors in terms of functionality?

A

Over functioning and non functioning

70
Q

What are the types of hormone tumors?

A

Prolactin Secreting, Growth Hormone, TSH secreting

71
Q

What are some hormones that are secreted by the pituitary?

A

Prolactin, Growth Hormone, TSH, ADH, ACTH, Oxytocin, FSH, LH

72
Q

What does ADH stand for and whats its function?

A

Anti-diuretic Hormone and regulates fluid balance

73
Q

what is oxytocin’s function?

A

Smooth muscle contraction, often during childbirth

74
Q

What does FSH stand for and whats its function?

A

Follicle Stimulating Hormone and it stimulates the production of egg and sperm

75
Q

What does LH stand for and whats its function?

A

Luteinizing Hormone and stimulates sexual and reproductive activities

76
Q

Where is the pituitary locates on the brain?

A

Base of brain

77
Q

What structure does the pituitary lie in?

A

Sella Turcica

78
Q

What are some critical structures associated with the pituitary gland?

A

Optic Chiasma, Brain stem,

79
Q

What are some of the clinical presentations of pituitary gland?

A

Hormonal effects, pressure effects, Endocrine abnormalities,

80
Q

Explain the pressure effects exhibited by those that have pituitary tumors?

A

Headaches and vision impairments when the pituitary is outside of the sella turcica, which puts pressure on the optic chiasma and also the brain

81
Q

How is pathology of pituitary tumors decided?

A

Based on size of the tumor

82
Q

What is the difference in micro vs. macro adenomas?

A

Micro is 10 mm or less and Macro is 10 mm or more

Principles and Procedures (27 decks)

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