Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

EOR General Surgery > Endocrinology (8%) > Flashcards

Endocrinology (8%) Flashcards

1
Q

Risk factors for thyroid carcinoma with thyroid nodules

A

Extremes of age (very young or > 60 y/o)

History of neck/head radiation

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

Most thyroid nodules in women are benign, and are either _____ _________ or _______

A

Follicular adenomas

Cysts

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

Only ___% of thyroid nodules are malignant

A

10%

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

Most thyroid nodules found in _____ & _____ are malignant

A

Men & children

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

Most common form of thyroid cancer in women

A

Papillary CA

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

Symptoms of thyroid nodules

A 
Most are asymptomatic
Worrisome sx: compressive sx
Difficulty swallowing or breathing
Neck, jaw, or ear pain
Hoarseness (rare)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Characteristics of benign thyroid nodules

A

Smooth, firm, regular, sharply outlined, discrete, painless

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

Characteristics of malignant thyroid nodules

A

Rapid growth
Fixed in place
No movement with swallowing

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

Diagnostic modalities for thyroid nodules

A
  1. Thyroid Function Tests
  2. FNA with Biopsy - best initial test
  3. Radioactive Iodine Uptake Scan - performed if FNA is indeterminate - cold nodules suspicious for CA
  4. Thyroid ultrasound - often used with FNA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Treatment of thyroid nodules

A
  1. Surgical thyroidectomy - if CA is suspected or if indeterminate FNA w/ cold thyroid scan
  2. Observation of suspicious nodules (every 6-12 mo)
  3. Suppressive therapy with thyroid hormone in attempt to shrink nodule in some cases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Should have increased suspicion of thyroid cancer if patients < ____ y/o with thyroid nodules

A

20 y/o

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

Two types of thyroid cancer with best prognosis

A

Papillary (Most Common)

Follicular (2nd MC)

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

Type of thyroid cancer with the worst prognosis

A

Anaplastic (only 10% survive three years after dx)

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

In papillary thyroid CA, local (cervical) lymph node METS are _________, and distant METS are ________

A

Common

Uncommon

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

Management of papillary thyroid CA

A

Total thyroidectomy
OR
Subtotal thyroidectomy coupled with radioiodine therapy to destroy residual cells

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

What can be monitored after thyroidectomy to check for recurrence of thyroid cancer?

A

Thyroglobulin
Monitor for 6 mo
If medullary CA, monitor calcitonin levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Follicular thyroid cancer is associated with:

A

Iodine deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In follicular thyroid CA, local (cervical) lymph node METS are _________, and distant METS are __________

A

Less common

Common (lung, brain, bone, liver, skin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Management of follicular thyroid CA

A

Same as papillary

Thyroidectomy or subtotal thyroidectomy with radioiodine therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Medullary thyroid CA is associated with:

A

MEN 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

In medullary thyroid CA, local (cervical) lymph node METS occur ______, and distant METS occur _______

A

Early

Late

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Management of medullary thyroid CA:

A
  1. Total thyroidectomy - include neck dissection of all lymph nodes
  2. Calcitionin levels used to monitor is residual disease is present after tx or for recurrence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Anaplastic thyroid CA is associated with:

A

Radiation exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Anaplastic thyroid CA is most common in:

A

Males > 65 y/o

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Symptoms of anaplastic thyroid CA
Often will see compressive symptoms | Rapid growth and most aggressive
26
In anaplastic thyroid CA, local (cervical) lymph node METS are _______, and distant METS are _______
Common Also common May invade trachea!
27
Management of anaplastic thyroid CA:
Most not amenable to surgical resection External beam radiation Chemotherapy Palliative tracheostomy in 20% to maintain airway
28
Pts with adrenal carcinoma will often present with _______ _______ and _________
Cushing's Syndrome (fatty hump b/w shoulders, excessive hunger, purple stretch marks) Virilization (development of male physical characteristics) Males may present with feminization (breast enlargement, decreased libido)
29
All adrenal tumors that are _______ and/or ________ secreting are malignant until proven otherwise
Androgen | Estrogen
30
Diagnostic modalities for adrenal carcinoma
1. Adrenal androgens (DHEA, androstenedione, testosterone and 17-OH) 2. Elevated levels of estradiol 3. Incidentally found - screen for aldosteronism, cushings, and pheochromocytoma - if found, remove tumor
31
Management for tumors/nodules found on adrenals incidentally
If > 4 cm and non-functioning, remove due to increased risk of CA If < 4 cm, a CT is warranted every 6 mo
32
Aldosteronism is defined as an increased:
Aldosterone:Renin Ratio (20:1)
33
Diagnosis of aldosteronism
1. Aldosterone suppression test w/ oral sodium chloride 2. Elevated urine aldosterone excretion confirms hyperaldosteronism 3. Order adrenal CT
34
Diagnosis of Cushing's syndrome
1. 24 hour urine free cortisol | 2. 1 mg overnight dexamethasone test
35
Diagnosis of pheochromocytoma
1. 24 hour urine catecholamines, metanephrines, and normetanephrines 2. Levels need to be 3x the upper limit of normal for a positive screening 3. If positive, order adrenal CT 4. Labs: hyperglycemia, hypokalemia
36
Treatment of adrenal carcinoma
Surgical resection is treatment of choice | Glucocorticoid replacement is also needed after resection
37
Catecholamine-secreting adrenal tumor
Pheochromocytoma
38
A pheochromocytoma secretes ___________ and ________ autonomously and intermittently
Norepinephrine and epinephrine
39
___% of pheochromocytomas are benign
90%
40
Signs/Symptoms of pheochromocytoma
1. Hypertension 2. PHE (Palpitations, Headache, Excessive sweating) 3. Chest or abdominal pain, weight loss (despite increased appetite)
41
Management of pheochromocytoma
1. Complete adrenalectomy 2. Preoperative non-selective alpha blocker: Phenoxybenzamine or Phentolamine for 7-14 days 3. Next, beta blockers or CCBs to control HTN ***** very important to lead with alpha blockers to avoid life threatening hypertension
42
Decreased serum calcium stimulates a release of _____
PTH
43
Hyperparathyroidism is most commonly secondary to an ___________
Adenoma
44
Most common presentation of hyperparathyroidism
Asymptomatic hypercalcemia
45
Symptoms of hyperparathyroidism
Bones, stones, abdominal moans, psychic groans
46
Hyperparathyroidism - bone symptoms
Osteitis fibrosa cystica, decreased bone mineral density
47
Hyperparathyroidism - stone symptoms
Renal stones
48
Most common complication of hyperparathyroidism
Renal stones
49
Hyperparathyroidism - abdominal moan symptoms
Anorexia Nausea Constipation
50
Hyperparathyroidism - psychic groan symptoms
Lethargy Depression Psychosis
51
Diagnosis of hyperparathyroidism
``` Labs: Elevated PTH Elevated serum calcium Decreased phosphate EKG: shortened QT interval ```
52
Treatment for hyperparathyroidism
Surgery is indicated for pts with symptoms If cannot have surgery: Cinacalcet or bisphosphonates
53
Indications for surgical intervention in asymptomatic hyperparathyroidism pts
1. Serum calcium over 1.0 mg/dL the upper limit of normal 2. Reduced creatinine clearance 3. Osteoporosis 4. Under 50 years old
54
Most common cause of hyperthyroidism
Grave's disease
55
Signs/symptoms of hyperthyroidism
``` Heat intolerance Menstrual irregularities Weight loss Palpitations Hyperdefecation Anxiety Tachycardia ```
56
Grave's disease specific symptoms
Eye proptosis Chemosis Lid Retraction Pretibial myxedema
57
Diagnosis for hyperthyroidism
1. Rule out pregnancies 2. Thyroid panel (looking for low TSH and high T4) 3. Radioactive iodine uptake - decreased uptake Except in grave's, which will have increased uptake
58
Treatment for hyperthyroidism
1. Beta blockers 2. PTU or methimazole 3. Definitive treatment: radioactive iodine 4. Steroids for ophthalmopathy
59
Treatment of thyroid storm
PTU or methimazole Beta blockers High dose corticosteroids
60
Complications of methimazole
Leukopenia | Agranulocytosis
61
Complications of PTU
Hepatotoxicity

EOR General Surgery (10 decks)

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