Goitres Flashcards
1
Q
What is a goitre?
A
Enlarged thyroid gland
2
Q
What are the red flags of a goitre?
A
• Growth over several months
• Dysphagia – decompression symptoms
• Neck pain
• Hoarseness or aphonia (loss of voice)
Recurrent laryngeal nerve palsy
• Hx of radiation exposure to the neck
• Family Hx of thyroid cancer
3
Q
What produces a diffuse smooth goitre?
A
o Grave’s disease o Hypothyroidism (hasimoto’s) o Thyroiditis o Iodine deficiency o Drugs – lithium and amiodarone
4
Q
What produces a nodular goitre?
A
o Multinodular
o Single nodule:
Cyst
Adenoma
Cancerous tumour
5
Q
How would you investigate a goitre?
A
• US followed by fine needle aspiration (FNA) of the lump
6
Q
What are the diagnostic stages of a thyroid cancer?
A
- Non-diagnostic: Thy1
- Benign: Thy2
- Indeterminate: Thy3
- Suspicious of malignancy: Thy4
- Diagnostic of malignancy: Thy5
7
Q
What are the 2 most common thyroid carinomas?
A
- Papillary 70%
- Follicular 20%
8
Q
Where do papillary carcinomas commonly metastasise to?
A
Local lymph nodes in neck
9
Q
Where are papillary and follicular carcinomas derived from?
A
Follicular epitheliem
10
Q
How would you treat a thyroid cancer?
A
• Surgery (total thyroidectomy or lobectomy)
• Post-operative radioactive iodine treatment
• Thyroid hormone suppression
Suppresses TSH so tumour growth is not stimulated
