Neck Lumps Flashcards
What are the two types of goitre + what is the most common cause of goitre?
Diffuse
Multinodular
Iodine deficiency
What is the TSH and T3/T4 level in goitre?
High TSH
Normal T3/4
What is multi-nodular goitre caused by?
Hyperplasia due to long term goitre
What are the 2 risks of multi nodular goitre?
Hyperthyroidism
Malignancy
Do a CT scan in MNG to check for what 2 things?
Retrosternal extension
Tracheal compression
MNG may have what type of lesion?
Dominant nodule
Name 5 tests for thyroid lumps.
US TSH FNA Core biopsy Laryngoscopy
US scored from U2-U5 with 2 being … and 5 being …?
Benign
Malignant
FNA scored from Thy2-Thy5 with 2 being … and 5 being …?
Benign
Malignant
Follicular lesions are always scored … on the Thy score?
Thy 3
Most common benign thyroid lump?
Follicular adenoma
What is a follicular adenoma + solitary/multifocal + functional/non-functional?
Neoplastic thyroid follicles with collagen capsule
Solitary
Non-functional
Name the the 2 mutations of the TSHR linked to follicular adenoma.
Ras
PIK3CA
Thyroid cancer is associated with … and … and is more common in men/women?
Ionising radiation
Iodine deficiency
Women
Name 5 AMES red flags of malignant thyroid disease.
Age < 20 or > 50 Increasing size > 4 cm History of radiation Vocal nerve palsy
Name 4 types of thyroid cancer + what cells they arise from + which is the most common?
Papillary, follicular (MOST COMMON)
Follicular, follicular
Medullary, parafollicular
Anaplastic, follicular
Are papillary tumours solitary or multifocal + type of spread?
Multifocal
Lymph and haematogenous spread
2 mutations associated with papillary thyroid tumours?
PET/PTC
BRAF
Papillary thyroid tumours can be c…. and c…. and are seen with …. bodies?
Cystic
Calcified
Psammoma
Name 2 causes of papillary thyroid tumours?
Ionising radiation
Hashimoto’s thyroiditis
What is the prognosis for papillary thyroid tumours?
Good
What is the treatment for thyroid tumours + non-surgical option if cancer persists?
Lobectomy or total thyroidectomy + radioioidine
Thyroid remnant ablation
Are follicular carcinomas solitary or multifocal + key mutation + type of spread?
Solitary
PAX8-PPAR
Haematogenous
What is follicular carcinoma associated with?
Iodine deficiency
Prognosis of follicular carcinomas depends on?
Degree of capsular invasion
What do medullary carcinomas secrete?
Calcitonin
Name 2 paraneoplastic syndromes associated with medullary carcinoma + the hormones?
Diarrhoea = VIP Cushing's = ACTH
Sporadic and familial medullary carcinoma are seen in … people whereas … cases are linked to …?
Older
MEN 2
Sporadic medullary carcinoma is usually … and familial is ….?
Solitary
Bilateral/multicentric
Name a type of cell + a deposition molecule associated with medullary carcinoma.
Spindle cell
Amyloid
Anaplastic carcinoma is seen in what age group with what history?
Older
Thyroid cancer
What type of care is needed for anaplastic carcinoma + why?
Palliative
Poorly differentiated cancer so very aggressive
What 2 tests are done post-thyroid surgery and what are they looking for?
Serum Ca = Ca < 2 mmol/l
Iodine body scan = cancer cells
When does T4 and T3 need to be stopped before an iodine body scan?
T4 = 4 weeks T3 = 2 weeks
