Pathology

Question 1

Each follicle is surrounded by which type of epithelium?

Answer 1

Cuboidal

Question 2

C-cells / parafollicular cells secrete

Answer 2

Calcitonin

Question 3

Most common cause of hyperthyroidism

Answer 3

Graves’ Disease

Question 4

What’s the triad of pathology in Graves?

Answer 4

1) Hyperthyroidism with goitre 2) Eye changes 3) Pretibial myxoedema

Question 5

What disease is this section representative of?

Answer 5

Graves

Question 6

Most cases of hypothyroidism are due to…

Answer 6

Hashimoto’s thyroiditis (goitrous)

Question 7

Which disease is this image represenative of?

Answer 7

Hashimoto’s Thyroiditis

Question 8

Adenomas are malignant tumours, true or false?

Answer 8

False

Question 9

What’s the most common thyroid cancer?

Answer 9

Papillary (75%) followed by follicular (10%)

Question 10

Adenomas are usually functional in the thyroid, T/F?

Answer 10

False (usually non-functional)

Question 11

Encapsulated, well circumscribed, circular nodule is suggestive of which neoplasm?

Answer 11

Adenoma (follicular)

Question 12

Papillary carcinomas usually activate which pathway?

Answer 12

MAP-kinase

Question 13

Follicular carcinomas activate which pathway?

Answer 13

PIRE/AET

Question 14

Papillary carcinoma is most likely to metastasise via which route?

Answer 14

Lymphatics

Question 15

Follicular carcinoma is most likely to spread via which route?

Answer 15

Haematogenous

Question 16

What’s the 10-year survival rate for papillary carcinoma (treated)?

Answer 16

95%

Question 17

Which type of thyroid cancer may secrete calcitonin?

Answer 17

Medullary

Question 18

Anaplastic thyroid tumours are usually benign, T/F?

Answer 18

False - very aggressive and poorly differentiated

Question 20

Thyroid cancer has a strong association with smoking, FH and diet. True or false?

Answer 20

False - no association with these, only associated with radiation exposure

Question 21

Clinical indicators of malignancy in thyroid nodules include (4)

Answer 21

1) Male sex
2) New nodule at <20 years old OR >50 years old
3) Nodule increasing in size
4) Vocal cord palsy

Question 22

In thyroid cancer, radio-iodine is the treatment of choice, T/F?

Answer 22

False - surgery is the treatment of choice

Question 23

At Ninewells, which system is used to stratify the risk of recurrence for thyroid cancers?

Answer 23

AMES

Question 24

When is radio-iodine ablation used in thyroid cancer?

Answer 24

If there are active remnants

Question 25

Thyroid remnant ablation is associated with developing which cancer?

Answer 25

Acute Myeloid Leukaemia

Question 26

Whole-body iodine scanning for those who have undergone total thyroidectomy is usually given how many months post-op?

Answer 26

3-6 months

Question 27

T4 should be stopped how long before iodine scanning? What about T3?

Answer 27

T4 - 4 weeks prior

T3 - 2 weeks prior

Question 28

What’s the recurrence rate for thyroid cancer?

Answer 28

30%