Surgery: Superficial Lumps - Solitary Thyroid Nodules, The Neck Flashcards
Solitary Thyroid Nodules, The Neck
What are the features of Follicular Adenoma?
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Solitary Thyroid Nodules, The Neck
What is the management of Follicular Adenoma?
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Solitary Thyroid Nodules, The Neck
What are the features of Thyroid Cyst?
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Solitary Thyroid Nodules, The Neck
What is the management of Thyroid Cyst?
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Solitary Thyroid Nodules, The Neck
What are the types of Thyroid Cancer?
- Benign
- Follicular Adenoma
- Thyroid Cyst
- Malignant
- Papillary
- Follicular
- Medullary
- Anaplastic
- Lymphoma
Solitary Thyroid Nodules, The Neck
What is the frequency of Papillary Thyroid Cancer?
- 80%
- Assoc. c¯ irradiation
Solitary Thyroid Nodules, The Neck
What is the typical age group of Papillary Thyroid Cancer?
- 20-40
Solitary Thyroid Nodules, The Neck
What is the cell origin of Papillary Thyroid Cancer?
- Follicular cells
- Tg tumour marker
Solitary Thyroid Nodules, The Neck
What is the spread of Papillary Thyroid Cancer?
- Nodes and lung - JDG node = lateral aberrant thyroid
- May be multifocal
Solitary Thyroid Nodules, The Neck
What is the management of Papillary Thyroid Cancer?
- Total thyroidectomy + T4 to suppress TSH ± node excision ± radioiodine
- >95% 10ys
Solitary Thyroid Nodules, The Neck
What is the frequency of Follicular Thyroid Cancer?
- 10%
- F>M = 3:1
Solitary Thyroid Nodules, The Neck
What is the typical age group of Follicular Thyroid Cancer?
- 40-60
Solitary Thyroid Nodules, The Neck
What is the cell origin of Follicular Thyroid Cancer?
- Follicular cells
- Tg tumour marker
Solitary Thyroid Nodules, The Neck
What is the spread of Follicular Thyroid Cancer?
- Blood → bone and lungs
Solitary Thyroid Nodules, The Neck
What is the management of Follicular Thyroid Cancer?
- Total thyroidectomy + T4 suppression + Radioiodine
- >95% 10ys
Solitary Thyroid Nodules, The Neck
What is the frequency of Medullary Thyroid Cancer?
- 5%
- 30% are familial
- e.g. MEN2
Solitary Thyroid Nodules, The Neck
What is the typical age group of Medullary Thyroid Cancer?
- MEN2: young
- Sporadic: 40-50
Solitary Thyroid Nodules, The Neck
What is the cell origin of Medullary Thyroid Cancer?
- Parafollicular C-cells
- CEA and calcitonin markers
Solitary Thyroid Nodules, The Neck
What is the management of Medullary Thyroid Cancer?
- Do phaeo screen pre-op Thyroidectomy + Node clearance
- Consider radiotherapy
Solitary Thyroid Nodules, The Neck
What is the frequency of Anaplastic Thyroid Cancer?
- Rare
- F>M = 3:1
Solitary Thyroid Nodules, The Neck
What is the typical age group of Anaplastic Thyroid Cancer?
- >60
Solitary Thyroid Nodules, The Neck
What is the cell origin of Anaplastic Thyroid Cancer?
- Undifferentiated follicular cells
Solitary Thyroid Nodules, The Neck
What is the spread of Anaplastic Thyroid Cancer?
- Rapid growth
- Aggressive: local, LN and blood.
Solitary Thyroid Nodules, The Neck
What is the management of Anaplastic Thyroid Cancer?
- Usually palliative
- May try thyroidectomy + radiotherapy
- <1% 10ys
Solitary Thyroid Nodules, The Neck
What is the frequency of Lymphoma Thyroid Cancer?
- 5%
Solitary Thyroid Nodules, The Neck
What is the cell origin of Lymphoma Thyroid Cancer?
- Lymphocytes
- MALToma in Hashi’s
Solitary Thyroid Nodules, The Neck
What is the management of Lymphoma Thyroid Cancer?
Chemoradiotherapy
Solitary Thyroid Nodules, The Neck
What are the main Thyroid Nodule Facts?
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Solitary Thyroid Nodules, The Neck
What is the Thyroid Nodule Triple assessment?
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Solitary Thyroid Nodules, The Neck
What are the features of Men-1?
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Solitary Thyroid Nodules, The Neck
What are the features of Men-2?
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Solitary Thyroid Nodules, The Neck
What are the early complications of Thyroid Surgery?
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Solitary Thyroid Nodules, The Neck
What are the late complications of Thyroid Surgery?
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Solitary Thyroid Nodules, The Neck
What are the practicalities of Thyroid Surgery?
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Solitary Thyroid Nodules, The Neck
What is needed to prepare a Neck Examination?
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Solitary Thyroid Nodules, The Neck
What are the neck inspection features in a Neck Examination?
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Solitary Thyroid Nodules, The Neck
What are the mouth inspection features in a Neck Examination?
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Solitary Thyroid Nodules, The Neck
What are the eye inspection features in a Neck Examination?
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Solitary Thyroid Nodules, The Neck
What are the palpation findings in a Neck Examination?
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Solitary Thyroid Nodules, The Neck
What are the percussion findings in a Neck Examination?
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Solitary Thyroid Nodules, The Neck
What are the auscultation findings in a Neck Examination?
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Solitary Thyroid Nodules, The Neck
What should be done if there are no obvious findings in a Neck Examination?
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Solitary Thyroid Nodules, The Neck
What is needed to complete a Neck Examination?
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Solitary Thyroid Nodules, The Neck
What are the main anatomical areas that differentiate a neck examination?
- Anywhere Midline
- (Solid and Cystic)
- Anterior triangle
- (Solid and Cystic)
- Posterior triangle
- (Solid and Cystic)
Solitary Thyroid Nodules, The Neck
What Neck differentials can be anywhere and solid or cystic?
- Lipomas and Sebaceous Cysts
Solitary Thyroid Nodules, The Neck
What Neck differentials are Midline and Solid?
- Ectopic thyroid tissue
- Thyroid isthmus mass Inclusion dermoid
Solitary Thyroid Nodules, The Neck
What Neck differentials are Midline and Cystic?
- Thyroglossal Cyst
Solitary Thyroid Nodules, The Neck
What Neck differentials are Anterior Triangle and Solid?
- LNs
- Chemodectoma
- Goitre
- Parotid tumour
Solitary Thyroid Nodules, The Neck
What Neck differentials are Anterior Triangle and Cystic?
- Branchial Cyst
- Laryngocele
Solitary Thyroid Nodules, The Neck
What Neck differentials are Posterior Triangle and Solid?
- LNs
- Cervical Rib
- Pancoast tumour
Solitary Thyroid Nodules, The Neck
What Neck differentials are Posterior Triangle and Cystic?
- Cystic Hygroma
- Pharyngeal Pouch
Solitary Thyroid Nodules, The Neck
What are the investigations needed in a Neck Examination?
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Solitary Thyroid Nodules, The Neck
What are the key Onset questions in a Neck Lump History?
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Solitary Thyroid Nodules, The Neck
What are the key Continued Symptom questions in a Neck Lump History?
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Solitary Thyroid Nodules, The Neck
What are the key Treatment and Cause questions in a Neck Lump History?
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