Surgery: Superficial Lumps - Solitary Thyroid Nodules, The Neck Flashcards

1
Q

Solitary Thyroid Nodules, The Neck

What are the features of Follicular Adenoma?

A
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2
Q

Solitary Thyroid Nodules, The Neck

What is the management of Follicular Adenoma?

A
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3
Q

Solitary Thyroid Nodules, The Neck​

What are the features of Thyroid Cyst?

A
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4
Q

Solitary Thyroid Nodules, The Neck​

What is the management of Thyroid Cyst?

A
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5
Q

Solitary Thyroid Nodules, The Neck​

What are the types of Thyroid Cancer?

A
  • Benign
    • Follicular Adenoma
    • Thyroid Cyst
  • Malignant
    • Papillary
    • Follicular
    • Medullary
    • Anaplastic
    • Lymphoma
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6
Q

Solitary Thyroid Nodules, The Neck

What is the frequency of Papillary Thyroid Cancer?

A
  • 80%
  • Assoc. c¯ irradiation
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7
Q

Solitary Thyroid Nodules, The Neck

What is the typical age group of Papillary Thyroid Cancer?

A
  • 20-40
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8
Q

Solitary Thyroid Nodules, The Neck

What is the cell origin of Papillary Thyroid Cancer?

A
  • Follicular cells
  • Tg tumour marker
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9
Q

Solitary Thyroid Nodules, The Neck

What is the spread of Papillary Thyroid Cancer?

A
  • Nodes and lung - JDG node = lateral aberrant thyroid
  • May be multifocal
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10
Q

Solitary Thyroid Nodules, The Neck

What is the management of Papillary Thyroid Cancer?

A
  • Total thyroidectomy + T4 to suppress TSH ± node excision ± radioiodine
  • >95% 10ys
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11
Q

Solitary Thyroid Nodules, The Neck

What is the frequency of Follicular Thyroid Cancer?

A
  • 10%
  • F>M = 3:1
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12
Q

Solitary Thyroid Nodules, The Neck

What is the typical age group of Follicular Thyroid Cancer?

A
  • 40-60
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13
Q

Solitary Thyroid Nodules, The Neck

What is the cell origin of Follicular Thyroid Cancer?

A
  • Follicular cells
  • Tg tumour marker
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14
Q

Solitary Thyroid Nodules, The Neck

What is the spread of Follicular Thyroid Cancer?

A
  • Blood → bone and lungs
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15
Q

Solitary Thyroid Nodules, The Neck

What is the management of Follicular Thyroid Cancer?

A
  • Total thyroidectomy + T4 suppression + Radioiodine
  • >95% 10ys
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16
Q

Solitary Thyroid Nodules, The Neck

What is the frequency of Medullary Thyroid Cancer?

A
  • 5%
  • 30% are familial
    • e.g. MEN2
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17
Q

Solitary Thyroid Nodules, The Neck

What is the typical age group of Medullary Thyroid Cancer?

A
  • MEN2: young
  • Sporadic: 40-50
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18
Q

Solitary Thyroid Nodules, The Neck

What is the cell origin of Medullary Thyroid Cancer?

A
  • Parafollicular C-cells
  • CEA and calcitonin markers
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19
Q

Solitary Thyroid Nodules, The Neck

What is the management of Medullary Thyroid Cancer?

A
  • Do phaeo screen pre-op Thyroidectomy + Node clearance
  • Consider radiotherapy
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20
Q

Solitary Thyroid Nodules, The Neck

What is the frequency of Anaplastic Thyroid Cancer?

A
  • Rare
  • F>M = 3:1
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21
Q

Solitary Thyroid Nodules, The Neck

What is the typical age group of Anaplastic Thyroid Cancer?

A
  • >60
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22
Q

Solitary Thyroid Nodules, The Neck

What is the cell origin of Anaplastic Thyroid Cancer?

A
  • Undifferentiated follicular cells
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23
Q

Solitary Thyroid Nodules, The Neck

What is the spread of Anaplastic Thyroid Cancer?

A
  • Rapid growth
  • Aggressive: local, LN and blood.
24
Q

Solitary Thyroid Nodules, The Neck

What is the management of Anaplastic Thyroid Cancer?

A
  • Usually palliative
  • May try thyroidectomy + radiotherapy
  • <1% 10ys
25
Q

Solitary Thyroid Nodules, The Neck

What is the frequency of Lymphoma Thyroid Cancer?

A
  • 5%
26
Q

Solitary Thyroid Nodules, The Neck

What is the cell origin of Lymphoma Thyroid Cancer?

A
  • Lymphocytes
    • MALToma in Hashi’s
27
Q

Solitary Thyroid Nodules, The Neck

What is the management of Lymphoma Thyroid Cancer?

A

Chemoradiotherapy

28
Q

Solitary Thyroid Nodules, The Neck

What are the main Thyroid Nodule Facts?

A
29
Q

Solitary Thyroid Nodules, The Neck

What is the Thyroid Nodule Triple assessment?

A
30
Q

Solitary Thyroid Nodules, The Neck

What are the features of Men-1?

A
31
Q

Solitary Thyroid Nodules, The Neck

What are the features of Men-2?

A
32
Q

Solitary Thyroid Nodules, The Neck

What are the early complications of Thyroid Surgery?

A
33
Q

Solitary Thyroid Nodules, The Neck

What are the late complications of Thyroid Surgery?

A
34
Q

Solitary Thyroid Nodules, The Neck

What are the practicalities of Thyroid Surgery?

A
35
Q

Solitary Thyroid Nodules, The Neck

What is needed to prepare a Neck Examination?

A
36
Q

Solitary Thyroid Nodules, The Neck

What are the neck inspection features in a Neck Examination?

A
37
Q

Solitary Thyroid Nodules, The Neck

What are the mouth inspection features in a Neck Examination?

A
38
Q

Solitary Thyroid Nodules, The Neck

What are the eye inspection features in a Neck Examination?

A
39
Q

Solitary Thyroid Nodules, The Neck

What are the palpation findings in a Neck Examination?

A
40
Q

Solitary Thyroid Nodules, The Neck

What are the percussion findings in a Neck Examination?

A
41
Q

Solitary Thyroid Nodules, The Neck

What are the auscultation findings in a Neck Examination?

A
42
Q

Solitary Thyroid Nodules, The Neck

What should be done if there are no obvious findings in a Neck Examination?

A
43
Q

Solitary Thyroid Nodules, The Neck

What is needed to complete a Neck Examination?

A
44
Q

Solitary Thyroid Nodules, The Neck

What are the main anatomical areas that differentiate a neck examination?

A
  • Anywhere Midline
    • (Solid and Cystic)
  • Anterior triangle
    • (Solid and Cystic)
  • Posterior triangle
    • (Solid and Cystic)
45
Q

Solitary Thyroid Nodules, The Neck

What Neck differentials can be anywhere and solid or cystic?

A
  • Lipomas and Sebaceous Cysts
46
Q

Solitary Thyroid Nodules, The Neck

What Neck differentials are Midline and Solid?

A
  • Ectopic thyroid tissue
  • Thyroid isthmus mass Inclusion dermoid
47
Q

Solitary Thyroid Nodules, The Neck

What Neck differentials are Midline and Cystic?

A
  • Thyroglossal Cyst
48
Q

Solitary Thyroid Nodules, The Neck

What Neck differentials are Anterior Triangle and Solid?

A
  • LNs
  • Chemodectoma
  • Goitre
  • Parotid tumour
49
Q

Solitary Thyroid Nodules, The Neck

What Neck differentials are Anterior Triangle and Cystic?

A
  • Branchial Cyst
  • Laryngocele
50
Q

Solitary Thyroid Nodules, The Neck

What Neck differentials are Posterior Triangle and Solid?

A
  • LNs
  • Cervical Rib
  • Pancoast tumour
51
Q

Solitary Thyroid Nodules, The Neck

What Neck differentials are Posterior Triangle and Cystic?

A
  • Cystic Hygroma
  • Pharyngeal Pouch
52
Q

Solitary Thyroid Nodules, The Neck

What are the investigations needed in a Neck Examination?

A
53
Q

Solitary Thyroid Nodules, The Neck

What are the key Onset questions in a Neck Lump History?

A
54
Q

Solitary Thyroid Nodules, The Neck

What are the key Continued Symptom questions in a Neck Lump History?

A
55
Q

Solitary Thyroid Nodules, The Neck

What are the key Treatment and Cause questions in a Neck Lump History?

A