Thyroid Flashcards
In case of Thyroid nodule
With LOW TSH
What do you do next?
Thyroid scan
In case of Thyroid nodule
With HIGH TSH
What do you do next?
Ultrasound then FNA
Regardless of TSH
A thyroid nodule must undergo FNA if […]
Size >1x1 cm
Thyroid nodule with low TSH
low RAI
Most likely is […]
Subacute thyroiditis
Thyroid nodule with low TSH
High RAI
Most likely is […]
Diffuse uptake: Graves
Nodular: Toxic multinodular goiter
Single Nodule: Adenoma
Initial treatment of hot nodule […]
Antithyroid (methimazole, PTU) + ß-b for symptom control
Then RAI or surgery
If you have a case of symptomatic hot nodule you have to choose […]
as initial drug for symptomatic relief
Beta blocker
In what cases surgery is needed for hot nodule?
-Compressive symptoms (dysphagia)
-Exophthalmos
-Failure of medical treatment
What surgical procedure is for treatment of hot nodule?
Total or
Near-total thyroidectomy
🚫Subtotal is wrong
What is your management in case of
Cold nodule, bethesda 1
nondiagnostic
Repeat FNA
What is your management in case of
Cold nodule, bethesda 2
benign
Follow up with US
What is your management in case of
Cold nodule, bethesda 3
AUS/FLUS
Repeat FNA
What is your management in case of
Cold nodule, bethesda 4
FN/SFN
Lobectomy (hemithyroidectomy)
What is your management in case of
Cold nodule, bethesda 5
sus malignant
Near-total thyroidectomy
What is your management in case of
Cold nodule, bethesda 6
Malignant
Near-total thyroidectomy
If diagnosis of hypothyroidism is made start levothyroxine and reassess after […]
6 weeks
If patient present with hypothyroidism not controlled with medications, currently his TSH is high and is asking for surgical tx
What is your recommendation?
Postpone surgery until Euthyroid
in critically ill patient
TSH low T3/T4 low
Dx: […]
Sick Euthyroid syndrome
Most common thyroid cancer associated with Autoimmune thyroiditis is […]
1# Lymphoma
2# papillary
🚫Lymphoblastic is wrong
Follow up papillary cancer by […]
Thyroglobulin
Follow up follicular cancer by […]
Thyroglobulin
Follow up medullary cancer by […]
Calcitonin
Central neck mass moves with tongue protrusion
Thyroglossal cyst
Tx: surgically
Lateral neck mass has clear lymphatic fluid
Cystic hygroma
Tx:
ASx» sclerotherapy
+Sx» surgical •definitive•
Most contraindicated treatment of hyperthyroid in pregnancy
RAI
Which antithyroid medication given during first trimester of pregnancy?
PTU
If hematoma developed post thyroid surgery management is […]
Surgical evacuation
Lateral aberrant thyroid
Metastatic papillary carcinoma to a LN
If only 1 LN involved malignancy unlikely just “aberrant thyroid”
Case of bone pain and numbness 4 months post lower parathyroidectomy. PTH & Ca 🔺
Most likely cause […]
Missed adenoma
📆 <6m : missed adenoma
📆 >6m: hyperplasia
