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Pathology > Thyroid > Flashcards

Thyroid Flashcards

0
Q

If FNAC suggests follicular cells what must be done?

A

Hemithyroidectomy to distinguish histopathalogically between adenoma and carcinoma

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1
Q

Is it possible to distinguish follicular adenoma from carcinoma on cytological grounds?

A

No

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2
Q

Treatment for follicular carcinoma?

A

Completion thyroidectomy and post operative radio ablation

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3
Q

Where does follicular carcinoma metastasise to?

A

Bone via blood stream

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4
Q

Where does papillary carcinoma commonly metastasise to?

A

Cervical LN

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5
Q

What is thyroxine bound to?

A
  1. Thyroid binding globulin 99.98%
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6
Q

What is the most common thyroid cancer?

A

Papillary thyroid cancer 70%

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7
Q

What is the drug of choice during pregnancy for Graves’ disease ?

A

Propothyouracil - as it less readily crosses the placenta

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8
Q

What type of goitre does Graves’ disease produce?

A

Diffuse

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9
Q

What is the mean age of presentation of follicular carcinoma?

A

50 (usually as a solitary thyroid lump)

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10
Q

What % of medullary thyroid cancer is familial?

A

20%

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11
Q

What does MTC arise from?

A

Para follicular c cells which are neural ectodermal in origin

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12
Q

Treatment of MTC?

A

Total thyroidectomy with bilateral LN clearance

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13
Q

What hormones does MTC produce?

A
  1. Calcitonin
  2. Prostaglandins
  3. 5 HT (hydroxytryptamine) - serotonin
  4. ACTH
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14
Q

Features of malignancy in a thyroid nodule?

A
  1. Hard fixed mass
  2. Elevated serum calcitonin levels
  3. History of neck irradiation
  4. Nerve palsy
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15
Q

What percentage of cold nodules are malignant in adults?

A

10-20%

50% in children

16
Q

What thyroid cancers does FNA have a high pick up rate for?

A
  1. Medullary carcinoma
  2. Anaplastic carcinoma
  3. Papillary carcinoma
  4. Hashimoto’s thyroiditis
17
Q

Adjuvant treatments for papillary thyroid cancer?

A
  1. Radio iodine therapy

2. Thyroid hormone suppression

18
Q

What % of thyroxine is bound in plasma?

19
Q

What is thyroxine bound to?

A

Thyroid binding globulin

20
Q

What is Berrys sign?

A

Absence of carotid pulse due to malignant thyromegaly

21
Q

Anaplastic carcinoma

A

Poor prognosis

Older patients

22
Q

Men1

A
  1. Parathyroid hyperplasia
  2. ZES
  3. Insulinoma
  4. Ppoma (pancreatic polypeptide)
  5. Pituitary adenoma (prolactinoma, ACTHoma)
  6. Thyroid adenoma
  7. Adrenal adenoma
  8. Foregut or midgut carcinoid
  9. Lipoma
23
Q

MEN2a

A
  1. Parathyroid hyperplasia
  2. Phaeochromocytoma
  3. MTC
24
Q

MET2b

A
  1. Phaeochromocytoma
  2. MTC
  3. Marfanoid appearance
  4. Mucosal and ganglioneuroma
25
Q

MEN2

A

Ret mutation

26
Q

Graves’ disease

A

Auto antibody to TSH receptor

27
Q

Hashimoto’s

A

Autoantibodies to thyroid per oxidase or thyroglobulin

Pathology (23 decks)

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