Thyroid Cancer Flashcards

1
Q

what types of thyroid cancer are differentiated thyroid cancers (DTC’s)?

A

papillary

follicular

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2
Q

what do DTC’s tend to take up and what does this mean?

A

iodine

radioactive iodine can be used as an investigation

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3
Q

what do DTC’s tend to secrete and what does this mean?

A

thyroglobulin

can be used as a tumour markers

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4
Q

what drives DTC’s?

A

TSH

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5
Q

who is more commonly affected by DTC’s?

A

women

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6
Q

what is a strong risk factor for DTC’s?

A

exposure to radiation

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7
Q

what are two weak risk factors for DTC’s?

A

thyroid adenoma

chronic elevation of TSH

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8
Q

how do most thyroid tumours present?

A

a palpable nodule in the neck

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9
Q

what is the most common type of thyroid cancer?

A

papillary

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10
Q

how does papillary thyroid cancer tend to spread?

A

lymphatics

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11
Q

what does papillary thyroid cancer have a small association with?

A

hashimoto’s thyroiditis

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12
Q

what is the prognosis for papillary thyroid cancer?

A

very good

10 year mortality is <5%

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13
Q

what is the second most common type of thyroid cancer?

A

follicular thyroid cancer

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14
Q

where is incidence of follicular thyroid cancer slightly higher?

A

in regions of iodine deficiency

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15
Q

how does follicular thyroid cancer tend to spread?

A

hematogenously

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16
Q

how is thyroid cancer investigated if it presents as a thyroid lesion?

A

USS guided FNA

17
Q

how is thyroid cancer investigated if it presents as an enlarged neck lymph node?

A

excision biopsy of the node

18
Q

what is the treatment of choice for thyroid cancer?

A

surgery

19
Q

what are the three most common surgical options for thyroid cancer?

A

hemi-thyroidectomy
sub total thyroidectomy
total thyroidectomy

20
Q

what is another name for a hemi-thyroidectomy?

A

thyroid lobectomy with isthmusectomy

21
Q

when is hemi-thyroidectomy done for thyroid cancer?

A

papillary microcarcinoma
minimally invasive follicular
low risk AMES group

22
Q

what score is used to classify thyroid cancer patients as low or high risk?

A

AMES

23
Q

what four things are considered in an AMES score?

A

age
metastases?
extent of primary tumour
size of primary tumour

24
Q

what is the post op care after thyroid surgery?

A

check calcium

discharge with levothyroxine

25
Q

when is a whole body iodine scan done?

A

3-6 months after thyroidectomy

26
Q

what does TSH need to be for the best results in an iodine scan and how is this achieved?

A

greater than 20

rhTSH injections