Thyroid Cancer Flashcards

1
Q

What is the key clinical feature that the majority of thyroid cancer’s present with

A

Thyroid lump

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2
Q

Name the two most common types of thyroid cancer

A

Papillary and follicular

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3
Q

Papillary and follicular are the two most common types of thyroid cancers.

Which one is the most common

A

Papillary (70%) of cases

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4
Q

What is the pathology of papillary thyroid cancer

A

Contains a mixture of papillary and colloidal filled follicles

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5
Q

What age bracket does papillary thyroid cancers typically present in

A

Tends to present 30-40 years of age

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6
Q

Where does papillary thyroid cancers typically metastase to?

A

Lymph node metastasis predominate

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7
Q

What is the prognosis of papillary thyroid cancers

A

Excellent prognosis

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8
Q

How does follicular thyroid cancer typically present with

A

Usually present as a solitary thyroid nodule

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9
Q

Name two risk factors for follicular thyroid cancer

A

Areas of low iodine

Women

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10
Q

What age group does follicular thyroid cancers typically present in

A

Tends to present 30-60 years of age

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11
Q

Name three risk factors for thyroid cancer

A

Radiation exposure (particularly in childhood)

Family history of thyroid cancer

Female sex

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12
Q

The majority of thyroid lump have a ___ disease

a) benign
b) cancerous

A

a) benign

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13
Q

The most common clinical feature of a thyroid cancer is a thyroid nodule or mass.

Name some of the other clinical features of thyroid cancer

A

Hoarseness/change in voice

Cervical lymphadenopathy

Stridor

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14
Q

What is a stridor

A

A harsh, high pitched sound, normally heard on inspiration

Indicative of upper airway obstruction

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15
Q

What does a stridor indicate

A

Indicative of upper airway obstruction

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16
Q

Why are features of hyperthyroidism or hypothyroidism not commonly seen in patients with thyroid malignancies?

A

Thyroid cancers rarely secrete thyroid hormones

17
Q

When should you consider two week suspected cancer pathway referral for thyroid cancer ​

A

Anyone with an unexplained thyroid lump

18
Q

What is the name of the set of investigations used to diagnose thyroid cancer

A

Triple Assessment

19
Q

Triple Assessment refers to the set of investigations used to diagnose thyroid cancer

What are the three components of the triple assessment

A

Clinical examination with TFT

Ultrasound scan

Fine needle aspiration cytology

20
Q

If we were unable to determine the type of thyroid cancer from fine needle aspiration cytology what is the next investigation?

A

Diagnostic hemithyroidectomy

21
Q

What is the mainstay of thyroid cancer treatment

A

Surgical resection

22
Q

What type of treatment may be included alongside surgical resection for thyroid cancer

A

Adjuvant management

23
Q

Name the two types of thyroid surgical resection

A

Thyroidectomy – complete removal of the thyroid gland

Hemithyroidectomy – removal of half of the thyroid gland

24
Q

Why might Hemithyroidectomy be a better option for smaller, unilocal thyroid cancers

A

There is an increased risk of hypoparathyroidism in thyroidectomy

25
Q

What are two specific post op things that must be monitored after thyroid resection

A

Monitor serum calcium (+/- PTH)

Evaluate vocal cord function

26
Q

Name three complications of thyroidectomy

A

Recurrent laryngeal nerve injury

Haematoma

Hypoparathyroidism

27
Q

What happens if the recurrent laryngeal nerve is injured

A

Unilateral injury can result in vocal cord dysfunction

Bilateral injury as well as give vocal cord dysfunction it can threaten the airway and present with stridor

28
Q

Haematoma is a potential complication of thyroidectomy.

Why is it so dangerous?

A

There is limited space for expansion and thus increasing pressure can threaten the airway.

29
Q

What are the two forms of adjuvant therapy used in thyroid cancer management

A

Radioiodine remnant ablation

External beam radiotherapy

Remember these are only used with MDT input