Thyroid cancer

Question 1

thyroglossal duct cyst

Answer 1

ectopic thyroid tissue and or cysts present along the course or the thyroglossal duct, which is a midline structure

Question 2

what is the most reliable and cost effective method for diagnosing thyroid cancer?

Answer 2

FNA

Question 3

what is the false negative rate for FNA?

Answer 3

1%

Question 4

role of US in thyroid cancer

Answer 4

• differentiate solid vs cystic
• homogenous vs heterogenous
• multinodular gland
• screening for high risk patients
• localize nodule for biopsy

Question 5

which is more likely malignant - a hot or cold nodule?

Answer 5

cold

Question 6

what is the most common type of thyroid cancer?

Answer 6

papillary

Question 7

what are the classifications of thyroid cancer?

Answer 7

differentiated
undifferentiated
C cell origin
other

Question 8

what are the differentiated thyroid cancers?

Answer 8

papillary
follicular
hurthle cell

Question 9

what is seen histologically with papillary carcinoma?

Answer 9

psammoma bodies

Question 10

follicular carcinoma

Answer 10

5th or 6th decade
usually solitary mass
metastasize to bone, liver, CNS

Question 11

hurthle cell carcinoma is what type of variant?

Answer 11

follicular

Question 12

20% of medullary thyroid cancers are hereditary and partoof what mutation?

Answer 12

MEN2 syndrome (multiple endocrine neoplasia)

Question 13

what markers are elevated in medullary thyroid cancer?

Answer 13

serum calcitonin and CEA

Question 14

why is thyroid suppression unnecessary for medullary thyroid cancer?

Answer 14

because C cells are not TSH responsive

Question 15

which is the most aggressive thyroid cancer?

Answer 15

anaplastic

Question 16

advantages of total thyroidectomy

Answer 16

allows post op radioactive iodine treatment

Question 17

what is the downside to lumpectomy

Answer 17

lumpectomy increases recurrence rate (but not survival rate)

Question 18

what is the most common nerve injured during thyroid surgery?

Answer 18

external branch of superior laryngeal nerve

Question 19

what is the most dreaded nerve injury?

Answer 19

recurrent laryngeal nerve

Question 20

hypocalcemia as a result of thyroid surgery is usually due to what cause specifically? what signs would be present?

Answer 20

devascularization of parathyroids

Chvotek’s
Trousseau’s