Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Hematology, oncology > Thyroid cancer > Flashcards

Thyroid cancer Flashcards

1
Q

Histologic variants of thyroid cancer

A

1) Differentiated (papillary, follicular, Hurthle cell)
2) Medullary
3) Anaplastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

effect of gender as RF for thyroid cancer

A

Women are effected 3x men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How thyroid cancer is usually found

A
  • nodules

- incidentally on imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Next step after FNA suspicious for malignancy

A

surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Surgical treatment modalities for thyroid cancer

A

Total thyroidectomy OR lobectomy depending on tumor size, nodal involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

prognosis of anaplastic thyroid cancer

A

dismal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Thyroid cancers that are not RAI-avid

A

Medullary and anaplastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Management following thyroidectomy for patients with high risk disease

A

RAI ablation routinely recommended

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Preparation for RAI treatment

A
  • Stop thyroid supplementation until TSH >30

- Low iodine diet for 1-2 weeks before treatment + no contrast CTs + no iodine-containing drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Follow-up after total thyroidectomy and RAI remnant ablation

A

Perform RAI scan 1 week after remnant ablation to detect metastatic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Long term follow-up of patients with differentiated thyroid cancer after total thyroidectomy and RAI remnant ablation

A
  • Measure Tg q6-12 months for first 5 years
  • ATGAB titer every 6-12 months for first 5 years
  • IF high or intermediate risk, RAI scan 6012 months after
  • Cervical neck US 6-12 months post surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why is ATGAB measured?

A
  • seen in 25% of patients with thyroid cancer and falsely lowers Tg level
  • Persistence of ATGAB over 1 year or rise after thyroidectomy and RAI ablation may indicate recurrence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How else can you decrease mortality in differentiated thyroid cancer?

A

TSH suppression – TSH suppression to >0.1 is recommended for patients with high-risk differentiated thyroid cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Risks of TSH suppression therapy

A

1) Increased risk of AF
2) Increased risk of osteoporosis in postmenopausal women and older men
3) Symptomatic exacerbation of CAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What thyroid cancers should not be managed with TSH suppression?

A

Medullary and anaplastic cancers – these are managed with thyroid supplementation to maintain euthyroid state after thyroidectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Significance of Tg rise after ablation

A

Concerning for relapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Most common site of local recurrence in patients with thyroid cancer

A

Cervical lymph nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Most common sites of distant mets in patients with differentiated thyroid cancer

A

Lungs and bones, rarely brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Most common sites of distant mets in patients with medullary thyroid cancer

A

Lungs, liver, and bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Management of locoregional metastases in differentiated thyroid cancer

A

Surgical, adjuvant RAI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Management of pulmonary mets in differentiated thyroid cancer

A

IF RAI-avid –> RAI

22
Q

Side effect to consider with RAI treatment

A

May cause acute swelling in metastatic areas, causing mass effect/compression of nearby structures – manage with steroids

23
Q

efficacy of chemotherapy for metastatic differentiated thyroid cancer

A

Usually ineffective

24
Q

Treatment of brain lesions

A

IF RAI avid –> steroids and EBRT, followed by RAI

25
Management of metastatic medullary thyroid cancer
- IF resectable lesions --> surgery +/o adjuvant EBERT | - Palliative EBRT to symptomatic distant lesions
26
SE's of sorafenib
HTN + hand/foot syndrome
27
FDA-approved drugs for treatment of differentiated thyroid cancer
Sorafenib + lenvatinib
28
What is EBRT?
external beam radiation therapy
29
typical diagnosis of thyroid cancer
Ultrasound guided FNA
30
Management of anaplastic thyroid cancer
EBRT with radiosensitizing doxorubicin (Excision is often impossible due to invasion of local structures, but may be considered after neoadjuvant radiation)
31
Treatment of choice for localized medullary thyroid cancer
Total thyroidectomy with central neck dissection
32
Syndromes associated with increased risk of thyroid cancer
MEN2A and MEN2B Cowden syndrome Familial adenomatous polyposis
33
Treatment of choice for metastatic medullary thyroid cancer
Cabozantinib
34
Molecular target in medullary thyroid cancer
RET
35
FDA approved drugs for medullary thyroid cancer
Vandetanib, cabozantinib, RET inhibitors —selpercatinib
36
Vandetanib SE to know about
QT prolongation
37
Cabozantinib AE to know about
fistula formation, GI tract perforation
38
goal of treatment in anaplastic
palliative in most cases
39
Targeted therapies approved for anaplastic
Dabrafenib + trametinib approved for BRAFV600E mutated anaplastic thyroid cancer
40
Differentiated thyroid cancer includes
Papillary, follicular, or hurthle cell
41
To remember with staging work up orders
NEVER use contrast because it can block radioactive iodine uptake
42
Chest imaging modality for staging of advanced thyroid cancer
CXR not CT (90% of disease will be local)
43
Treatment modalities for differentiated thyroid cancer
- total thyroidectomy - RAI ablation - TSH suppression with thyroid hormone
44
how to monitor patients post therapy in differentiated thyroid cancer
serial thyroglobulin levels
45
What does RAI refractory mean
Lesions that are progressing and which don't take up RAI
46
RAI refractory on imaging
RAI uptake scan is negative but CT is positive
47
Targeted therapy approved for TRK/fusion cancers in differentiated thyroid cancer
Larotrectinib
48
Next step following diagnosis of medullary thyroid cancer
Germline RET gene mutation testing
49
Marker of recurrent or persistent cancer following thyroidectomy in differentiated thyroid cancers
thyroglobulin (secreted by most differentiated thyroid cancers (papillary and follicular))
50
Most common thyroid cancer type
papillary
51
Management of patient with differentiated thyroid cancer in surveillance with elevated thyroglobulin
US + radioiodine scan
52
surveillance of papillary thyroid cancer during year 1
- tsh, T4, thyroglobulin at 6 months | - neck US 6-12 months after initial therapy

Hematology, oncology (218 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions