Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

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
Q

Management of metastatic medullary thyroid cancer

A
  • IF resectable lesions –> surgery +/o adjuvant EBERT

- Palliative EBRT to symptomatic distant lesions

26
Q

SE’s of sorafenib

A

HTN + hand/foot syndrome

27
Q

FDA-approved drugs for treatment of differentiated thyroid cancer

A

Sorafenib + lenvatinib

28
Q

What is EBRT?

A

external beam radiation therapy

29
Q

typical diagnosis of thyroid cancer

A

Ultrasound guided FNA

30
Q

Management of anaplastic thyroid cancer

A

EBRT with radiosensitizing doxorubicin (Excision is often impossible due to invasion of local structures, but may be considered after neoadjuvant radiation)

31
Q

Treatment of choice for localized medullary thyroid cancer

A

Total thyroidectomy with central neck dissection

32
Q

Syndromes associated with increased risk of thyroid cancer

A

MEN2A and MEN2B
Cowden syndrome
Familial adenomatous polyposis

33
Q

Treatment of choice for metastatic medullary thyroid cancer

A

Cabozantinib

34
Q

Molecular target in medullary thyroid cancer

A

RET

35
Q

FDA approved drugs for medullary thyroid cancer

A

Vandetanib, cabozantinib,
RET inhibitors —selpercatinib

36
Q

Vandetanib SE to know about

A

QT prolongation

37
Q

Cabozantinib AE to know about

A

fistula formation, GI tract perforation

38
Q

goal of treatment in anaplastic

A

palliative in most cases

39
Q

Targeted therapies approved for anaplastic

A

Dabrafenib + trametinib approved for BRAFV600E mutated anaplastic thyroid cancer

40
Q

Differentiated thyroid cancer includes

A

Papillary, follicular, or hurthle cell

41
Q

To remember with staging work up orders

A

NEVER use contrast because it can block radioactive iodine uptake

42
Q

Chest imaging modality for staging of advanced thyroid cancer

A

CXR not CT (90% of disease will be local)

43
Q

Treatment modalities for differentiated thyroid cancer

A
  • total thyroidectomy
  • RAI ablation
  • TSH suppression with thyroid hormone
44
Q

how to monitor patients post therapy in differentiated thyroid cancer

A

serial thyroglobulin levels

45
Q

What does RAI refractory mean

A

Lesions that are progressing and which don’t take up RAI

46
Q

RAI refractory on imaging

A

RAI uptake scan is negative but CT is positive

47
Q

Targeted therapy approved for TRK/fusion cancers in differentiated thyroid cancer

A

Larotrectinib

48
Q

Next step following diagnosis of medullary thyroid cancer

A

Germline RET gene mutation testing

49
Q

Marker of recurrent or persistent cancer following thyroidectomy in differentiated thyroid cancers

A

thyroglobulin (secreted by most differentiated thyroid cancers (papillary and follicular))

50
Q

Most common thyroid cancer type

A

papillary

51
Q

Management of patient with differentiated thyroid cancer in surveillance with elevated thyroglobulin

A

US + radioiodine scan

52
Q

surveillance of papillary thyroid cancer during year 1

A
  • 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.
© 2024 Bold Learning Solutions. Terms and Conditions