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2 Endocrine > Thyroid Nodule Management > Flashcards

Thyroid Nodule Management Flashcards

1
Q

name the 2 kinds of benign thyroid nodule?

A

solitary thyroid nodule

multinodular goitre

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2
Q

what percentage of solitary thyroid nodules are benign?

A

95%

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3
Q

what could cause a solitary thyroid nodule?

A

cyst
colloid nodule
benign follicular adenoma
hyperplastic nodule

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4
Q

what is the most likely malignant diagnosis of a solitary thyroid nodule?

A

papillary thyroid carcinoma

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5
Q

what thyroid cancers could present with a solitary thyroid nodule?

A

papillary thyroid carcinoma
follicular thyroid carcinoma
medullary thyroid carcinoma

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6
Q

what clinical feature would show that the nodule is in the thyroid gland?

A

moves on swallowing

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7
Q

why does the thyroid move with swallowing?

A

sits in a sheath derived from the pretracheal fascia

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8
Q

what 2 history questions should you ask to differentiate a malignant from a benign nodule?

A

neck irradiation

FH of thyroid cancer

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9
Q

what would enlarged neck lymph nodes along with a thyroid nodule indicate?

A

papillary thyroid carcinoma until proven otherwise

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10
Q

what would a hoarse voice indicate?

A

recurrent laryngeal nerve palsy

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11
Q

what investigations should be done for a suspected malignant thyroid nodule?

A

TSH levels

USS guided fine needle aspiration

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12
Q

what is the only area of the thyroid to not be supplied by the recurrent laryngeal nerve?

A

cricothyroid

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13
Q

what would you expect to see on fine needle aspiration of a benign nodule?

A

macrophages

colloid

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14
Q

what is the normal range for TSH?

A

0.4-4mU/l

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15
Q

what investigation is good for looking for enlarged cervical lymph nodes?

A

USS

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16
Q

what 2 criteria would define you as low risk for thyroid cancer?

A

<50

tumour <4cm

17
Q

how should low risk patients with thyroid carcinoma be treated?

A

lobectomy

18
Q

how should high risk patients with thyroid cancer be treated?

A

total thyroidectomy

radioactive iodine

19
Q

what size would a thyroid tumour have to be to be T2 in the TNM classification?

A

> 2cm but <4cm

20
Q

what tumour marker can be used for papillary and follicular thyroid cancer?

A

thyroglobulin

21
Q

how often should TSH and Tg be monitored in a cured thyroid cancer patient?

A

every 6 months for 5 years

22
Q

how does follicular thyroid cancer spread?

A

haematogenously

23
Q

most common form of follicular thyroid cancer?

A

minimally invasive follicular thyroid cancer

24
Q

treatment for minimally invasive follicular thyroid cancer?

A

thyroid lobectomy

25
Q

when would you do a total thyroidectomy in minimally invasive follicular thyroid cancers?

A

if there is significant vascular invasion

26
Q

what cancer presents with a U3Thy3f lesion?

A

minimally invasive follicular thyroid cancer

27
Q

clinical presentation of thyroid lymphoma?

A

rapid onset of a mass in an elderly female who has a history of hypothyroid

28
Q

treatment for thyroid lymphoma?

A

chemo
steroids
radiotherapy

29
Q

3 types of medullary thyroid carcinoma?

A

sporadic
familial
non familial

30
Q

investigations for multinodular goitre?

A

TSH

CT scan

31
Q

results of TSH levels in multinodular goitre?

A

normal or slightly low

32
Q

what would you suspect in a high TSH and high free T4/3?

A

pituitary tumour

33
Q

results of CT in suspected multinodular goitre?

A

retrosternal extension

tracheal compression

34
Q

what respiratory complication is asociated with multinodular goitre?

A

stridor

35
Q

how should multinodular goitre be treated?

A

leave

radioactive iodine if really hypo

36
Q

what can multinodular look like on CXR?

A

superior mediastinal mass with tracheal deviation

2 Endocrine (35 decks)

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