Thyroid Nodules Flashcards
Thyroid Nodules epidemiology and kinds
Ninety-five percent are benign (adenoma, colloid nodule, cyst).
Rarely asoc. w clinically apparent hyperfunctioning
or hypofunctioning.
Thyroid Nodules, management if found
first: t4 and TSH level
Thyroid Nodules dx test. when to aspirate?
if >1.5 cm + normal thyroid function (T4/TSH) or “elevated”.= must be biopsied with a fine-needle aspirate
this is a high risk.
no need of US or RIUS
If biopsy shows indeterminant for follicular adenoma, what to do?
Surgical removal (excisional biopsy).
If biopsy shows medullary carcinoma.
Calcitonin
levels are useful to get
what pt are at higher risk to develope nodules?
Radiation exposed. Like hodking limphoma survivros
Hx of Cancer , personal o fam
Hoarseness
at what agre range are pt at higher risk to develope nodules?
Age <20 >60
if its non painfull, very less likely to be ca T/F
T
US Malignany signs
Solid hypoechogenic.
Size >2cm
microcalcification, irregular borders
what to do if hyper funcioning nodule?
trear hyperthyroidism: start with Beta blockers +
Antithyroid drugs to achieve euthyroidism
then go with Definitive treatment options:
Hemithyroidectomy
Radioactive iodine ablation (RAIA)
What does it mean a RAIU with hot or cold results
hot=hyperfunctioning
cold= nonfunctioning = CA risk
what to do if RAIU = cold
US & FNA biopsy
What to do if TSH is low + nodule
do RAIU, and next step would be according cold/hot result
What to do if TSH is high + nodule
US. if >1cm FNA
if <1cm US 6-12 months
If biopsy shows no CA
US 6-12 month
