Thyroid nodules Flashcards
What are thyroid nodules?
lumps in thyroid gland different from thyroid tissue
Are thyroid nodules common?
yes
When do you feel thyroid nodules?
- on palpitation
- Single or multiple and sometimes form of pre-existing goitre
What are the diffuse causes of goitre?
- Physiological
- Grave’s disease
- Hashimoto’s thyroiditis
- Subacute thyroiditis
What are the nodular causes of goitre?
- Multinodular goitre
- Adenoma
- Carcinoma
What are two different types of thyroid nodules?
- functional
2. non-functional
What investigations are used for thyroid nodules?
TFTs
What are TFTs in functional thyroid nodules?
- High T3 and T4
2. Low TSH
What are TFTs like in non-functional thyroid nodule?
normal or high TSH and normal T3 and T4
What is toxic thyroid adenoma usually associated with?
- hyperthyroidism
- young age
What is the TSH like in toxic thyroid adenoma?
normal
How do you treat and scan a toxic thyroid adenoma?
- Usually single large thyroid nodule
1. Thyroid scan with hot area and suppression of extra nodular thyroid tissue
2. Treatment: radioactive iodine therapy
What are RF for thyroid cancer?
- Prior radiation
- Fhx
- Over 65 or under 30
- Voice changes, difficulty breathing or swallowing
- Firm or hard on palpation or fixed or during swallowing
What would multiple nodules on a scintrgrapahic scan suggest?
toxic multinodualr goitre
How do you treat toxic multinodular goitre?
radioiondine therapy
Which type of nodule has a lower risk of cancer?
functional
What would high risk thyroid US show?
- solid
- hypo
- irregular margins
- microcalcification
- FNA is unsure
When do you do FNA for thyroid nodules?
- If >1cm in high or intermediate risk: FNA
- If >1.5cm in low risk: FNA
- If >2cm in very low risk: FNA
What are different types of thyroid cancer?
- Papillary
- Follicular
- Medullary
- Lymphoma
- Anaplastic
Which thyroid cancers are differentiated
- Papillary
2. Follicular
Which thyroid cancers are undifferentiated?
Anaplastic
Which type of thyroid cancer is most common?
papillary
What are RF for papillary thyroid cancer?
- Radiation exposure
2. Affects young people
What are the buzzwords for papillary thyroid cancer?
- Psammoma bodies
2. Orphan Anne Nuclei
