Brainscape's Knowledge GenomeTM

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


See full index

Year 3 > Thyroid nodules (E&M) > Flashcards

Thyroid nodules (E&M) Flashcards

1
Q

Define thyroid nodules.

A

Abnormal growths within the thyroid glands - they are usually non-functioning

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

Which groups do thyroid nodules happen more commonly in? (2)

A
  • F>M
  • incidence increases with age
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some benign causes of thyroid nodules? (4)

A
  • multinodular goitre
  • Hashimoto’s thyroiditis
  • thyroid adenoma
  • thyroid cyst
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are types of thyroid cysts (benign thyroid nodules)? (3)

A
  • colloid - overgrowths of normal thyroid tissue (most common type of thyroid nodules)
  • simple - growths that are filled with fluid/partly solid and partly filled - pose low risk for cancer = monitored/biopsies if >2cm
  • haemorrhagic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some malignant causes of thyroid nodules? (3+3)

A
  • thyroid carcinoma:
    • papillary carcinoma
    • follicular carcinoma
    • medullary carcinoma
  • anaplastic carcinoma
  • lymphoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the three types of thyroid carcinoma (malignant thyroid nodules)?

A
  • papillary carcinoma - most common, 30-40y
  • follicular carcinoma - second most common, 30-60y
  • medullary carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where can papillary carcinoma metastasise to?

A

Cervical lymph nodes

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

What can you use as a tumour marker for papillary carcinoma?

A

Thyroglobulin

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

What do you see on light microscopy in papillary carcinoma?

A

Orphan Annie eyes

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

What is the prognosis of papillary carcinoma like?

A

Very good

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

When is follicular carcinoma more common?

A

In areas of low iodine and in women (30-60y)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where does follicular carcinoma metastasise to?

A

Lung and bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What can you use as a tumour marker for follicular carcinoma?

A

Thyroglobulin

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

What is medullary carcinoma?

A

Cancer of parafollicular cells, secretes calcitonin

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

What hereditary condition is medullary carcinoma a part of?

A

MEN-2 (Multiple Endocrine Neoplasia Type 2):

  • medullary carcinoma
  • parathyroid hyperplasia
  • phaeochromocytoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the risk factors for thyroid cancer? (4)

A
  • radiation
  • family Hx
  • rapid enlargement/compression
  • lymphadenopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are some different types of neck lumps? (7)

A
  • reactive lymphadenopathy - tender LNs, Hx of local infection/viral illness
  • lymphoma - rubbery and painless lymphadenopathy, B symptoms (fever, WL, night sweats), splenomegaly
    • thyroid lymphoma linked with Hashimoto’s thyroiditis
  • thyroid swelling - hypo/hyper/euthyroid Sx, moves upwards on swallowing
  • thyroglossal cyst - mass that develops from tissues that remains after formation of thyroid gland
  • pharyngeal pouch - part of pharyngeal lining herniates through pharyngeal wall
  • branchial cyst - embryonic remnant
  • carotid aneurysm
18
Q

What are the clinical features of lymphoma (thyroid nodules)? (3)

A
  • rubbery and painless lymphadenopathy
  • B symptoms - fever, WL, night sweats
  • splenomegaly
19
Q

What are the clinical features of thyroid swelling (thyroid nodules)? (2)

A
  • hyper/hypo/euthyroid symptoms
  • lump moves upwards on eating
20
Q

What are the clinical features of a thyroglossal cyst (thyroid nodules)? (4)

A
  • age <20y
  • midline
  • moves upwards on protrusion of tongue
  • painful if infected
21
Q

What are the clinical features of a pharyngeal pouch? (7)

A
  • older men
  • not seen usually but if large, then midline mass
  • gurgles on palpation
  • dysphagia
  • regurgitation
  • aspiration
  • chronic cough
22
Q

What are the clinical features of a branchial cyst (thyroid nodules)? (4)

A
  • oval, mobile, cystic mass
  • between SCM and pharynx
  • presents in early adulthood
  • contains cholesterol crystals
23
Q

What are the clinical features of carotid aneurysm (thyroid nodules)? (3)

A
  • pulsatile
  • lateral neck mass
  • does not move on swallowing
24
Q

How do most thyroid nodules present?

A

Asymptomatic

25
Q

Which type of thyroid nodule is most likely to be malignant?

A

Single isolated nodule

26
Q

What is a red flag for thyroid cancer?

A

Radiation to head or neck

27
Q

What is the first-line imaging for thyroid nodules?

A

Ultrasonography to check for features of malignancy

28
Q

What other investigation would we do if we suspect malignancy (thyroid nodules)?

A

Fine needle aspiration biopsy (alongside ultrasound)

29
Q

What bloods do we do for thyroid nodules?

A

TFTs

30
Q

What scan can we do for thyroid nodules?

A

Radioiodine uptake scan

31
Q

What different results could there be of a radioiodine uptake scan? (5)

A
  • Graves disease - diffuse uptake throughout enlarged gland
  • toxic adenoma - single hot nodule
  • toxic multinodular goitre - multinodular gland with single hot nodule, patchy uptake
  • thyroid cancer - diffuse uptake with single cold nodule
  • de Quervain’s (viral) thyroiditis - no uptake
32
Q

How would Grave’s disease present on radioiodine uptake scan?

A

Diffuse uptake throughout enlarged gland

33
Q

How would toxic adenoma present on radioiodine uptake scan?

A

Single hot nodule

34
Q

How would toxic multinodular goitre present on radioiodine uptake scan?

A

Multinodular gland with single hot nodule + patchy uptake

35
Q

How would thyroid cancer present on radioiodine uptake scan?

A

Diffuse uptake with single cold nodule

36
Q

How would de Quervain’s (viral) thyroiditis present on radioiodine uptake scan?

A

No uptake

37
Q

Describe the diagnostic flowchart for thyroid nodules.

A
  • history and examination
  • TSH + ultrasound of neck
  • TSH subnormal –> thyroid scintigraphy
    • functioning (hot) nodule = evaluation for hyperthyroidism (T3/4)
    • non-functioning (cold) nodule OR if TSH normal/elevated –> criteria for FNA met? (suspicious nodule >1cm, large nodule >1.5-2cm, RFs for malignancy) –> if Y = FNA + cytology, if N = monitor with ultrasound
38
Q

What is the main form of management for thyroid nodules?

A

Thyroid surgery

39
Q

How do we manage papillary and follicular carcinoma (thyroid nodules)?

A

Total thyroidectomy followed by radioiodine to kill residual cells

After - give thyroxine and do yearly thyroglobulin levels check to detect early recurrent disease

40
Q

How do we treat hyperthyroidism? (2)

A
  • beta blockers
  • anti-thyroid drugs (carbimazole)

Year 3 (171 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions