thyroid therapy

Question 1

what cells trap and concentrate idodide

Answer 1

follicular cells

Question 2

indications for thyroid therapy

Answer 2

hyperthyroidism- graves disease, toxic multinodular goiter, non toxic multinodular goiter (shrinks it), toxic autonomously functioning thyroid nodules (plummers), ablation from thyroid cx

Question 3

radionuclide for hyperthyroidisim and energies and T1/2 and type

Answer 3

I-131 T1/2 8 days and gamma is 364 KeV and beta is 606 KeV and travels 0.8mm and fission product

Question 4

how is I-131 given

Answer 4

Po in liquid or sodium iodide capsule

Question 5

how does i131 localize

Answer 5

active transport- organified by thyroid andn held in cells or follicular lumen

Question 6

dose range for i131

Answer 6

1<=30 mCi

Question 7

graves dose i131

Answer 7

5-10mCi

Question 8

goiter dose i131

Answer 8

10-29 mCr

Question 9

how to calculate dose

Answer 9

gram wt of thyroid (20-30g) X 0.08-0.20 mCi/g / uptake value

Question 10

goiters more resistnat to rad so higher dose

Answer 10

true

Question 11

graves dose range

Answer 11

5-10 mCi

Question 12

nodular goiter dose

Answer 12

10-29 mCi

Question 13

pregnancy is a contraindication true or false

Answer 13

true and should wait to have kids for a year

Question 14

how many weeks does fetus start absorbing iodine

Answer 14

12 weeks

Question 15

do u need to pump and dump

Answer 15

yes

Question 16

what is elevated iodine level

Answer 16

> 200 ug/L

Question 17

diet for low iodine allows for

Answer 17

allows for thyroid to asborb as much of I as possible and should be followed for 1-2 weeks and limit to 50ug a day

Question 18

foods with iodine

Answer 18

-seafood
-dairy
-salt
-eggs
-seaweed
-chocolate
-multivitamins
-red dye 3

Question 19

indications for thyroidectomy

Answer 19

detroy remaining tumor cells in thyroid remnant post op, treat mets, allow thyroglobulin measurements and WB radioiodine scans to detect reucrrent disease

Question 20

thyroglobulin of ____ or more post thyroidectomy indicates what

Answer 20

10 ng.mL with recurrance even if scan is negative

Question 21

ablation dose and if primary tumor <1.5 cm

Answer 21

30-300 mCi and less tan 30 mCi

Question 22

when is ablation given

Answer 22

4-8 wks post op and WB 4-10 days after I-131

Question 23

RSO to emasure with cutie pie if dose

Answer 23

> 33mCi

Question 24

pt to leave when TEDE is

Answer 24

<=0.5 rem to any individual in a year

Question 25

dose for mets to neck area

Answer 25

75-100 mCi

Question 26

dose for distant mets (lung/bone)

Answer 26

150-200 mCi

Question 27

dose for if surgery (thyroidectomy) was successful and no mets

Answer 27

30-50 mCi

Question 28

caution for leukemia and bone marrow supression when dose is

Answer 28

> 500 mCi

Question 29

cumulative doses of ____ are rearely given

Answer 29

> 1000 mCi

Question 30

uptake of I-131

Answer 30

nasualmucosa, slaivary glands, thymus, stomac, bowel, bladder, diffuse liver uptake (T3 and T4 metabolized by liver)

Question 31

why in normal circumstance dow thyroid cancer patients not want high TSH

Answer 31

want low TSH so thyroid isnt active so thyorid mets cant grow and function. keep it low by taking meds with neg feedbakc system

Question 32

2 ways to rasie tsh for why

Answer 32

upatke, scan, therapy
1-take off meds
2- thyrogen injections 2 days prior

Question 33

recordable event =

Answer 33

-outside 20% prescribed dose AND 5 rem WB effective dose equiv OR outside 30% prescribed dose AND 50 rem to any tissude

Question 34

who do we contact for recordable event

Answer 34

notify the stae, referring doc, and patient within 24 hrs