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23 Cards in this Set
- Front
- Back
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__ is useful to accurately determine the size of nodules and change in size over time
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Thyroid U/S
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What are some radionucleotides used for scanning thyroid?
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Tc-99m
I-131 |
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non-toxic goiter -->
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euthyroid or hypothyroid
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toxic goiter -->
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hyperthyroid
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what are some conditions causing toxic goiter?
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diffuse toxic goiter (Graves')
Toxic multinodular goiter Toxic adenoma |
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what are some conditions causing non-toxic goiter?
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simple or colloid goiter
iodine deficiency goitrogens (substances blocking thyroid) chronic lymphocytic thyroiditis (Hashimoto's) non-toxic multinodular goiter |
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What are some growth factors that lead to goiters?
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TSH
IGFs TGFb Fibroblast growth factors (FGFs) VEGF, HGF, etc. |
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what is a dietary factor that leads to goiter?
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Iodine deficiency
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what are some drugs that can lead to goiter?
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antithyroid drugs, lithium, amiodarone
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firm, nontender, diffuse goiter --> think
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AI thyroiditis
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What is the likely cause of Granulomatous thyroiditis (deQuervain's)?
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viral infx of the thyroid gland
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tender thyroid w/ moderate enlargement w/ transient hyperthyroidism -->
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Granulomatous (deQuervain's) thyroiditis
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thyroid scan reveals multiple areas of increased and decreased uptake, w/ normal thyroid function tests -->
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non-toxic multinodular goiter
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T or F: 50% of pts over 50 have thyroid nodules
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TRUE
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what are some risk factors for thyroid malignancy?
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single nodule
male < 20 or > 60 euthyroid hx of prior RT hx of stem cell tranx fam hx of thyroid cancer (MEN II) nodule hypofunctioning |
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how do you work up a thyroid nodule?
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check TSH (normal or elevated and > 1cm --> bx)
if biopsy benign --> watch and consider re-bx if grows If TSH suppressed get RAI uptake/scan (if hyperfcn, no ca so consider Rx w/ radioiodine) |
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what are some proposed mechanisms for thyroid neoplasia?
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1. TSH receptor mutation (constituitively activated)
2. Gs protein mutation (constitutively activated) 3. Activated oncogenes and inactive tumor suppresors |
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which thyroid has an AD inheritance (germ-line mutation)?
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medullary carcinoma
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what's the stage: 1 lobe involvement, no mets, tumor < 1.5 cm
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Stage I
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how do you small treat stage 1 cancer w/ favorable cytology (papillary or min invasive follicular carc)?
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ipsilateral lobectomy and isthmusectomy w/ thyroid replacement
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how do you treat big papillary or min invasive follicular or any invasive follicular, medullary carcinomas?
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total thyroidectomy +/- node dissection body I-131 scan and thyroid replacement
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thyroglobulin concentratoin above __ ng/ml suggests persistent cancer after thyroidectomy
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5 ng/ml
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what makes the thyroglobulin test more sensitive to check for persistent cancer?
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give thyrogen (recombinant TSH) --> amps up thyroglobulin if there is any
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