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17 Cards in this Set
- Front
- Back
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How does the thyorid change in older adults?
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It migrates below sternum so you might not be able to see it
also not unusual to see mass on CXR - actually thyroid |
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What is the 1st question to ask regarding thyroid nodules?
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Is it malignant?
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Prevalence of thyroid nodules?
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More common in women
Single nodules 50% Up to 35% of glands at autopsy have small unimportant malignancies |
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Who are thyroid nodules more likely to malignant in?
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- Male
- Age > 60 - Rapid growth - Sxs of local invasion, such as fixation, vocal cord paralysis - Single firm nodule - Family hx |
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What is the only routine lab in the workup of a thyroid nodule?
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TSH
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What imaging procedure is done initially in the workup of a thyroid nodule?
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Ultrasound (NOT thyroid scan!)
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What is the next step after ultrasound in the workup of a thyroid nodule?
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FNA,
If this is indeterminate, then move to scan |
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Treatment for benign thyroid nodule
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Observation or Thyroxine - suppress TSH to 0.2-0.4 and evaluate for decreased size
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Treatment for malignant thyroid nodule
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Surgery then lifelong thyroxine, TSH at low normal
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Treatment for Indeterminate Thyroid nodule
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Thyroid Scan,
If Hot - Follow-up, If Cold - Surgery, |
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Treatment for thyroid nodule cyst
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Aspirate,
Thyroxine (Synthroid) does NOT treat cysts |
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What is the least common cancer death?
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Thyroid Carcinoma
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What are most deaths caused by in thyroid carcinoma?
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Anaplastic carcinoma
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Clinical presentation of anaplastic carcinomas
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usually a new rapidly enlarging mass
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Symptoms of anaplastic carcinomas
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Likely to be pain,
hoarseness, dysphagia, hemoptysis, SHOULD BE FOLLOWED CLOSELY |
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Workup for thyroid cancer
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Needle Biopsy,
If No metastasis, Surgery - long term survival still 20-30% |
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What type of thyroid carcinoma is NOT common in elders?
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Medullary carcinoma
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