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14 Cards in this Set
- Front
- Back
how many thyroid nodules are benign? |
about 95% |
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and what % of men and women can present with a thyroid nodule? |
5% of women
1 % of men |
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What is the most common cause/type of a thyroid nodle? |
benign collection of colloid material |
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how often do nodules associate with hyper/hypo symptoms and presentation? |
it's very rare to present this way |
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So a woman presents with a thyroid nodule, and is completely asymptomatic. The nodule is non-tender. What is the next step in mgmt.? |
you get a TSH and T4 then follow from afar essentially |
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Why do you get a TSH and T4 here>? |
because it tells you whether it's a hot or cold nodule |
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What does a hot nodule mean? |
it means that it's NOT malignant. rules out cancer functionally. |
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And what does a cold nodule mean? |
it means the possibility of malignancy still exists |
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When do you have to do FNA on a nodule? |
when it's over 1 cm |
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What comes BEFORE FNA? |
you've ruled out a hot nodule with TSH/T4
and you've done an ULTRASOUND to confirm its size is sufficiently large to indicate a biopsy |
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But if you can feel that the nodule is over 1 cm in size... |
then U/S is NOt indicated. it cannot be used to evaluate likelihood of malignancy so it doesn't really tell you very much |
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So basic workup is: |
Perform TSH and T4
If tests are normal--> biopsy |
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If the nodule is biopsied and path shows "indeterminant for follicular adenoma" what do you do? |
it needs to be excised, surgical/excisional biopsy
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Why removal? |
because the result of follicular adenoma actually CANNOT rule out cancer. the only way to exclude a malignancy is to completely remove the nodule |