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27 Cards in this Set
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- Back
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Types of goiter?
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1. nonendemic goiter (sporadic)- usually from excess iodine intake or exporsure to radiation
2. Endemic- MCC is iodine deficiency |
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For toxic multinodular goiter what are common causes?
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1. Graves' (autoimmune)
2. Single toxic adenoma (autonomous hyperfunction) 3. Diffuse toxic thyroiditis (autonomous hyperfunction) 4. Iatrogenic0 syndthroid, iodine administration with drugs or contrast material |
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Best tool machine wise to find nodule of thyroid?
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high resolution ultra sound
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What are important questions to ask in regard to pt history with thyroid...
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Rate of growth
hoarseness Pain previous radiation exposure |
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What complaint could send a red flag that usually means something bad?
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hoarseness! = invasive thyroid cancer (bad sign)
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Majority of pts with multinodular goiter are what?
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most have no symptoms and are euthyroid
- Ultra sound is only way to find out |
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Hard, fixed nodular mass probably?
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malignancy
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Most common benign nodule of thyroid gland
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single or multiple nodular goiter
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What is most useful test in evaluating thyroid nodules identified by ultra sound? What if nondiagnostic?
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FNA
if nondiagnostic- repeat FNA |
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What is most def. treatment for long term of thyroid multinodular goiter
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surgery or I131... drugs are only a short term
95% recurrence after use of PTU |
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Which type of surgery for thyroid has highest rate of success?
Negatives about this type of surgery? |
total thyroidectomy, less risk of recurrent postop toxic goiters, but with higher morbidity
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When would u choose RAI therapy over surgery?
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if risks of surgery are high or patient refuses (40-60% reduction in size after 1-2 yrs)
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For patients with small to modest size nontoxic goiter, that are asymptomatic and are euthyroid according to TSH levels, and who have prominent nodules that are benign by FNA,
Yearly evail? When do surgery? |
yearly evaluation with serum TSH and palpation/USN evaluation is sufficient.
For large nontoxic goiter with local symptoms, surgery is preferred |
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MC inflammatory disorder of the thyroid?
also MCC of goiter in US? |
hashimoto's thyroiditis
(chronic lymphocytic thyroiditis) |
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MCC of hypothyroidism in US?
MC in what population? presentation? |
Hashimoto's
MC in middle aged females hard, nontender goiter, occasionally painful - patient may compalin of fullness in neck only |
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Tx of hashimoto's
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in absence of cancer surgery only for large compressive goiters, Synthroid if hypothyroidism
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Painful thyroid gland MCC
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Subacut thyroiditis (de Quervain's)
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# 1 test for thyroid function?
If suspect autoimmune dysfunction which test? |
Serum TSH
- anti- thyroid peroxidase titer (antimicrosomal antibody) Most sensitive marker (aka AMA titer) |
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With the elderly hyperthyroid pt what are they 4 times more risk for?
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atrial fib
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Best imaging of thyroid for use in children?
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Technetium pertechnetate (99mTc)
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MC of thyroid cancers?
Prognosis? |
papillary carcinoma
- best prognosis |
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Second most common type of thyroid
cancer. Stimulated how? |
folliclar carcinoma- can be stimulated by increased TSH sean higher in endemic goiter
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Tumor of parafollicular, or C cells, of thyroid gland.
Explain the marker for this type of cancer |
Medullary carcinoma
Serum calcitonin released by C cells, and a marker for medullary carcinoma. |
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Considered one of the most lethal
cancers in man. tx? |
anaplastic carcinoma- airway managment
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Lymphoma of thyroid is MC associated with what?
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hashimoto's
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Which thyroid cancer is associated with MEN 2A and 2B?
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medullary carcinoma
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Food in particular that raises iodine levels?
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kelp
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