Thyroid Tumors

Question 1

only noduels __ should be evaluated

Answer 1

> 1 cm

Question 2

appropriate lab and imaging

Answer 2

serum thyrotropin measurement

• if subnormal -> radionuclide thyroid scan
• if normal or elevated -> NO RADIONUCLIDE

Question 3

pertinent hx

Answer 3

• hx of childhood h&n radiation
• total body radiation
• exposure to ionizing radiation
• familial thyroid ca or thyroid ca syndrome in first degree relative
• rapid noduel growth
• hoarseness

Question 4

t/f routune measurement of tg for initial evaluation is recommended

Answer 4

false, not recommended, not sensitive and not specific

Question 5

t/f thyroid sonography with survey of the cervical ln should be performed in all pts with known or suspected thyroid nodules

Answer 5

true

Question 6

procedure of choice in evaluation of thyroid nodules

Answer 6

fna

Question 7

thyroid nodule fna cytology should be reported in the ___

Answer 7

bethesda system for reporting thyroid cytopathology

Question 8

what to do with nondiagnostic cytology

Answer 8

• repeat fna
• repeatedly nondiagnostic = observe or excise
• excise if sus, growth >20% in 2 dimensions, or risk factors

Question 9

t/f if the nodule is benign, further diagnostics is not required

Answer 9

true

Question 10

if cytology is diagnostic for thyroid malignancy, ___ is recommended

Answer 10

surgery

Question 11

surveillance mgt can be considered in ___

Answer 11

• very low risk tumors
• high surgical risk
• short remaining life span
• concurrent medical or surgical issues

Question 12

t/f pt with multiple thyroid nodules >/= 1 cm should be evaluated in the same fashion as solitary nodule >/= 1 cm

Answer 12

true

Question 13

t/f multiple nodules of >/= 1, fna should be performed based on preference

Answer 13

false, based on sonographic pattern and respective size cut off

Question 14

t/f patients with multiple thyroid nodules have higher risk than solitary nodules

Answer 14

false, same risk

Question 15

t/f routine tsh suppression for benign thyroid nodules in iodine sufficient populations is recommended

Answer 15

false, not recommended

Question 16

t/f surgery may be considered for growing nodules that are benign after repeat fna if they are large (>4 cm)

Answer 16

true