Monday, September 23, 2013

9/23/2013

9/23/2013

Answers:
If the following is found on histology of a thyroid nodule this would indicate a diagnoses of...
A) Papillary Carcinoma 
B) Papillary Adenoma 
C) Follicular Carcinoma 
D) Follicular Adenoma 
E) Medullary Carcinoma 
F) Anaplastic Thyroid Cancer

This is a psammoma body which is highly suggestive of papillary carcinoma.

What is the most common type of thyroid cancer?  What is the second most common type?

The most common type is papillary (75%).  The second most common type is follicular (16%).

MC Questions:
A patient with medullary carcinoma and multiple mucosal neuromas presents to the ED with palpitations, diaphoresis and an impending feeling of doom.  What is their likely diagnosis?
A) MEN1 
B) MEN2a 
C) MEN2b 
D) FMTC

Free Response Question:
What is the rule of 3rds with respect to medullary thyroid carcinoma?


Quick Facts:

Graves’
-autoimmune disorder.  Immunoglobulins bind and activate TSH receptor.
-F>M
Clinical Findings
-symptoms unique to Graves’: ophthalmopathy (exophthalmos) dermopathy (thick skin) and osteopathy (pretibial myxedema).
Lab Tests:
-decreased TSH and increased T4/3
-If no ophthalmopathy then dx w/ TSI (specific for graves’)

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