Thyroid MCQs

Medullary thyroid cancer – Management

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Q) Male patient with 1 cm nodule in Right side of Thyroid. Biopsy shows medullary carcinoma. No neck nodes are seen on USG. What is the management

a) Total thyroidectomy

b) Total thyroidectomy with central node dissection

c) Total thyroidectomy with lateral and central neck dissection

d) Right hemithyroidectomy

Thyroid MCQs 

NEET SS 22

Ans b 

For patients with disease confned to the thyroid, total thyroidectomy is recommended to remove all C cells with elective dissection of the central neck nodes. If there is evidence of nodal metastases, gross
disease should be remove

Bailey 28th page 831

 

Prognosis Carcinoma thyroid

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Q) Not an important prognostic factor in Carcinoma thyroid (JIPMER) 
A. Age
B. Completeness of resection
C. Multicentricity
D. Extra thyroid extension

Ans c

MOst of the papillary carcinoma are multicentric any way

As per AGES And AMES criteria.

HIgh risk - Male. Age more than 40 years, Size more than 4 cm, Capsular or extra thyroid extension, Regional or distant metastasis and poor differentiation

Low Risk - Well differentiated less than 2 cm. Age benefit is extended to 50 yrs in women

Ref ( Sabiston page page 903) 

IN younger patients (<45 years old), the presence of lymph node metastases had no effect on the excellent overall survival, but the presence of lymph node metastases increased the risk of death by 46% in patients older than 45

The presence of lymph node metastasis in patients with contained intrathyroidal primary papillary carcinoma also does not affect
long-term survival.

If there is gross or microscopic extension of a primary PTC through the thyroid capsule, a poor prognosis and
possibly a higher rate of lymph node metastasis may be anticipated.

Papillary carcinoma thyroid

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Q) 40 yr old lady 2X 2 Solitarty thyroid nodule left lobe. FNAC shows  classic type of papillary  carcinoma . Usg no neck nodes. Management? ( Questions on Surgical Onco - thyroid) 

A. Total thyroidectomy
B. Total thyroidectomy with Radio active Iodine
C. Total thyroidectomy with central compartment neck dissection
D. Hemithyroidectomy + follow up

 

 

Radio active Iodine in Thyroid Cancer

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Q) Which of the following is not true about Radioactive Iodine (RAI) use in thyroid cancer? (Thyroid onco) 

a) Screening with RAI  is less sensitive than Thyroglobulin estimation in most differentiated thyroid cancers for detecting metastasis

b) Metastatic differentiated thyroid carcinoma can be detected by  131I in about 50% of patients

c) Current guidelines s recommend RAI after total thyroidectomy only for patients with known distant metastases

d) Hurthle cell cancer des not take up RAI

 

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