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Q16. Carcinoma thyroid with Lymph Node metastasis?
A. Worse prognosis in elderly
B. Worse prognosis in younger
C. Increased local recurrence in younger
D. Increased local recurrence in elderly
Most patients with PTC can expect an excellent prognosis, with the 10-year survival rate greater than 95% for the most favorable stages
Age at diagnosis is the most important prognostic factor in DTC. Diagnosis at an age younger than 40 years is associated with excellent survival.
(AMES or AGES) LOW RISK HIGH RISK
Age <40 years
Sabiston page 904
Q17. Chance of metastasis to lymph node in Papillary thyroid cancer a) <10% b) 10-20 c) 20-40 d) >60
Ans 17) d
Q18) Prophylactic thyroidectomy is done for
a) Medullary Carcinoma thyroid
d) Papillary Ca thyroid
ans 18 a) Medullary carcinoma thyroid
Hereditary MTC is identified through germline RET mutation
When to do Prophylactic thyroidectomy
Children identified to harbor the ATA highest-risk RET mutations (i.e., Met918Thr) are recommended to undergo total thyroidectomy in the first year of life.
In children with ATA high-risk mutations (i.e., codon Cys634 and Ala883Phe mutations), prophylactic thyroidectomy is typically recommended before 5 years of age, with the exact timing based on annual clinical examination, neck ultrasound, and serum calcitonin levels starting from the age of 3 years
Children with ATA moderate-risk RETmutations, the timing of prophylactic thyroidectomy should be based on the findings of clinical examination, neck ultrasound, and serum calcitonin concentrations commencing at age 5 years.
Once calcitonin levels are greater than 30 pg/mL, the likelihood of nodal metastases increases, and this will often necessitate central node dissection, which is associated with increased operative morbidity and a reduction in duration of long-term remission.
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