Thyroid Cancer Quiz
Created by Chris Galbraith and Connor Bohlken
Edited by Dr. Paris Ingledew
You are a R2 Family Medicine Resident working in clinic. You are seeing Mrs. Howlow is a 45 year old female who is coming in today for a persistent cough and a new finding of a painless lump on her neck. You review her history and find that she takes no medical conditions and is otherwise healthy. She is a current smoker, with a 20 pack year history and she consumes alcohol socially. You do note that she has come in for low energy and weight gain several times and routine blood work has always shown her to have a somewhat elevated TSH at 4.9 mU/L (normal range 0.5 - 5.0). On review of her family history, her mother had breast cancer, treated definitively with mastectomy, and goiter. Her father has Type II diabetes which is effectively managed with diet and exercise. Mrs. Howlow has several risk factors for thyroid cancer, which of the following is NOT one of them?
Family History of Goiter
Chronically Elevated TSH
You are seeing Mr. Ty Roid, a 35 year old gentleman. Mr. Roid tells you that his mom has been recently diagnosed with thyroid cancer. This makes him a little nervous, and he is wondering if there is anything he can take to help prevent thyroid cancer. What is table salt fortified with in North America that prevents thyroid cancer?
You have just finished seeing Mrs. Papillary Clinton, a middle aged female who is presenting with a new painless swelling in her neck. During your interview, you notice that she sounds somewhat hoarse, and is having some difficulties breathing. She also endorses a persistent cough, as well as double vision and drooping eyelids at the end of the day. You report back to your attending and they ask you which of her signs and symptoms is NOT associated with thyroid cancer. You answer:
Painless Swelling in Neck
You are a 4th year medical student doing an elective in Radiology. You are working with your attending, Dr. Donald Bump, who has an interest in his teaching, which he proudly tells anyone is the best teaching, the most suburb teaching, really, unrivaled. You are reviewing several ultrasounds patient’s who presented with thyroid nodules. He asks you, which of the following patients should undergo a fine need aspiration based on their ultrasound findings?
Mrs. Wall: 0.7 cm hypoechoic nodule with irregular margins and some rim calcification.
Mr. Chloroqin: 3 cm purely cystic nodule.
Mr. Ogate: 1.4 cm spongiform nodule that lacks any other suspicious radiographic features.
Mrs. Stormy: 1.7 cm hypoechoic component of a partially cystic nodule with a soft tissue component that is taller than it is wide.
Mrs. Mylnn: 0.8 cm hypoechoic nodule with smooth margins.
You are a third year medical student on your 3rd year surgery rotation. You are working with Dr. N. Carryiton, a general surgeon whose focus is thyroidectomy. She asks you, if following a FNA and repeat FNA the diagnoses of a thyroid nodule was still unclear, and the patient had undergone a radioactive isotope scan, which nodule would surgery be recommended for?
Today was your lucky day. You get to scrub into a surgery for removal of a pheochromocytoma. Prior to the surgery you are talking to the patient, who is a 27 year old male. The patient describes the symptoms leading to his diagnosis of pheochromocytoma (hypertension, headache, palpitations, perspiration, and pallor). Astutely you notice a mucosal aroma in the patients mouth, and their overall marfanoid body habitus. What type of thyroid cancer is this patient condition associated with?
What is the most common subtype of thyroid cancer?
You are a third year medical student who has just started their third year clinical rotation in Oncology. Today you will be working with Dr. Trident, who primarily treats thyroid cancers. You begin the day with a quick review of TNM staging. To gauge your knowledge she asks the following: If you have a patient with a known thyroid cancer that has the following characteristics: 3 cm size in greatest dimension, Invading the superior belly of the omohyoid muscle, 1 regional lymph node, no distant metastasis.
T2, N1, M0
T3b, N1, M0
T4a, N1a, M1
T3b, N0, M1
T1, N1, M0
Mrs. Goit Hur is presenting to your office today to discuss treatment options for her thyroid cancer. She is a 52 year old, otherwise healthy female, with a 4.2cm papillary thyroid carcinoma. Her tumor is localized, and no metastases have been located. What is an appropriate primary modality of treatment?
Mrs. Iat Rogenic is presenting to your clinic today. She recently had a total thyroidectomy performed by the totally not esteemed surgeon Dr. Dull Blade. You are familiar with the techniques performed by Dr. Dull Blade, and have never seen them perform a surgery without complications. Thus, you enter the room on high guard looking for potential signs or symptoms of thyroid surgery cancer complications. Which of the following might you see?
Dahl’s Sign and Weakness of the Muscle Innervated by the Deep Femoral Nerve.
Crowe Sign and Axillary Itchiness.
Blumberg Sign and Abdominal Distention.
Chwostek’s Sign and Recurrent Laryngeal Nerve Injury.
Froment’s Sign and Ulnar Nerve Palsy.
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