Read the following publication: Haugen B. R., Alexander E. K., Bible K. C., Doherty G. M., Mandel, S. J., Nikiforov, Y. E., … Wartofsky, L. (2016). 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid, 26(1), 1-133.
2.
Describe the four major carcinomas of the thyroid gland (incidence, risk factors, histologic features and prognosis). What are Hurthle cells?
3.
In the evaluation of a patient with a thyroid nodule, what should you look for in the H&P? How do you work it up? Discuss the role of lab work and radiologic tests in the work up of a thyroid nodule.
4.
Discuss the differential diagnosis of a thyroid mass. What % of thyroid nodules are malignant? Why can’t you depend on an FNA or frozen section diagnosis of follicular carcinoma?
5.
What is the Bethesda System?
Reference(s):
Cibas, E. S., & Ali, S. Z. (2009). The Bethesda System for Reporting Thyroid Cytopathology. Thyroid : Official Journal of the American Thyroid Association, 19(11), 1159–1165.
6.
Educate us on the thyroid molecular testing.
7.
How would you manage a patient with a 1cm papillary thyroid cancer? Discuss the controversy of observation.
Reference(s):
Davies, L., & Welch, H. G. (2010). Thyroid cancer survival in the United States: observational data from 1973 to 2005. Archives of Otolaryngology–Head & Neck Surgery, 136(5), 440–444.
8.
Should ALL patients with thyroid cancer receive post-operative radioactive iodine? How will you counsel patients about potential side effects?
Reference(s):
Almeida, J. P., Sanabria, A. E., Lima, E. N. P., & Kowalski, L. P. (2011). Late side effects of radioactive iodine on salivary gland function in patients with thyroid cancer. Head & Neck, 33(5), 686–690.
9.
Discuss guidelines for follow-up post-thyroidectomy for cancer (labs/tests)
10.
List prognostic factors (Ames criteria).
11.
A 50-year-old healthy man presents for evaluation of an asymptomatic 5cm thyroid gland. An ultrasound confirms a single heterogeneous nodule and FNA is benign. What are your recommendations?
12.
Who should get a central neck dissection? Will it change patient outcomes? Does adding central compartment neck dissection increase post operative complications?
13.
Describe surgical methods of identifying parathyroid glands during thyroid surgery.
14.
Discuss incidence and management of thyroidectomy complications.
15.
Intraoperative laryngeal nerve monitoring? When should it be used?
16.
How would you manage a post-thyroidectomy patient with asymptomatic hypocalcemia POD#1? Symptomatic hypocalcemia?