1. The answer is D
- Papillary carcinoma is the most common and least aggressive thyroid cancer
- Medullary cancer accounts for about 3% of thyroid cancer and is more aggressive than papillary carcinoma, but no the most aggressive
- Follicular thyroid cancer accounts for about 15% of thyroid cancer and is not the most aggressive
- Anaplastic thyroid cancer accounts for only about 2% of thyroid cancers. It also grows very quickly and tends to move to both local and distant sites quickly.
2. The answer is C
- Papillary carcinoma will typically have normal levels of TSH and T4.
- Medullary cancer may produce enough T4 to create a thyroid storm. TSH will also be low in that case.
- Follicular cancer will typically have normal levels of TSH and T4.
- Anaplastic cancer will typically have normal levels of TSH and T4.
3. The answer is A
- Medullary thyroid cancer may secrete serotonin and prostaglandins causing flushing and diarrhea. There is also a strong genetic component and family members should have genetic testing and thyroid monitoring.
- Anaplastic thyroid cancer does not cause flushing and diarrhea.
- Follicular cancer neither causes flushing and diarrhea or does it have a strong genetic component.
- Papillary carcinoma does not cause flushing and diarrhea and does not require immediate surgical removal.
4. False – Two clean successive whole body radioisotope scans are the definition of remission.
5. The answer is D
Anaplastic thyroid cancer is fast growing and is the most likely to cause mass affect issues like dysphagia, dyspnea or hoarseness.
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