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First Aid for the USMLE Step 1 2019 Medical (MD/DO) School Study Aid

Page 340 -
5 Picmonics to Learn | 8 mins

Thyroid Nodule Assessment
Initial Tests
Thyroid-Stimulating Hormone (TSH)
Normal / Elevated TSH
Fine Needle Aspiration
Most Accurate Test
Decreased TSH
Radioactive Iodine Uptake (RAIU)
Hot Nodules Rarely Malignant
Free T3 and T4
Repeat Ultrasound 6 -18 Months
1 min
Papillary Carcinoma
Most Common Thyroid Cancer
Excellent Prognosis
Lymphatic Spread
Orphan Annie Nuclei
Empty Nuclei with Central Clearing
Psammoma Bodies
Risk Factors
Head and Neck Radiation
RET and BRAF Mutations
Gardners Syndrome
Cowdens Syndrome
1 min
Follicular Carcinoma
Most Common to Present as Solitary Cold Nodule
Hematogenous spread
Good Prognosis
Histological findings
Uniform Follicles
May Invade Capsule
Risk factors
Head and Neck Radiation
1 min
Medullary Carcinoma
Sporadic and Familial Types
Arises from Parafollicular C cells
Produces Calcitonin
May Produce ACTH
Sheets of Cells With Amyloid Deposition
Increased calcitonin with Pentagastrin Infusion
Risk Factors
MEN 2A and 2B
2 mins
Anaplastic Thyroid Cancer
Rapidly Progressive
Poor Prognosis
Invades Local Structures
Mixed Morphology
Risk Factors
Multinodular Goiter
Older Age
History of Thyroid Disease
1 min

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