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PBL: "save my neck", image, image, image, image, image, image,…

- - - - family history of MEN2
      - Firm & fixed:
        Lump in the neck >1cm
      - Dysphagia, & pain in the ears
      - Voice changes (stridor)
  - - - Importance
        
        Abnormal amount is proportional to cancer stage
      - normal amount is
        
        0.5 to 5.0 mIU/L
    - - Important in
        
        Follow up & MTC
      - normal amount is
        
        below 10 pg/ml
  - - - Bathesda System
    - - Surgical excision
        needed
- - - - cell-cycle phase independent drugs
      - cell-cycle phase dependent drugs
    - - lower or block hormone release
    - - interferons
      - interleukins
    - - Monoclonal antibodies
      - Small-molecule drugs
  - - - curative
      - palliative
      - debulking
    - - External beam radiation therapy
      - Internal radiation therapy
- - - - respiratory tract
      - liver
      - brain
      - bones -> osteolytic destruction
        
        assessed/diagnosed using
        
        X-Ray
      - lymph nodes
- - - - assessing long-term side effects
      - asking questions to health care team
      - assessing signs of cancer
    - - Thyroglobulin Test for Thyroid cancer
  - - - Cancer support groups
        
        Help in
        
        expressing feelings
        
        coping with side effects of treatment
        
        Making the patient feels better
      - Family support
        
        Includes
        
        Practical support
        
        Emotional Support
- - - - lung cancer
    - - breast cancer
  - - - it takes place when the disease process has advanced beyond its early stages.
      - aim to
        
        A) reduce or limit impairments and disabilities,
        
        B) promote the patients’ adjustment to irremediable impairments associated with disability.
    - - Applied to
        
        Population-level (mass screening)
        
        Individual-level ( case finding )
    - - Compliance bias (Selection bias)
      - Lead-time bias
        
        occer when
        
        Early treatment ineffective
      - Length-time bias
        
        occer when
        
        Early treatment unnecessarily
- - - - size measured
        
        by
        
        Ultrasound
- - - - presence of a nodule
      - Changes to the voice
      - Difficulty swallowing
      - Swollen lymph nodes
      - Pain in the neck and throat
    - - Females are at higher risk
      - Exposure to high levels of radiation
      - Certain inherited genetic syndromes
    - - Family history of thyroid cancer
      - inflammatory bowel disease
      - Acromegaly
      - Radiation exposure
    - - papillary Thyroid Cancer
      - Follicular Thyroid Cancer
      - Medullary Thyroid Cancer
      - Anaplastic Thyroid Cancer
    - - Fatigue, nausea, loss of appetite
      - increased chance of infections
      - Weight loss
      - metastasis
      - Injury to the voice box
- - - - Gross feature
        
        Well-defined
        
        encapsulated
        
        smaller than malignant
        
        no hemorrhage, no necrosis
      - Microscopic feature
        
        Well differentiated, resembles normal tissue
        
        surrounded by febrous capsule
    - - Gross feature
        
        ill-defined
        
        non-capsulated
        
        bigger than benign
        
        Hemorrhage and necrosis
      - Microscopic feature
        
        Metastasis (grow by invasion)
        
        Poorly differentiated, don't resemble the normal tissue
  - - - Used together with conventional medicine
    - - Used in place of conventional medicine
- - - - Initiation
        
        examples
        
        Chemical carcinogens ie benzene
        
        Physical carcinogens ie UV radiation
        
        Infectious carcinogens ie hepatitis B virus
    - - Proliferation
        
        examples
        
        Growth factors