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7. ENDOCRINE > 3. Thyroid + Parathyroid > Flashcards

3. Thyroid + Parathyroid Flashcards

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1
Q

Microcalcifications are supposed to be the buzzword fo

A

Papillary thyroid cancer

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2
Q

“Comet Tail” artifact is seen

A

Colloid nodules

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3
Q

This classificaiton have the highest accuracy, specificity, and positive predictive value for detecting malignancy

A

Microcalcification

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4
Q

Hallmark of papillary CA

A

Microcalcifciations

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5
Q

most common calcification in medullary CA

A

MACROcalcifications

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6
Q

Macrocalcifications in a single nodule =

Macrocalcifications in a multi-nodule goiter =

A

Macrocalcifications in a single nodule = High risk

Macrocalcifications in a multi-nodule goiter = Lower risk

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7
Q

Complete hypoechoic halo =

A

Highly suggestive of a benign disease

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8
Q

Irregular, spiculated, microlobulated margins =

A

Malignancy

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9
Q

Central pattern of flow =

A

Malignancy

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10
Q

Pure cystic, or spongiform with more than 50% specific =

A

Benign

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11
Q

Nodule size is NOT predictive of malignancy

True or False?

A

TRUE

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12
Q

Solid + Hyperfunctioning =

A

Thyroid adenoma

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13
Q

Female + Painflul gland + Hx of URTI =

A

Subacute Thyroiditis I De Quervains Thyroiditis

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14
Q

In Subacute Thyroiditis I De Quervains Thyroiditis, you eventually get

A

You get hyperthyroidism (from spilling the hormone) and then later hypothyroidism.

As you get over your cold, the gland recovers to normal function.

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15
Q

This is an actual bacterial infection of the thyroid. It is possible to develop a thyroid abscess in this situation.

A

Acute Suppurative Thyroiditis

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16
Q

Kids + Acute Suppurative Thyroiditis may be due to

A

start in a 4th branchial cleft anomaly (usually left) = travel via pyriform fistula = infection of the thyroid

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17
Q

Women in 40s-70s + IgG4 associated =

A

Reidels Thyroiditis

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18
Q
A

Reidels Thyroiditis

A sneak trick would be to show you a MR (it’s gonna be dark on all sequences - like a fibroma).

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19
Q

The most common congenital neck cyst in Pediatrics.

A

Thyrogiossai Duct Cyst (TGDC)

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20
Q

The thyroid is replaced by fibrous tissue and diffusely enlarges causing compression of adjacent structures (dysphagia, stridor, vocal cord palsy). On US there will be decreased vascularity.

A

Reideis Thyroiditis;

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21
Q

Thyrogiossai Duct Cyst (TGDC)

why care?

A

*They can get infected
*They can have ectopic thyroid tissue
*Rarely, that ectopic tissue can get papillary thyroid cancer (if you see an enhancing nodule)

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22
Q
Study These Flashcards
A

Thyrogiossai Duct Cyst (TGDC)

This can occur anywhere between the foramen cecum (the base of the tongue) and the thyroid gland (or below). It looks like a thin walled cyst

Suprahyoid = 25% At the Hyoid = 30% Infrahyoid = 45%

23
Q

The most common location of ectopic thyroid (90%)

Study These Flashcards
A

Toungue

the rate o f malignant
transformation is rare (3%)

24
Q

Autoimmune + causes hyperthyroidism (most common) =

25
It’s primarily from an antibody directed at the TSH receptor
Graves
26
Spares the tendon insertions, doesn’t hurt (unlike pseudotumor). Also has increased intra-orbital fat.
Graves Orbitopathy
27
most common cause of goitrous hypothyroidism
Hashimotos
28
It is an autoimmune disease that causes hyper then hypo thyroidism (as the gland bums out later).
Hashimotos
29
Hashimotos Heterogeneous “giraffe sldn” appearance,
30
Hashimotos White Knights - uniform hyperechoic nodules - which are actually regenerative nodules.
31
These are the nodes around the thyroid in the front ofthe neck.
Level 6 Nodes - “Delphian Nodes”
32
You can commonly see them enlarged with Hashimotos.
Level 6 Nodes - “Delphian Nodes”
33
a sick looking level 6 node - or “Delphian Node” is a>
Laryngal Cancer metastasis
34
There are 4 main subtypes of primary thyroid cancer.
1. Papillary 2. Follicular 3. MEdullary 4. Anaplastic
35
The Most Common Subtype of Thyroid CA
Papillary
36
Microcalcifications is the buzzword and key finding (seen in the cancer and nodes).
Papillary
37
Mets via the lymphatics. Has an overall excellent prognosis, and responds well to 1-131.
Papillary
38
The second most common subtype of Thyroid CA
Follicular CA
39
Mets hematogenously to bones, lung, liver, etc.. Survival is still ok, (less good than papillary). Does respond to I-131.
Follicular CA
40
Association with MEN II syndrome + Calcitonin production =
Medullary Thyroid CA
41
Tendency towards local invasion, lymph nodes, and hematogenous spread. Does NOT respond to 1-131.
Medullary Thyroid CA
42
Thyroid CA Elderly + Hx of radiation treatment
Anaplastic
43
Rapid growth, with primary lymphatic spread. Does NOT respond to 1-131.
Anaplastic
44
Does not take up 1-131 as well as normal follicular. FDG-PET is the way to go for surveillance.
Hurthle Cell (variant of Follicular)
45
"microcalcifications in a node"
Thyroid metastasis
46
Metastasis on imageing
USD: hyperechoic CT: Hyperenhancing MR: bright T1 Classic pattern of pulmonary mets = miliary
47
How many parathyroid glands are located posterior to the thyroid?
4
48
This is by far the most common cause of hyperparathyroidism (90%).
Parathyroid Adenoma
49
Parathyroid Adenoma 4D C T shows early enhancement, and delayed washout
50
hypoechoic beans posterior to the thyroid.
51
Parathyroid Carcinoma
Uncommon 1% causes hyperparathyroidism
52
What are the causes of hyperparathyroidism?
Hyperfunctioning Adenoma (85-90%) Multi-Gland Hyperplasia (8-10%) Cancer (l-3%>).
53
What factors does sestamibi parathyroid imaging depend on ?
A: Mitochondrial density and blood flow

7. ENDOCRINE (3 decks)

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