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7. ENDOCRINE > 3. Thyroid + Parathyroid > Flashcards

3. Thyroid + Parathyroid Flashcards

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
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%)

A

Toungue

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

24
Q

Autoimmune + causes hyperthyroidism (most common) =

A

Graves

25
Q

It’s primarily from an antibody directed at the TSH receptor

A

Graves

26
Q

Spares the tendon insertions, doesn’t hurt (unlike pseudotumor). Also has increased intra-orbital fat.

A

Graves Orbitopathy

27
Q

most common cause of goitrous hypothyroidism

A

Hashimotos

28
Q

It is an autoimmune disease that causes hyper then hypo thyroidism (as the gland bums out later).

A

Hashimotos

29
Q
A

Hashimotos

Heterogeneous “giraffe sldn” appearance,

30
Q
A

Hashimotos

White Knights - uniform hyperechoic nodules - which are actually regenerative nodules.

31
Q

These are the nodes around the thyroid in the front ofthe neck.

A

Level 6 Nodes - “Delphian Nodes”

32
Q

You can commonly see them enlarged with Hashimotos.

A

Level 6 Nodes - “Delphian Nodes”

33
Q

a sick looking level 6 node - or “Delphian Node” is a>

A

Laryngal Cancer metastasis

34
Q

There are 4 main subtypes of primary thyroid cancer.

A
  1. Papillary
  2. Follicular
  3. MEdullary
  4. Anaplastic
35
Q

The Most Common Subtype of Thyroid CA

A

Papillary

36
Q

Microcalcifications is the buzzword and key finding (seen in the cancer and nodes).

A

Papillary

37
Q

Mets via the lymphatics. Has an overall excellent prognosis, and responds well to 1-131.

A

Papillary

38
Q

The second most common subtype of Thyroid CA

A

Follicular CA

39
Q

Mets hematogenously
to bones, lung, liver, etc.. Survival is still ok, (less good than papillary). Does respond to I-131.

A

Follicular CA

40
Q

Association with MEN II syndrome + Calcitonin production =

A

Medullary Thyroid CA

41
Q

Tendency towards local invasion, lymph nodes, and hematogenous spread.

Does NOT respond to 1-131.

A

Medullary Thyroid CA

42
Q

Thyroid CA

Elderly + Hx of radiation treatment

A

Anaplastic

43
Q

Rapid growth, with primary lymphatic spread. Does NOT respond to 1-131.

A

Anaplastic

44
Q

Does not take up 1-131 as well as normal follicular. FDG-PET is the way to go for surveillance.

A

Hurthle Cell (variant of Follicular)

45
Q

“microcalcifications in a node”

A

Thyroid metastasis

46
Q

Metastasis on imageing

A

USD: hyperechoic
CT: Hyperenhancing
MR: bright T1

Classic pattern of pulmonary mets = miliary

47
Q

How many parathyroid glands are located posterior to the thyroid?

A

4

48
Q

This is by far the most common cause of hyperparathyroidism (90%).

A

Parathyroid Adenoma

49
Q
A

Parathyroid Adenoma

4D C T shows early enhancement, and delayed washout

50
Q
A

hypoechoic beans posterior to the thyroid.

51
Q

Parathyroid Carcinoma

A

Uncommon
1% causes hyperparathyroidism

52
Q

What are the causes of hyperparathyroidism?

A

Hyperfunctioning Adenoma (85-90%)
Multi-Gland Hyperplasia (8-10%)
Cancer (l-3%>).

53
Q

What factors does sestamibi parathyroid imaging depend on ?

A

A: Mitochondrial density and blood flow

7. ENDOCRINE (3 decks)

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