Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

ECNU - CCE Examination > Evaluation And Analysis Of Thyroid Nodules > Flashcards

Evaluation And Analysis Of Thyroid Nodules Flashcards

1
Q

What age groups are higher risk for thyroid malignancy?

A

Age less than 20 years or greater than 60 - 80.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name 6 thyroid cancer risk factors on history and physical (other than age).

A
  • Prior radiation
  • Rapid growth
  • Family history
  • Hoarseness
  • Dysphagia
  • Lymphadenopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What features have high clinical suspicion for thyroid cancer?

(8 features)

A
  • Rapid tumor growth
  • Very firm nodule (rock hard)
  • Fixation to adjacent structures
  • Vocal cord paresis
  • Enlarged regional lymph nodes
  • Family history of PTC or MEN 2
  • Distant metastasis
  • History of radiation exposure to the head/neck
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the positive predictive value of ‘high clinical suspicion’ features for thyroid cancer?

A

70 - 75% (Good)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the negative predictive value of ‘high clinical suspicion’ features for thyroid cancer?

A

85% (Unacceptable)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Name three tests for thyroid nodules.

A
  • I-123 scan
  • Thyroid ultrasound
  • FNA biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Palpation is not accurate in up to ____% of patients with solitary palpable nodules.

A

30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

___% of patients have no corresponding nodule on US.

A

16

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

____% have an additional non-palpable nodule > 1 cm on US

A

15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ultrasound will find additional non-palpable nodules > 1 cm in ___ in ___ patients.

A

1 in 7 patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ultrasound is extremely sensitive.

True or false?

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In what 5 scenarios does the normal neck need to be ultrasound-ed?

A
  • External radiation during childhood
  • History of familial thyroid cancer
  • Previous history of thyroid cancer
  • Hyperparathyroidism
  • Morphology impeding exam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Are discrepancies between ultrasound features of risk of malignancy operator-dependent?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a ‘white knight’?

A

Hyperechoic nodule - particularly in Hashimoto’s thyroiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the primary goal in evaluating thyroid nodules?

A

To determine if the nodule is benign or malignant.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Are most hyperechoic nodules benign or malignant?

A

Benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What kind of neoplasm is a thick, irregular halo suggestive of?

A
  • Follicular or Hurthle cell carcinoma or adenoma

- Encapsulated papillary cancer follicular variant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is a halo thought to represent?

A

Thought to represent the compressed perinodular vessels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

If halo is absent - suggestive of an infiltrative malignancy…

Sensitivity?

A

66%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If halo is absent - suggestive of an infiltrative malignancy…

Specificity?

A

54%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Benign or malignant?

Thin-walled cyst without a solid component.

A

Benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Benign or malignant?

Halo

A

Benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Benign or malignant?

Smooth margin

A

Benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Benign or malignant?

Hyperechoic nodule

A

Benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Benign or malignant?

Colloid within cystic nodule…

A

Benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What artifact does colloid within a cystic nodule produce on ultrasound?

A
  • Comet tail

- Cat’s eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Benign or malignant?

Eggshell calcifications (smooth)…

A

Benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Benign or malignant?

Eggshell calcifications (interrupted)…

A

Malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Amorphous calcifications with shadowing…

Diagnosis?

A

Hashimoto’s thyroiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Benign or malignant?

Multiple confluent nodules without normal intervening parenchyma.

A

Benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

A patient with a multiple discrete thyroid nodules has ______ risk of malignancy as a patient with a solitary nodule.

A

The same

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Multiple discrete nodules need to be evaluated individually.

True or false?

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Benign or malignant?

Spongiform echotexture

34
Q

“Spongiform” nodules have an aggregation of multiple microcystic components in more than ___% of the volume of the nodule.

35
Q

What is the best ultrasound test for benign nodules?

A

Shrinkage of a nodule over time

36
Q

How do you calculate the volume of a nodule?

A

Pi/6 (width x depth x length)

37
Q

Name the types of thyroid cancer.

6 types

A
  • Papillary
  • Follicular
  • Medullary
  • Anaplastic
  • Lymphoma
  • Metastatic
38
Q

Benign or malignant?

Hypoechoic (or heterogeneous)

39
Q

Is Anaplastic carcinoma usually hypoechoic or hyperechoic?

A

Hypoechoic

40
Q

Which four cancers most commonly metastasize to the thyroid?

A
  • Renal cell carcinoma
  • Breast carcinoma
  • Lung carcinoma
  • Melanoma
41
Q

Benign or malignant?

Irregular or ‘infiltrative’ border

42
Q

Benign or malignant?

Irregular mural component of cyst

43
Q

Benign or malignant?

Invasion of adjacent tissues…

44
Q

Benign or malignant?

Cervical lymphadenopathy

45
Q

Thyroid ultrasound should always include evaluation of the neck for abnormal lymph nodes.

True or false?

46
Q

When abnormal lymph nodes are present, biopsy for ______ and _______ should be performed at the same time as the nodule biopsy.

A
  • Cytology

- Thyroglobulin analysis

47
Q

Benign or malignant?

Intranodular vascularity…

48
Q

Benign or malignant?

Microcalcifications…

49
Q

What do dense calcifications look like on ultrasound?

A

Hyperechoic spots with acoustic shadowing

50
Q

What do micro-calcifications look like on ultrasound?

A

Hyperechoic spots without acoustic shadowing (thought to represent psammoma) (

51
Q

Does distinction between small calcifications and comet tail artifact require a lower or higher frequency probe?

A

Lower

10 mHz, rather than 12 - 14 mHz

52
Q

What are ‘string of pearls’ microcalcifications suggestive of?

A

Papillary cancer

53
Q

Benign or malignant?

Increasing size on or off TSH suppression

54
Q

Benign or malignant?

Microcalcifications without shadowing

55
Q

Benign or malignant?

Macrocalcifications…

56
Q

How big are macrocalcifications?

A

More than 1 - 2 mm

57
Q

Are macrocalcifications usually solitary or multiple?

58
Q

Benign or malignant?

“Taller than wide” (on transverse view)

59
Q

_____% of all thyroid cancers are iso/hyperechoic: they are predominantly ______ type.

A

20 - 30%

Follicular / Hurthle

60
Q

Diagnosing papillary cancer…

Sensitivity?

Microcalcifications.

61
Q

Diagnosing papillary cancer…

Sensitivity?

Absence of halo.

62
Q

Diagnosing papillary cancer…

Sensitivity?

Irregular margins.

63
Q

Diagnosing papillary cancer…

Sensitivity?

Hypoechoic.

64
Q

Diagnosing papillary cancer…

Sensitivity?

Increased intranodular flow.

65
Q

Diagnosing papillary cancer…

Sensitivity?

Microcalcifications + irregular margin.

66
Q

Diagnosing papillary cancer…

Sensitivity?

Microcalcifications + hypoechoic.

67
Q

Diagnosing papillary cancer…

Sensitivity?

Solid + hypoechoic.

68
Q

Diagnosing papillary cancer…

Sensitivity?

FNA.

69
Q

Diagnosing papillary cancer…

Specificity?

Microcalcifications.

70
Q

Diagnosing papillary cancer…

Specificity?

Absence of halo.

71
Q

Diagnosing papillary cancer…

Specificity?

Irregular margins.

72
Q

Diagnosing papillary cancer…

Specificity?

Hypoechoic.

73
Q

Diagnosing papillary cancer…

Specificity?

Increased intranodular flow.

74
Q

Diagnosing papillary cancer…

Specificity?

Microcalcifications + irregular margins.

75
Q

Diagnosing papillary cancer…

Specificity?

Microcalcifications + hypoechoic.

76
Q

Diagnosing papillary cancer…

Specificity?

Solid + hypoechoic.

77
Q

Diagnosing papillary cancer…

Specificity?

FNA.

78
Q

Ultrasound allows an objective method to follow the size of a nodule.

True or false?

79
Q

Does ultrasound replace FNA biopsy?

80
Q

Knowledge of a nodule’s characteristics and changes in size component the FNA biopsy data in deciding which nodules need surgery.

True or false?

ECNU - CCE Examination (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions