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ARDMS ABD PATHOLOGY > Face & Neck Pathology > Flashcards

Face & Neck Pathology Flashcards

1
Q

nuclear medicine utilizes ______ to classify thyroid nodules

A

scintigraphy

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2
Q

hyperfunctioning thyroid nodules or “hot nodules” appear as _____

A

dark areas

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3
Q

hypofunctioning thyroid nodules or “cold nodules” appear as _____

A

light or blank areas

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4
Q

most thyroid cancers are _____

A

hypofunctioning
“cold nodules”

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5
Q

_____ is the most effective method for diagnosing malignancy in a thyroid nodule

A

fine needle aspiration (FNA)

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6
Q

FNA should be considered in a (5)

A
  1. nodule > 1.0 cm with microcalcifications
  2. nodule > 1.5 cm that is predominately solid
  3. nodule > 2.0 cm that has mixed components
  4. nodule demonstrating growth
  5. nodule with ipsilateral abnormal lymph nodes ( > 7mm in short axis )
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7
Q

what does TI-RADS stand for?

A

thyroid imaging, reporting and data system

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8
Q

what is TI-RADS used for?

A

identifies most clinically significant malignancies while reducing the number of biopsies performed on benign nodules

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9
Q

TI-RADS categories (5)

A

benign
not suspicious
minimally suspicious
moderately suspicious
highly suspicious for malignancy

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10
Q

malignant features of thyroid nodules (5)

A

solid
hypoechoic
taller than wide
lobulated or irregular margins
calcifications

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11
Q

what is a goiter?

A

abnormal enlargement of the thyroid gland

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12
Q

what is the most common cause worldwide of goiters?

A

iodine deficiency

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13
Q

other causes of goiters (2)

A

hashimoto’s
grave’s

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14
Q

nontoxic/simple goiters are associated with

A

normal or low thyroid hormone levels

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15
Q

ultrasound appearance of nontoxic/simple goiters

A

homogenous, diffuse enlargement

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16
Q

toxic/multinodular goiters are associated with

A

hyperparathyroidism

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17
Q

ultrasound appearance of toxic/multinodular goiters

A

heterogeneous
decreased echogenicity

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18
Q

signs/symptoms of goiters (4)

A

dysphagia
dyspnea
coughing
hoarseness

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19
Q

another name for Grave’s disease

A

diffuse toxic goiter

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20
Q

what is the most common cause of hyperthyroidism?

A

grave’s disease

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21
Q

the presence of _____ is in grave’s disease

A

thyroid-stimulating immunoglobins

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22
Q

ultrasound appearance of Grave’s disease (2)

A

** thyroid inferno **
diffusely heterogeneous or hypoechoic

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23
Q

signs/symptoms of Grave’s (5)

A

bulging eyes
weight loss
tremors
tachycardia
heat intolerance

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24
Q

what is euthyroid?

A

thyroid is producing the right amount of thyroid hormones

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25
Q

5 types of thyroiditis

A
  1. hashimotos
  2. subacute granulomatous thyroiditis
  3. subacute lymphocytic thyroiditis
  4. acute suppurative thyroiditis
  5. riedel struma
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26
Q

another name for hashimotos

A

chronic lymphocytic thyroiditis

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27
Q

____ is the most common cause of hypothyroidism

A

hashimoto’s

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28
Q

lab values of hyperthyroidism

A

increase T3 and T4
decrease TSH

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29
Q

lab values of hypothyroidism

A

decrease T3 and T4
increase TSH

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30
Q

ultrasound appearance of Hashimoto’s (3)

A
  1. diffusely heterogeneous
  2. coarse parenchyma
  3. multiple, ill-defined hypoechoic regions separated by fibrous hyperechoic tissue
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31
Q

signs/symptoms of Hashimoto’s (5)

A

puffiness under eyes
puffy face
dry skin
increased cold sensitivity
elevated blood cholesterol levels

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32
Q

what is the most common mass identified within the thyroid?

A

benign nodule

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33
Q

___ is the most common type of thyroid adenoma

A

follicular adenoma

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34
Q

what is the most common cause of thyroid nodules?

A

nodular hyperplasia

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35
Q

adenomatous nodules are _____

A

hyperplastic nodules

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36
Q

____ nodules are cystic and have hyperechoic foci that produce ____ artifacts

A

colloid nodules
produce comet-tail artifacts

37
Q

what is the most common primary thyroid cancer?

A

papillary carcinoma

38
Q

____ carcinoma is the least aggressive of thyroid tumors

A

papillary carcinoma

39
Q

papillary carcinoma spreads through the _____ to nearby _____

A

spreads through the lymphatics to nearby cervical lymph nodes

40
Q

ultrasound appearance of papillary carcinoma (3)

A

hypoechoic
calcifications
hypervascular

41
Q

what is the second most common thyroid cancer?

A

follicular carcinoma

42
Q

follicular carcinoma spreads via ____ and metastasize to the ____

A

spreads via blood streams
metastasize to lungs and bone

43
Q

ultrasound appearance of follicular carcinoma (3)

A

irregular margins
thick irregular halo
chaotic arrangement of internal blood vessels

44
Q

medullary carcinoma develop from _____ that secrete calcitonin

A

parafollicular cells

45
Q

medullary carcinoma is associated with ____

A

MEN syndrome

46
Q

what is the rarest and fastest growing thyroid cancer?

A

anaplastic carcinoma

47
Q

anaplastic carcinoma usually causes death by (2)

A

compression and asphyxiation

48
Q

what is the most common cause of an enlarged parathyroid gland?

A

parathyroid adenoma

49
Q

ultrasound appearance of parathyroid adenomas (2)

A

single lesion (80%)
oval, hypoechoic

50
Q

what is the most common type of hyperparathyroidism?

A

primary hyperparathyroidism

51
Q

lab values of primary hyperparathyroidism (2)

A

increase serum calcium and PTH

52
Q

in primary hyperparathyroidism there is an adenoma in ____ parathyroid gland

A

one

53
Q

secondary hyperparathyroidism occurs in patients with ____

A

chronic renal failure

54
Q

____ parathyroid glands are enlarged in secondary hyperparathyroidism

A

all 4 parathyroid glands

55
Q

what is the most common manifestation of MEN type I?

A

secondary hyperparathyroidism

56
Q

lab values of secondary hyperparathyroidism (2)

A

increase serum phosphates
decrease serum calcium

57
Q

parathyroid carcinoma is ____

A

rare

58
Q

what is sjögren syndrome?

A

autoimmune disease that leads to the dysfunction of the salivary glands

59
Q

ultrasound appearance of sjögren syndrome (4)

A

heterogeneous
hyperemic
diffuse hypoechoic regions
sialadenitis

60
Q

what is sialadenitis?

A

inflammation of the salivary glands

61
Q

signs/symptoms of sjögren syndrome

A

severe dryness of the eyes, nose, skin, and mouth

62
Q

what is sialolithiasis?

A

salivary duct stones most commonly located within the submandibular gland

63
Q

what is sialadenosis?

A

benign, painless enlargement of the parotid glands

64
Q

what is pleomorphic adenoma?

A

most frequent benign tumor of the salivary glands commonly seen in the parotid glands

65
Q

what is the most common malignancy of the salivary glands?

A

mucoepidermoid carcinoma

66
Q

mucoepidermoid carcinoma starts in the ____ glands

A

parotid glands

67
Q

what is the most common superficial midline neck mass?

A

thyroglossal duct cyst

68
Q

thyroglossal duct cysts are associated with ____ and typically seen in ____

A

associated with upper respiratory infections

seen in adolescents

69
Q

ultrasound appearance of thyroglossal duct cyst

A

< 3 cm
well defined
cystic

70
Q

what is a branchial cleft cyst?

A

congenital cyst that arises on the lateral part of the neck

71
Q

_____ is a remnant of embryonic development

A

branchial cleft cyst

72
Q

ultrasound appearance of branchial cleft cysts (3)

A

unilateral
cystic or complex
low level internal echoes

73
Q

another name for cystic hygromas

A

cystic lymphangiomas

74
Q

what is cystic hygroma?

A

congenital lymphatic malformation

75
Q

____% of cystic hygromas occur in the neck

A

75%

76
Q

cystic hygromas are associated with (4)

A

turner syndrome
trisomy 21
klinefelter syndrome (XXY)
trisomy 18 and 13

77
Q

3 vessels of the aortic arch that extend into the neck

A

innominate (brachiocephalic) artery
left common carotid artery
left subclavian artery

78
Q

there is ___ innominate artery and ___ innominate veins

A

1 artery (right)
2 veins

79
Q

position of the ICA

A

lateral and posterior

80
Q

the ICA has a ___ resistance waveform

A

low resistance

81
Q

1st branch of the ICA

A

ophthalmic artery

82
Q

position of the ECA

A

medial and anterior

83
Q

the ECA shows a ____ resistance waveform

A

high resistance

84
Q

1st branch of the ECA

A

superior thyroid artery

85
Q

what two veins drain into the innominate vein?

A

internal jugular and subclavian

86
Q

what is fibromatosis colli?

A

rare, pediatric fibrous tumor within the sternocleidomastoid muscle

87
Q

fibromatosis colli causes twisting off the infant’s chin toward the nonaffected side which is termed ____

A

congenital muscular torticollis

88
Q

ultrasound appearance of fibromatosis colli (3)

A

fusiform-shaped mass
calcifications that shadow
hyperemic pattern with color doppler

ARDMS ABD PATHOLOGY (13 decks)

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