Fellowship - July 2014 Flashcards
Do rib fractures show up on bone scans?
Usually because they never really completely heal.
Do old fractures show up on a bone scan?
Only if they haven’t completely healed.
Which endocrine syndrome is associated with the physical exam finding of lipomas?
MEN-1
Which endocrine disorder can cause vertical ridges on the nails?
Hypothyroidism
Does radioactive iodine ablation suppress bone marrow?
It can theoretically.
Estrogen can precipitate a porphyria attack.
True or false?
True
Extreme hypertriglyceridemia can spuriously lower HbA1c.
True or false?
True
Is fenofibrate associated with higher rates of pancreatitis?
Yes.
Either directly or through increased risk of gallstones.
What percentage of microprolactinomas enlarge during pregnancy?
3%
What percentage of macroprolactinomas enlarge during pregnancy?
30%
What do normal lymph nodes look like on ultrasound?
Dark with a white halo/spot in the middle.
Length more than twice the depth.
When doing a FNA biopsy of the thyroid and you are moving the needle up and down in the nodule - should you do it fast or slow?
Fast
During an FNA of the thyroid; do you get more cells if you spend a shorter or longer amount of time in the nodule?
More cells if you spend a shorter amount of time in the nodule.
Which side is the marked side of the probe supposed to be pointing at?
Right side in transverse view.
Superior side in sagittal view.
What does a horizontal line on a genetic family tree denote?
Marriage
What does a double horizontal line in a genetic family tree denote?
Consanguinity
What does fludrocortisone do to potassium levels?
Makes them lower.
What does fludrocortisone do to renin levels?
Lowers them
How many repeats should you have for good exome sequencing?
At least 20 or more.
What percentage of cystic thyroid nodules shrink with levothyroxine suppression?
20%
Is it a good idea to look at static thyroid ultrasound images?
No.
What is a significant change in the size of a thyroid nodule on ultrasound?
20% in 2 dimensions
Can you give contrast to patients with pheochromocytomas and paragangliomas?
Contrast agents are not as high osmolar volume as 20 years ago - so it is not an issue anymore and you can give contrast.
Can patients be asymptomatic with pheochromocytomas?
Yes - they can subclinical pheochromocytomas/paragangliomas.
What imaging modality is recommended to check for metastasis of paragangliomas or pheochromocytomas?
FDG-PET scan per endocrine society guidelines as opposed to I-123 MIBG scan.
How long after the surgery for pheochromocytoma or paraganglioma should you biochemically check for cure?
1 - 3 months.
What are Lisch nodules/iris hamartomas and pheochromocytomas associated with?
Neuro-fibromatosis type 1 (NF1)
Also known as von Recklinghausen’s disease.
Which two genetic conditions can cause pheochromocytomas and renal cell carcinoma?
VHL
SDHB
Genetic transmission of SDHD.
Autosomal dominant with maternal imprinting (only gene from father is phenotypically expressed; gene from mother is transmitted to offspring but not phenotypically expressed).
What is the conventional order of measuring the thyroid lobes in ultrasound?
Length X Depth X Width
How many pictures of the thyroid gland need to be taken for billing purposes?
13
Name the pictures that need to be taken with thyroid ultrasound.
Right transverse inferior Right transverse mid Right transverse superior Right sagittal lateral Right sagittal mid Right sagittal medial Isthmus Left transverse inferior Left transverse mid Left transverse superior Left sagittal lateral Left sagittal mid Left sagittal medial