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ECNU - CCE Examination > Hyperparathyroidism > Flashcards

Hyperparathyroidism Flashcards

1
Q

Hyperparathyroidism is more common in…

Males or females?

A

Females

3:1

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2
Q

What percentage of hyperparathyroidism patients have a single adenoma?

A

85 - 90%

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3
Q

What percentage of hyperparathyroidism patients have multiple adenomas?

A

2 - 4%

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4
Q

What percentage of hyperparathyroidism patients have hyperplasia?

A

6 - 8%

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5
Q

US is localization and not a diagnostic study in hyperparathyroidism.

True or false?

A

True

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6
Q

What needs to be done other than biochemically confirm hyperparathyroidism before localization with ultrasound?

A

Rule out FHH

Fractional excretion of urine calcium

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7
Q

When is ultrasound not useful for localizing parathyroids?

A

Posterior and intrathoracic locations

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8
Q

Name three reasons for doing an ultrasound in hyperparathyroidism?

A
  • Localization (parathyroid adenoma)
  • coexisting thyroid nodules (thyroid cancer incidence 2 - 6%)
  • ethanol ablation in select patients
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9
Q

What is the most common frequency used for parathyroid adenomas?

A

7 - 10 mHz

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10
Q

How should the patient be positioned for parathyroid ultrasound?

A

With neck extended

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11
Q

Inferior parathyroid glands take a longer migratory route along with the thymus gland.

True or false?

A

True

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12
Q

Which pair of parathyroid glands is more constant?

A

Superior

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13
Q

Which pair of parathyroid glands migrates posteriorly?

A

Superior

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14
Q

Which pair of parathyroid glands migrates anteriorly and medially?

A

Inferior

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15
Q

Superior parathyroid: Location (%)

Carotid sheath?

A

1%

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16
Q

Superior parathyroid: Location (%)

Upper pole of thyroid?

A

10%

17
Q

Superior parathyroid: Location (%)

Mid portion thyroid lobe?

A

77%

18
Q

Superior parathyroid: Location (%)

Paraesophageal?

A

11%

19
Q

Inferior parathyroid: Location (%)

Undescended?

A

2%

20
Q

Inferior parathyroid: Location (%)

Mid thyroid?

A

3%

21
Q

Inferior parathyroid: Location (%)

Inferior pole of thyroid?

A

56%

22
Q

Inferior parathyroid: Location (%)

Thyrothymic ligament?

A

26%

23
Q

Inferior parathyroid: Location (%)

Mediastinal?

A

9%

24
Q

Parathyroid glands conform to surrounding structures.

True or false?

A

True

25
Q

Parathyroid glands have a vascular pedicle from polar artery.

True or false?

A

True

26
Q

Are parathyroids hypo- or hyperechoic?

A

Hypoechoic

27
Q

What can ‘bring out’ a parathyroid lesion that is located in the tracheo-esophageal groove?

A

Valsalva

28
Q

What is the concern when biopsy-ing a parathyroid adenoma?

A

Fibrosis from biopsy

29
Q

When biopsy-ing a parathyroid how should the needle be moved?

A

Rotation and instead of jabbing

30
Q

When biopsy-ing a parathyroid what gauge needle should be used?

A

27 G

31
Q

What are the absolute contra-indications to parathyroid biopsy?

A
  • Parathyroid carcinoma

- Familial jaw tumor - HPT syndrome

32
Q

What are the relative contra-indications to parathyroid biopsy

(4)

A
  • Anti-coagulation
  • Partial or complete obscuration by vessels
  • Significant respiratory movements
  • Morbid obesity
33
Q

When is cytology performed on parathyroid biopsies?

A

When PTH analysis is negative.

34
Q

Is cytology useful in the identification of parathyroid adenomas?

A

No

PTH level from syringe washing more useful

ECNU - CCE Examination (13 decks)

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