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SON 131 FINAL > Tempkin Ch. 23 Thyroid > Flashcards

Tempkin Ch. 23 Thyroid Flashcards

1
Q

Neck muscles located anterolateral to the thyroid gland include all of the following except the
Select one:
a. sternothyroid (ST) and sternohyoid (SH).
b. sternocleidomastoid muscle (SCM).
c. longus colli muscle (LCM).
d. omohyoid (OH) and thyrohyoid (TH).

A

c. longus colli muscle (LCM).

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2
Q 
The average weight of the thyroid gland is approximately
Select one:
a. 25 g. 
b. 40 g.
c. 15 g.
d. 10 g.
A

a. 25 g.

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3
Q 
The high resolution sonography recommended for evaluation of parathyroid adenomas is
Select one:
a. 3.5 to 5 MHz.
b. 5 MHz only.
c. 4.5 MHz.
d. 7.5 to 15 MHz.
A

d. 7.5 to 15 MHz.

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4
Q

The mathematical method for calculating thyroid volume is based on the ellipsoid formula with a correction factor, which is:
Select one:
a. Length ´ Width ´ Thickness ´ 0.72 for each lobe.
b. Length ´ Width ´ Thickness ´ 0.62 for each lobe.
c. Length ´ Width ´ Circumference ´ 0.52 for each lobe.
d. Length ´ Width ´ Thickness ´ 0.52 for each lobe.

A

d. Length ´ Width ´ Thickness ´ 0.52 for each lobe.

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5
Q 
The secretion of triiodothyronine (T3), thyroxine (T4), and calcitonin is regulated by the
Select one:
a. pituitary gland only.
b. hypothalamus only.
c. hypothalamus and pituitary gland. 
d. parafollicular cells (C cells).
A

c. hypothalamus and pituitary gland.

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6
Q

The sonographic appearance of the normal parathyroid glands generally is
Select one:
a. hyperechoic compared with the thyroid gland.
b. mixed echogenicity with calcifications.
c. anechoic with through transmission.
d. hypoechoic compared with the thyroid gland.

A

d. hypoechoic compared with the thyroid gland.

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7
Q

The sonographic appearance of the normal thyroid gland is uniformly
Select one:
a. echogenic with medium level echoes, similar to the testes and liver.
b. heterogeneous with medium to high level echoes.
c. hyperechoic with high level echoes.
d. hypoechoic with medium level echoes.

A

a. echogenic with medium level echoes, similar to the testes and liver.

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8
Q

The superior and inferior parathyroid glands are supplied by the
Select one:
a. superior thyroid artery and vein.
b. inferior thyroid artery only.
c. venous plexus only.
d. separate small branches of the superior and inferior thyroid arteries and by branches from the longitudinal anastomoses between these vessels.

A

d. separate small branches of the superior and inferior thyroid arteries and by branches from the longitudinal anastomoses between these vessels.

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9
Q 
The superior thyroid artery is a branch of the :
Select one:
a. common carotid artery.
b. internal carotid artery.
c. external carotid artery. 
d. vertebral artery
A

c. external carotid artery.

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10
Q 
The thyroid gland is composed of follicles filled with a substance called
Select one:
a. thyrotropin.
b. parafollicular cells (C cells).
c. colloid. 
d. none of the above
A

c. colloid.

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11
Q

The thyroid is an endocrine gland that secretes three hormones, which are
Select one:
a. triiodothyronine (T4), thyroxine (T5), and calcitonin.
b. triiodothyronine (T3), thyroxine (T4), and calcium oxide.
c. thyroxine (T4), triiodothyronine (T3), and calcitonin.
d. triiodothyronine (T3), thyroxine (T7), and iron.

A

c. thyroxine (T4), triiodothyronine (T3), and calcitonin.

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12
Q

When ultrasound fails to identify abnormal parathyroid glands preoperatively, and in patients considered for repeat surgery, which test(s) is/are commonly used?
Select one:
a. Selective venous sampling
b. Arteriography and magnetic resonance imaging (MRI)
c. Computed tomography only
d. Scintigraphy, SPECT, and MRI

A

d. Scintigraphy, SPECT, and MRI

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13
Q 
Which neck muscle(s) is/are located posterior to the thyroid gland?
Select one:
a. Longus colli muscle 
b. Omohyoid and thyrohyoid muscles
c. Sternocleidomastoid muscle
d. Sternothyroid and sternohyoid muscles
A

a. Longus colli muscle

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14
Q

Which statement is NOT true about imaging of the parathyroid glands?
Select one:
a. High resolution (7.5 to 15 MHz) linear transducers are routinely used to image abnormal parathyroid glands.
b. In a patient with a thick neck, a lower frequency (e.g., a 4 to 8 MHz convex transducer) may be required to enhance acoustic visualization.
c. In examinations for inferior parathyroid adenomas, the swallow maneuver briefly elevates the thyroid gland, permitting acoustic access to the most inferior aspect of the gland.
d. Sonography routinely is performed on patients with normal calcium levels.

A

d. Sonography routinely is performed on patients with normal calcium levels.

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15
Q

Which statement is NOT true about parathyroid gland physiology?
Select one:
a. When serum calcium levels are low, PTH raises serum calcium by releasing calcium from the bone and decreasing calcium absorption in the liver.
b. The parathyroid glands maintain homeostasis of blood calcium by promoting calcium absorption into the blood and preventing hypocalcemia.
c. The parathyroid glands secrete parathyroid hormone, also called PTH or parathormone.
d. Hypercalcemia (calcium levels greater than 10.2 mg/dl in adults and 10.7 mg/dl in children) is an indication for localizing abnormal parathyroid glands.

A

a. When serum calcium levels are low, PTH raises serum calcium by releasing calcium from the bone and decreasing calcium absorption in the liver.

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16
Q

Which statement is NOT true about the adult thyroid gland?
Select one:
a. It plays a major role in growth and development and regulates basal metabolism through the synthesis, storage, and secretion of thyroid hormones.
b. In cross-section, it is outlined posterolaterally by the CCA and the IJV.
c. The isthmus measures approximately 2 to 6 mm in AP diameter.
d. The thyroid parenchyma is composed of connective tissue and masses of chief cells.

A

d. The thyroid parenchyma is composed of connective tissue and masses of chief cells.

17
Q

Which statement is NOT true about the parathyroid glands and parathyroid adenomas?
Select one:
a. Approximately 35% of parathyroid glands are ectopic.
b. Ectopic locations for parathyroid glands include the carotid bulb, as well as retroesophageal space, the thymus and perithymic tissues, and within the thyroid gland.
c. Current state-of-the-art color flow imaging of parathyroid adenomas demonstrates intraparenchymal hypervascularization in approximately 90% of cases.
d. Normal cervical structures, such as the longus colli muscle, esophagus, and small extrathyroidal arteries and veins, can mimic parathyroid adenomas.

A

a. Approximately 35% of parathyroid glands are ectopic.

18
Q

Which statement is NOT true about the parathyroid glands?
Select one:
a. Most people (about 80%) have four parathyroid glands located in a symmetric position contiguous with the thyroid gland.
b. The parathyroid glands generally are situated anterior to the thyroid gland.
c. The parathyroid glands may be intrathyroidal.
d. Approximately 15% of parathyroid glands are ectopic.

A

b. The parathyroid glands generally are situated anterior to the thyroid gland.

19
Q

Which statement is NOT true about the parathyroid glands?
Select one:
a. They generally have a multilobulated shape.
b. Ectopic locations include the carotid bulb and retroesophageal, thymus, and intrathyroidal locations.
c. Normal parathyroid glands measure approximately 5 to 7 mm in length, 3 to 4 mm in width, and 1 to 2 mm in thickness.
d. Approximately 15% to 20% of parathyroid glands are ectopic.

A

a. They generally have a multilobulated shape.

20
Q

Which statement is NOT true about the parathyroid glands?
Select one:
a. Normal adult parathyroid glands generally are not seen with sonography.
b. The parathyroid glands are situated posterior to the thyroid gland and anterior to the longus colli muscle.
c. Normal parathyroid glands almost always can be seen, especially in young patients.
d. A prominent longus colli muscle may be mistaken for a parathyroid adenoma.

A

c. Normal parathyroid glands almost always can be seen, especially in young patients.

21
Q

Which statement is NOT true about the parathyroid glands?
Select one:
a. The typical sonographic appearance of a parathyroid adenoma is an oval, hyperechoic, structure without through transmission.
b. Primary hyperparathyroidism is caused by a solitary parathyroid adenoma in 80% to 90% of cases.
c. Most people have four parathyroid glands located posterior to the thyroid lobe and anterior to the longus colli muscle.
d. The most common indication for parathyroid imaging is hypercalcemia.

A

a. The typical sonographic appearance of a parathyroid adenoma is an oval, hyperechoic, structure without through transmission.

22
Q

Which statement is NOT true about the size and shape of the thyroid gland?
Select one:
a. The right lobe often is slightly larger than the left lobe.
b. Shorter, obese patients tend to have oval lateral lobes measuring less than 3.5 cm.
c. Tall, thin patients have elongated lateral lobes that can measure up to 7 to 8 cm in the longitudinal plane.
d. Thyroid gland measurements have a wide range of variability.

A

b. Shorter, obese patients tend to have oval lateral lobes measuring less than 3.5 cm.

23
Q

Which statement is NOT true about the sonographic appearance of the neck muscles and the esophagus?
Select one:
a. The esophagus appears hypoechoic with an echogenic center representing mucosa.
b. The infrahyoid muscles, or strap muscles, are hypoechoic relative to the thyroid gland.
c. The sternocleidomastoid muscle is hypoechoic compared with the thyroid gland.
d. The longus colli muscle is hyperechoic compared with the thyroid gland.

A

d. The longus colli muscle is hyperechoic compared with the thyroid gland.

24
Q

Which statement is NOT true about the sonographic appearance of the normal thyroid gland?
Select one:
a. It is more echogenic than contiguous muscles and vascular structures.
b. It is uniformly echogenic with medium level echoes, similar to the liver and testes.
c. Anechoic, 1- to 2-mm tubular structures represent the thyroid arteries and veins.
d. It is more uniformly hypoechoic than contiguous muscles and vascular structures.

A

d. It is more uniformly hypoechoic than contiguous muscles and vascular structures.

25
Q

Which statement is NOT true about the thyroid gland?
Select one:
a. It lies anterior to the trachea.
b. It is composed of right and left lobes only.
c. A pyramidal lobe is present in approximately 15% to 30% of the population.
d. It is composed of right and left lobes connected across the midline by the isthmus.

A

b. It is composed of right and left lobes only.

26
Q

Which statement is NOT true about the thyroid gland?
Select one:
a. It measures approximately 4 to 6 cm in length, 2 to 3 cm in anteroposterior (AP) diameter, and 1.5 to 2 cm in width.
b. In cross-section, it is outlined anteriorly by the longus colli muscle and the internal jugular vein.
c. The isthmus measures approximately 2 to 6 mm in AP diameter.
d. It plays a major role in growth and development and regulates basal metabolism through the synthesis, storage, and secretion of thyroid hormones.

A

b. In cross-section, it is outlined anteriorly by the longus colli muscle and the internal jugular vein.

27
Q

Which statement is NOT true about the thyroid gland?
Select one:
a. Thyroid volumes increase with age and body weight, as well as in patients with acute hepatitis and those living in regions deficient in iodine.
b. It is an endocrine gland that secretes triiodothyronine (T3), thyroxine (T4), and calcitonin.
c. It is an exocrine gland that secretes triiodothyronine (T3), thyroxine (T4), and iron.
d. The normal mean thyroid volume is 18.6 ± 4.5 ml (± SD), which converts to a 18.6-g gland.

A

c. It is an exocrine gland that secretes triiodothyronine (T3), thyroxine (T4), and iron.

28
Q

Which statement is NOT true about the thyroid gland?
Select one:
a. It is connected across the midline by the isthmus.
b. It is composed of right and left lobes.
c. It lies anterior to the trachea.
d. In cross-section, it is outlined posterolaterally by the common carotid artery (CCA) and internal jugular vein (IJV), and anteriorly by the longus colli muscle.

A

d. In cross-section, it is outlined posterolaterally by the common carotid artery (CCA) and internal jugular vein (IJV), and anteriorly by the longus colli muscle.

29
Q

Most parathyroid adenomas appear in the area of an anatomic “triangle” formed by the thyroid gland, longus colli muscle, common carotid artery, and internal jugular vein. ____
Select one:
True
False

A

True

30
Q

Patients with secondary hyperparathyroidism develop hypercalcemia. ____
Select one:
True
False

A

True

31
Q

The major neurovascular bundle is located posterolateral to the thyroid gland and consists of the common carotid artery, internal jugular vein, and vagus nerve. ____
Select one:
True
False

A

True

32
Q

The presence of an extrathyroidal artery leading to an abnormal parathyroid gland aids the detection of an otherwise inconspicuous parathyroid adenoma ____
Select one:
True
False

A

True

SON 131 FINAL (4 decks)

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