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Small Parts > Thyroid Masses > Flashcards

Thyroid Masses Flashcards

1
Q

Most thyroid nodules exceeding __ in max diameter should be evaluated further.

A

1.5 cm

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2
Q

This is the most effective method for dagnosing malignancy in a thyroid nodule.

A

FNA

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3
Q

Most physicians use a __ gauge needle for FNA procedures.

A

25

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4
Q

An FNA is performed with a MNG when there is a…

A

dominant nodule.

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5
Q

Would you rather have a solitary ‘cold’ thyroid nodule or a cold MNG?

A

A cold MNG. (Solitary ‘cold’ nodules are more likely to be malignant.)

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6
Q

What sonographic features are associated with benign vs malignant thyroid nodules?

A
  1. internal consistancy
  2. echogenicity
  3. margination
  4. calcification
  5. peripheral sonolucent halo
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7
Q

T/F? True simple thyroid cysts are extremely common.

A

FALSE, rare.

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8
Q

T/F? A nodule with a significant cystic component is usually benign.

A

true

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9
Q

Thyroid cancers are usually __echoic relative to the adjacent normal tissue.

A

hypo-

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10
Q

A __echoic thyroid nodule is more likely to be benign.

A

hyper-

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11
Q

T/F? Benign thyroid nodules tend to have sharp, well-defined margins.

A

true

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12
Q

T/F? Malignant thyroid nodules tend to have sharp, well-defined margins.

A

FALSE, benign

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13
Q

This is the most reliable feature of a benign nodule.

A

peripheral or eggshell calcification

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14
Q

Calcifications that are ___ are more suggestive of malignancy.

A

fine and punctate

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15
Q

A thin complete halo is more likely to be seen with a __ nodule.

A

benign

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16
Q

A ___ halo is more likely to be seen with a malignant nodule.

A

thick incomplete

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17
Q

This is the most common primary thyroid cancer accounting for 75-90% of all cases.

A

Papillary carcinoma

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18
Q

What age person is likely to get papillary carcinoma?

A

Someone is their 30s or 70s.

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19
Q

This is the major route of spread of papillary carcinoma.

A

lymphatics to nearby cervical lymphnodes

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20
Q

Sonographically, papillary carcinoma appears as __echoic, ___ calcifications, __vascularity, __ metastases.

A

hypo-, micro-, hyper-, cervical lymphnode

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21
Q

This is the second most common thyroid cancer accounting for 5-15% of cases.

A

follicular carcinoma

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22
Q

This is the major route of spread of follicular carcinoma.

A

bloodstream leading to distant mets

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23
Q

Often encapsulated, this thyroid cancer looks similar to benign adenomas.

A

follicular carcinoma

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24
Q

This is a rarer form of thyroid cancer accounting for around 5% of cases.

A

medullary carcinoma

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25
Q

This thyroid cancer secretes ‘calcitonin’, a useful serum marker.

A

medullary carcinoma

26
Q

This thyroid cancer is frequently familial and is a component of MEN type II syndromes.

A

medullary carcinoma

27
Q

T/F? Medullary carcinoma is unilateral about 90% of the time with a low incidence of lymphnode mets.

A

FALSE, bi-, high incidence

28
Q

Sonographically, medullary carcinoma appears as a __echoic solid mass with __ calcifications, and __ metastases.

A

hypo-, coarse, lymphnode

29
Q

This is a rare and lethal thyroid cancer of the elderly, accounting for only <2% of cases.

A

anaplastic thyroid carcinoma

30
Q

This thyroid tumor presents as a rapidly enlarging mass extending beyond the gland and invading adjacent structures.

A

anaplastic carcinoma

31
Q

These are small endocrine glands in the neck.

A

parathyroid glands

32
Q

These control the amount of calcium in the blood and within the bones.

A

parathyroid glands

33
Q

T/F? The parathyroids are anterior to the thyroid.

A

FALSE, posterior

34
Q

Sonographically, this appears as an oval hypoechoic mass posterior to the thyroid.

A

parathyroid adenoma

35
Q

This is the most common type of hyperparathyroidism.

A

primary hyperparathyroidism

36
Q

This is due to the development of an adenoma associated with one of the parathyroid glands.

A

primary hyperparathyroidism

37
Q

This is suspected with an increase in serum calcium levels.

A

primary hyperparathyroidism

38
Q

Primary hyperparathyroidism is confirmed by what lab values?

A

elevated serum parathyroid hormone (PTH) and elevated serum calcium

39
Q

This endocrine condition occurs in patients with chronic renal failure.

A

secondary hyperthyroidism

40
Q

In secondary hyperthyroidism, the inability of the kidneys to filter results in elevated amounts of…

A

serum phosphates.

41
Q

The inability to synthesize vitamin D depresses the ___ which stimulates parathyroid gland hyperplasia.

A

serum calcium

42
Q

In secondary hyperparathyroidism, how many parathyroid glands will enlarge?

A

all four

43
Q

Secondary hyperthyroidism is confirmed by what lab values?

A

elevated phosphates and decreased serum calcium

44
Q

Name three kinds of extrinsic neck masses.

A
  1. thyroglossal duct cyst
  2. branchial cleft cyst
  3. cystic hygroma
45
Q

This is a superficial cystic midline neck mass.

A

thyroglossal duct cyst

46
Q

This neck mass is commonly seen in adolescents following an URI.

A

thyroglossal duct cyst

47
Q

T/F? Carcinoma may develop in a thyroglossal duct cyst.

A

true

48
Q

T/F? Most thyroglossal duct cysts are located just superior to the hyoid bone.

A

FALSE, inferior

49
Q

This is a solitary predominantly cystic lateral neck mass.

A

branchial cleft cyst

50
Q

This is a congenital lymphatic malformation, a cystic multiloculated cervical mass.

A

cystic hygroma

51
Q

The left CCA and SCA originate from the…

A

aortic arch.

52
Q

The innominate artery is also known as…

A

the brachiocephalic trunk.

53
Q

The right CCA and SCA origniate from the…

A

brachiocephalic trunk.

54
Q

The CCAs ascend in the neck __ to the IJVs.

A

medial

55
Q

The ICA has a __ resistance waveform.

A

low

56
Q

The ECA has a __ resistance waveform.

A

high

57
Q

The 1st branch of the ICA is the __ artery.

A

ophthalmic

58
Q

The 1st branch of the ECA is the __ artery.

A

superior thyroid

59
Q

The IJV is __ to the CCA.

A

lateral

60
Q

The IJV and SCV drain into the __ veins bilaterally.

A

innominate (brachiocephalic)

61
Q

The external jugular vein is located superficially on the __ aspect of the neck.

A

lateral

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