Ultrasound In Thyroid Cancer Surveillance Flashcards

1
Q

How many surgical levels of the neck are they?

A

6 (I - VI)

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2
Q

Compartment I

A

Submandibular to hyoid bone

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3
Q

Compartment II

A

From vascular bundle to deep to the sternocleidomastoid above the hyoid.

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4
Q

Compartment III

A

From vascular bundle to deep to the sternocleidomastoid between the hyoid and cricoid.

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5
Q

Compartment IV

A

From vascular bundle to deep to the sternocleidomastoid below the cricoid.

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6
Q

Compartment V

A

Posterior to sternocleidomastoid

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7
Q

Compartment IV

A

Central compartment below cricoid cartilage.

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8
Q

Approximately how many lymph nodes in the normal neck?

A

300

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9
Q

Typically how many nodes can be identified on ultrasound?

A

6 - 20

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10
Q

Why is it important to identify suspicious lymph nodes in the neck?

A

It changes surgically management

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11
Q

Does prophylactic lateral neck dissection does not improve recurrence free survival for patients with peroperative US negative for lymph nodes?

A

No

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12
Q

Does lateral neck dissection alter the outcome for preoperative US positive for lymph nodes?

A

Yes

For macro-nodular disease

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13
Q

What is the sensitivity of a whole body scan?

A

60 - 75%

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14
Q

What does BRAF/RAS mutation do to sodium iodine symporter?

A

Lack of transmembrane sodium iodide symporter expression

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15
Q

Lymph nodes: is size or morphology more important?

A

Morphology

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16
Q

Lymph nodes: is border definition important?

A

No

17
Q

What does the hilum contain?

A

Fat and vessels

18
Q

Reactive nodes vary over time without progressive growth.

True or false?

A

True

19
Q

Lymph node: benign or malignant?

Absent hilar line.

A

Malignant

20
Q

Lymph node: benign or malignant?

Rounded appearance…

A

Malignant

21
Q

Lymph node: benign or malignant?

Cystic necrosis…

A

Malignant

22
Q

What should the AP/T ratio be in a benign lymph mode?

A
23
Q

Charecteristics of Malignant Nodes:

Sensitivity?

Disordered vascularity…

A

86%

24
Q

Charecteristics of Malignant Nodes:

Sensitivity?

Macrocalcifications…

A

45%

25
Q

Charecteristics of Malignant Nodes:

Sensitivity?

Cystic degeneration…

A

11%

26
Q

Charecteristics of Malignant Nodes:

Sensitivity?

Absence of hilar line…

A

95%

27
Q

Charecteristics of Malignant Nodes:

Sensitivity?

Hypoechoic echotexture…

A

39%

28
Q

Charecteristics of Malignant Nodes:

Specificity?

Disordered vascularity

A

82%

29
Q

Characteristics of Malignant Nodes:

Specificity?

Macrocalcifications…

A

100%

30
Q

Characteristics of Malignant Nodes:

Specificity?

Cystic degeneration…

A

100%

31
Q

Characteristics of Malignant Nodes:

Specificity?

Absence of hilar line…

A

20%

32
Q

Characteristics of Malignant Nodes:

Specificity?

Hypoechoic echotexture…

A

18%

33
Q

When should you biopsy a lymph node?

A

When a positive result will change management.

34
Q

How big should a lymph node be for it to be biopsied?

A

5 - 8 mm

35
Q

When is a neck MRI or CT done?

A

To look for occult nodes (mediastinum, retropharynx, parapharyngeal space, low cervical lymph nodes)

36
Q

Which are easier to detect - lateral or central lymph nodes?

A

Lateral