Pathology thyroid

Follicular carcinoma

10% to 20%

Which is the correct transducer for imaging a thyroid and parathyroid glands

12-5 MHz broadband linear array transducer

Hürthle cell carcinoma

3% to <10%

Medullary carcinoma

5%

Anaplastic carcinoma

<5%

Lymphoma

<5%

Hashimoto's disease is

A form of chronic thyroiditis

The patient presents for evaluation of the thyroid gland with a history of Hashimoto's thyroiditis. Which of the following is not a common symptom of this condition: A)Weight loss B) cold intolerance c) ministry regularities d)fatigue

A)Weight loss

A patient has had recent readiotherapy of the thyroid gland, what should you be aware of when performing the thyroid ultrasound examination?

Agenesis of thyroid tissue

Primary Hyperplasia is enlarged of ____________________________ and should be expected when ________ nodules are identified, whereas _____________ ___________ should be suspected when a solitary nodule is identified.

All 4 thyroid glands/ Multiple/ Parathyroid adenomas

Graves' disease (key term)

An auto immune hyperthyroidism caused by anti-bodies that continuously activate TSH receptors (definition)

The B-mode sonographic findings of a simple cyst are:

Anechoic, sharp well-defined walls, distal acoustic enhancement

Cold nodule (key term)

Arias seen on a nuclear medicine study as a region of thyroid where the radioisotope has not been taken up (definition)

That esophagus may often be confused for other structures in the neck. What can you do during the examination to help differentiate the esophagus from these other structures?

As the patient is followed, with or without water, his gun and transverse plane

The sonographer examining the thyroid gland is having difficulty in visualizing the lower poles of the thyroid gland. What can the sonographer do to improve the visualization?

Ask the patient to swallow

Which is a common ultrasonic finding of lymphoma?

Avascular mass, lobulated, & hypoechoic

A patient presents with a personal history of multiple endocrine neoplasia type 2 syndrome for an examination of the thyroid gland. Which type of thyroid cancer is seen in patients with this disorder? A) papillary carcinoma B) medullary carcinoma C) follicular carcinoma D) Anaplastic carcinoma

B) medullary carcinoma

What is the most common form of thyroid cancer? A) follicular B) papillary C) medullary D) Anaplastic

B) papillary

Adenoma (key term)

Benign soils tumor (definition)

Find needle aspiration is effective for diagnosing all of the following forms of thyroid carcinoma except: A) papillary carcinoma B) medullary carcinoma C) follicular carcinoma D) Anaplastic carcinoma

C) Follicular carcinoma

Which of the following characteristics increase the suspicion for malignancy in a thyroid nodule? A) eggshell calcifications B) hyperechogencitiy C)microcalcifications D) peripheral calcifications

C) microcalcifications

Which of he following is NOT a characteristic of a mestatic lymph node? A) Increasing size on serial examinations B) microcalcifications C) prominent fatty hilum D) rounded, bulging shape

C) prominent fatty hilum

Sonographically, large adenomas have the characteristics of a _______________.

Complex cyst

On ultrasound investigation of the thyroid gland, a mixed Echogenicity, mostly cystic, structure is identified. What is thought to be the most common cause of this finding in the thyroid gland

Cystic degeneration of a thyroid adenoma

Which aggressive form of thyroid cancer has a tendency to compress and destroy the local structures of the neck? A) papillary carcinoma B) medullary carcinoma C) follicular carcinoma D) Anaplastic carcinoma

D) Anaplastic carcinoma

What is the most common cause of a primary hyperparathyroidism? A) breast or prostate cancer B) chronic renal insufficiency C) parathyroid carcinoma D)parathyroid adenoma

D)parathyroid adenoma

Heiple thyroidism has the following effects on the body's metabolic processes

Decreased body metabolism

Goiter is:

Diffusley enlarged thyroid, with possible asymmetrical enlargement

Hyperparathyroidism (key term)

Disorder associated with elevated serum calcium levels, usually caused by benign parathyroid adenoma (definition)

50% of clinically palpable solitary thyroid nodules are

Dominant nodules of mutlinodular goiter

What beat describes the sonographic features of lipoma

Echogenic foci in the deep tissues

Adenopathy (key term)

Enlargement of the glands (definition)

Hyperparathyroidism is:

Enlargement of the parathyroid glands due to overactivity of the parathyroid glands

A definitive diagnosis of papillary carcinoma can be made by ___________. The overall survival rate of this type of thyroid cancer is__________, making it the least aggressive form of thyroid cancer.

FNA/ 98%

Thyroid adenomas are benign nodules contained within a ______________________.

Fibrous capsule

A useful investigation to determine if a lymph node is malignant is

Fine needle aspiration biopsy

Normal parathyroid glands, if seen on ultrasound,are:

Flat: elliptical, approximately 5 to 7 mm

A thyroid adenoma will typically demonstrate color Doppler flow in which pattern?

Flow around the periphery

Goiter (key term)

Focal or diffuse thyroid gland enlargement do to iodine deficiency (definition)

The majority of patients with hyperthyroidism have __________ disease, which is an ________________ disease.

Graves, autoimmune

Normal thyroid exhotexture is

Homogenous with mid-to-high- level echogenicity

The fine needle aspiration (FNA) needle on the ultrasound image appears as:

Hyperechoic liner structure

A minority of adenomas are toxic and cause _______________.

Hyperthyroidism

Malignant thyroid nodules are typically solid & _____________ when compared to the normal thyroid parenchyma.

Hypoechoic

The ultrasound appearance of enlarged parathyroid glands is the same for primary and secondary hyperparathyroidism. Secondary hyperparathyroidism compared with primary has:

Increased incidence of multiple parathyroid gland involvement

Fine needle aspirate [FNA] (key term)

Invasive procedure using a small gauge needle to obtain a tissue specimen from a specific lesion (definition)

Tyrosine combines with which substance to produce thyroid hormones?

Iodine

What is needed to properly synthesize the hormones?

Iodine

Anaplasia (key term)

Loss of differentiation of cells, which is characteristic of a tumor tissue (defenition)

Post-injection of ethanol, the vascularity of the lesion will be:

Markedly decreased

The presence of______________________ is one of the most specifics on a graphic features of thyroid malignancy. They are commonly found in______________ thyroid cancer.

Microcalcifications/ Papillary

Hashimoto thyroiditis (key term)

Most common inflammatory disease of the thyroid gland (definition)

Simple goiters may convert into ______________ goiters, demonstrated by a multilobulated, asymmetrically enlarged gland.

Multinoduliar

A nontoxic goiter refers to an enlargement of the entire gland without evidence of discrete _________________ & without ________________ disturbance.

Nodularity & functional

A radioiodine scintigraphy nomination can be used to evaluate thyroid nodules. Which of the following statements regarding the examination is FALSE?

Nodules maybe classified as either hot or cold nodule, a hot nodule traps and excess of amount of isotope and hyperfunctioning, a cold nodule does not absorb the isotope and demonstrates an area of decreased or absent activity (((all call nodules are malignant)))

Color Doppler investigation of Hashimoto's disease will reveal:

Normal to increased color flow

Heterotopic (key term)

Occurring at an abnormal plays or upon the wrong part of the body (definition)

The thyroid stimulating hormone is produced by the

Pituitary gland

The sonographer performing an examination of the thyroid gland discovers a structure arising from the isthmus of the thyroid, with the same echogenicity as the thyroid. What is the most likely cause of this structure?

Pyramidal lobe

Which of the following is not a typical symptom of graves disease

Shrunken echogenic thyroid gland

A malignant thyroid tumor may be difficult to differentiate from a non-malignant one. Cytology & histology under fine needle aspiration biopsy is also not a reliable means of differentiation, which of the following provides the most accurate diagnosis of a suspected malignant tumor?

Surgical excision

T3 & T4 are common abbreviations used in thyroid laboratory results & are abbreviations for

T3: triiodothyronine/ T4; thyroxine

Which of the following is NOT a characteristic of benign thyroid nodules? A) a uniform hypoechoic halo B) avascularity C) well defined, regular margins D) taller than wide shape

Taller than wife shape

Malignant thyroid nodules are more likely suspected when

The lesion has punctuated microcalcifications

Peripheral halo, usually solitary, with thin hypoechoic rim, peripheral calcification, variable size, & peripheral color Doppler flow are ultrasound characteristics that best describe

Thyroid adenoma

Euthyroid (key term)

Thyroid gland is producing the right amount of thyroid hormone (definition)

The pituitary gland has an important role in the production of which hormones that affects the function of the thyroid gland

Thyroid stimulating hormone

TSH

Thyroid-stimulating hormone

De Quervian's & Hashimoto's are both forms of which disease process?

Thyroiditis

___________________ is a hypermetabolic state caused by elevated levels of free ___________ & _____________.

Thyrotoxicosis, T(3) & T(4)

TBG

Thyroxine-binding globulin

Why do nuclear medicine investigation of the thyroid gland be preformed?

To determine gland function.

The trachea is visualized it was getting the thyroid and parathyroid glands. It is located:

To the right of that esophagus

The thyroid gland secretes three hormones;

Triodothroine Thyroxine Calcitonin

The sonographer is having difficulty measuring an large thyroid gland. Which technique may help the Sonographer measure the gland?

Using the extended field of view option on the linear array transducer

What may help the sonographer to determine if a lesion seen is a thyroid?

Usually solitary, homogenous solid echotexture, peripheral color Doppler flow

Clinical signs of hyperthyroidism include

Weight loss with increased appetite, tremors, palpitations

Clinical symptoms of hyperthyroidism include:

Weight loss, nervous energy, warm skin

What is the most common functional disorder of the thyroid gland

hypothyroidism

The most common cause of primary hyperthyroidism is_______________ _______________ _______________.

Chronic autoimmune thyroiditis

Papillary carcinoma

75% to 85% Most common malignant tumor of thyroid Any age Most frequently between 20 & 50 yrs old Female to male ratio is 3:1 in the adult