Endocrine Imaging

Question 1

what line in the pituitary gland in

Answer 1

midline

Question 2

where is skull is the pituitary gland

Answer 2

in the sella turcica, is closey related to the sphenoid sinus

Question 3

what connects the pituitary gland to the brain

Answer 3

the pituitary stalk

Question 4

what structures surround the pituitary gland

Answer 4

optic chiasms superiorly
carotid arteries laterally
hypothalamis superiorly

Question 5

what does a bone scan do

Answer 5

makes map of osteoclast activity

Question 6

what can cause peripheral vision loss

Answer 6

eye, optic nerve, chiasm, optic tract, brain

any pathology/ injury in these areas

Question 7

what retina does peripheral vision hit

Answer 7

medial retina

Question 8

which field of vision crosses the optic chiasm

Answer 8

peripheral

Question 9

when pituitary adenomas are more likely to be hormonally active

Answer 9

microadenoma

Question 10

what can show whether a pituitary adenoma is functional

Answer 10

contrast scan

Question 11

why is the thyroid easy to image

Answer 11

as superficial

Question 12

what is the thyroid anterior to

Answer 12

the trachea and the oesophagus

Question 13

what is the thyroid deep to

Answer 13

the strap muscles

Question 14

what is the thyroid medial to

Answer 14

common carotid arteries and internal jugular veins

Question 15

what nerve runs along the back of the thyroid

Answer 15

recurrent laryngeal nerve

Question 16

what is at risk in thyroid surgery

Answer 16

parathyroid glands and the recurrent laryngeal nerves

Question 17

what is inferior to the thyroid

Answer 17

sternum, great vessels and aortic arch

Question 18

what can cause a midline neck mass in adults

Answer 18

enlarged thyroid gland (benign, malignant, mets), enlarged lymph nodes, thryoglossal cyst, cystic hygroma

Question 19

what are the diffuse and focal causes of hyperthyroidism

Answer 19

diffuse- graves, thyroiditis

focal- dominant nodule

Question 20

how do differentiate the cause of hyperthyroidism

Answer 20

radioisotope studies and ultrasound

Question 21

what can be combined with ultrasound for investigating the thyroid

Answer 21

fine needle aspiration

Question 22

when in thyroid problems in fine needle aspiration done

Answer 22

in euthyroid patients with goitre/palpable nodules

in hyperthryoid patients with focal masses/ radioisotope uptake

Question 23

what does thyroid scintigraphy do

Answer 23

show pattern and quantity of tracer uptake

Question 24

what would thyroid scintigraphy show for graves

Answer 24

homogenously increased tracer uptake

Question 25

what would thyroid scintigraphy show for hypothyriodism

Answer 25

reduced tracer uptake

Question 26

what would thyroid scintigraphy show for thyroiditis

Answer 26

homogenously reduced tracer uptake

Question 27

what would thyroid scintigraphy show for a functional nodule

Answer 27

focal uptake increased

Question 28

where are the adrenal glands

Answer 28

retoperitoneal, suprarenal

Question 29

what imaging can show the adrenal glands

Answer 29

CT and MRI

Question 30

what are the two limbs of the adrenal gland

Answer 30

medial and laternal

Question 31

where in relation to adrenal glands in the IVC

Answer 31

right adrenal gland lies posterior to the IVC

Question 32

what does the left adrenal gland lie lateral to

Answer 32

aorta and left diaphragmatic crus

Question 33

what should you think if there is a SOLID mass in the adrenal glands

Answer 33

metastasis- lung most common

Question 34

give examples of flat bones

Answer 34

skull, pelvis, sternum

Question 35

what is trabeculae

Answer 35

cancellous bone- made of spongey, porous bone tissue loosely packed in the medulla - condense towards the cortex

Question 36

what is hypertrophic periosteal osteoarthroplasty

Answer 36

when endocrine problem causes the laying done of more bone layers

Question 37

what bones undergo endochondral ossification

Answer 37

long bones (femur, metatarsal)

Question 38

describe enchondral ossification

Answer 38

start as cartilage, osteoblasts replace the cartilage with oestoid which mineralises to form bony trabeculae

Question 39

where do cartilagnous bones ossify

Answer 39

firstly in the diaphysis and then within the epiphysis

Question 40

how is bone girth increased

Answer 40

cells from periosteum lay down cicrumferential new bone on the periphery of existing cortex

Question 41

how is bone length increased

Answer 41

cartilage proliferation at the growth plates between the metaphysis and epiphysis cartilage then ossifies

Question 42

how do you describe bone abnormalities

Answer 42

diffuse or focal

Question 43

what are the types of focal bone abnormalities

Answer 43

traumatic, neoplastic (lytic bone destruction or sclerotic bone formation) inflammatory degenerative

Question 44

what are the types of diffuse bone abnormalities

Answer 44

bones too brittles (osteoporosis) bones too soft (rickets and osteomalacia, pagets)

Question 45

what is process behind osteoporosis

Answer 45

reduction in trabecular density, common in post menopausal females

Question 46

what are the secondary causes of osteoporosis

Answer 46

steroids, early menopause, anorexia

Question 47

where are common sites for osteoporotic fractures

Answer 47

proximal femur, sacrum and pubic rami, thoracolumbar vertevral bodies, distal radius

Question 48

what does osteoporotic bone look like

Answer 48

lucent

Question 49

will a vertbral fracture involving the posterior parts of the vertebrae be osteoporotic

Answer 49

no- more likely to be due to a metastatic deposit

Question 50

what is the cause and outcome of rickets

Answer 50

``` Vitamin D deficiency Non-ossification of soft osteoid Bone deformity, pain and growth abnormality Widened growth plates Irregular, flared metaphyses ```

Question 51

what is the cause and outcome of osteomalacia

Answer 51

Vitamin D deficiency Non-ossification of soft osteoid Bone deformity, pain and tendency to partial fractures Poor cortico-medullary differentiation

Question 52

what causes pagets

Answer 52

increased bone turnover with unknown cause

Question 53

what are the features of pagets

Answer 53

``` single or multiple bones affected initial lytic phase results in well defined lucency latter sclerotic phase with enlarged bone increased density coarse trabecular pattern ```

Question 54

what does a lytic bone lesion look like

Answer 54

Medullary lucency and loss of trabeculae | loss of conrtex

Question 55

what can cause a lytic bone lesion

Answer 55

GCT, metastasis, simple bone cysts, osteomyelitis, +++ loads more

Question 56

what should you think of in a sclerotic bony metastatic disease in a man

Answer 56

prostate

Question 57

what are features of a sclerotic bone lesion

Answer 57

Subtle medullary density and loss of trabeculae Spreading zone of density which includes cortex Featureless white bone Expansion beyond normal bone limits, with cortical destruction and potential for pathological fracture

Question 58

are sclerotic bone lesions malignant or benign

Answer 58

can be both