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Thyroid Flashcards

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1
Q

What is the normal L x W x H for thyroid?

A

L= 4-6 cm, W= 1.5-2 cm, H= 2-3 cm

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2
Q

What is the normal measurement for thyroid isthmus?

A

2-6 mm A/P

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3
Q

What are the muscles located anterior to the thyroid?

A

Sternothyroid, Omohyoid, Sternohyoid, Sternocleidomastoid (anterolateral)

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4
Q

What muscle is located posterior to the thyroid?

A

longus colli muscle

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5
Q

Parathyroid glands are located ______ to the thyroid gland.

A

posterior

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6
Q

Which system is the thyroid gland a part of?

A

endocrine

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7
Q

Which hormones does the thyroid release?

A

T3 (triiodothyronine), T4 (thyroxine), Calcitonin

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8
Q

Where is TSH (thyrotropin) released from?

A

pituitary gland

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9
Q

What is the purpose of nuclear medicine?

A

to determine function

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10
Q

How does nuclear medicine work?

A

radioactive iodine is injected into the bloodstream, swallowed, or inhaled

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11
Q

_____ % of nodules are cold.

A

85

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12
Q

5-8% of cold and warm nodules are? & the remaining are?

A

malignant; cysts

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13
Q

What percentage of nodules are hot? Does hot determine benign or malignant?

A

5% - malignancy is nonexistent in hot nodules

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14
Q

What kind of transducer is used to scan thyroid?

A

High frequency 7.5-15MHz linear array

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15
Q

What does euthyroid mean?

A

normal thyroid function

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16
Q

Hypothyroidism is under secretion of which hormones?

A

T3 & T4

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17
Q

What may cause hypothyroidism?

A

low intake of iodine & inability to produce hormones

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18
Q

What are signs of hypothyroidism?

A

myxedema,
weight gain,
hair loss,
increased tissue around eyes,
lethargy,
cold intolerance, constipation,
deep voice,
decrease in mental and motor capacity

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19
Q

Hyperthyroidism is over secretion of which hormones?

A

T3 & T4

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20
Q

What are signs of hyperthyroidism?

A

increased metabolism,
weight loss,
increased appetite,
nervous energy,
tremor,
sweating,
heat intolerance,
palpitations,
exophthalmos

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21
Q

What is the most common abnormality of the thyroid?

A

Goiter

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22
Q

What is goiter caused by?

A

iodine deficiency

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23
Q

What are other causes of goiter?

A

graves disease, thyroiditis, neoplasm, cyst

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24
Q

What are clinical symptoms of goiter?

A

swelling in the neck, choking sensation, coughing, hoarseness, difficulty swallowing, difficulty breathing

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25
What are 3 hormone inhibiting foods?
cabbage, broccoli, cauliflower
26
Nodular thyroid diseases are:
Nontoxic (simple) goiter, Toxic multinodular goiter
27
One of the most common thyroid pathologies is?
toxic multinodular goiter (adenomatous hyperplasia)
28
Nontoxic goiter is described as:
diffuse enlargement not caused by neoplasm or inflammation
29
What can eventually occur with nontoxic goiter?
hypothyroidism
30
Ultrasound appearance of toxic multinodular goiter:
enlarged, inhomogeneous, progression to scarring, ischemia, necrosis, calcs, multiple nodules
31
Most common reason for an ultrasound in the thyroid is?
palpable mass
32
What are benign lesions of the thyroid?
cysts (20% solitary nodules), adenoma (5-10% of nodules)
33
Adenomas are more prevalent in which patient population?
women
34
Adenomas are characterized by:
complete fibrous encapsulation
35
Adenomas commonly appear as what on nuclear medicine? (hot or cold)
cold (hypofunctioning)
36
Ultrasound appearance of adenomas:
anechoic to hyperechoic, echolucent rim ('halo'), may experience cystic degeneration from hemorrhage, indistinct borders, echogenic foci with comet tail artifact
37
T/F? Thyroid cysts are always round.
false
38
Hyperfunction of adenomas can experience?
increased blood flow patterns along the peripheral borders or within the lesion
39
T/F? Ultrasound can determine whether a mass is benign or malignant.
False ## Footnote ALWAYS need a biopsy to know whether something is benign or malignant
40
T/F? Carcinomas of the thyroid are rare.
true
41
What are the different malignancies of the thyroid?
papillary carcinoma, follicular carcinoma, medullary carcinoma, anaplastic carcinoma, lymphoma
42
Which malignant thyroid cancer is most common? Which is most aggressive?
Most common: Papillary carcinoma, Most aggressive: Anaplastic carcinoma
43
Which thyroid cancer is the 2nd most common?
Follicular carcinoma - also more aggressive than papillary
44
What are the most common characteristics of thyroid cancers on ultrasound?
solitary, any size, single or multiple, solid, primarily cystic, or largely cystic mass, usually hypoechoic relative to normal thyroid, increased vascularity, calcification 50-80%
45
Papillary carcinoma is more prevalent in which patient population?
female 25-35 years old
46
How does follicular carcinoma spread?
through the bloodstream
47
Difference between follicular carcinoma and papillary carcinoma
follicular spreads through bloodstream and is associated with low iodine; papillary spreads through lymph nodes and is associated with high iodine
48
Which thyroid cancer is 10 years older than follicular carcinoma, benign or malignant & can be aggressive?
Hurtle cell cancer
49
Sonographic findings of follicular carcinoma:
Irregular margins with thick irregular halo, Nodular enlargement and tortuous internal blood vessels characteristic, but not specific for follicular carcinoma
50
Which thyroid cancer is often familial and an essential component of multiple endocrine neoplasia (MEN) type 2 syndrome?
Medullary carcinoma
51
Which thyroid carcinoma is the most rare? What patient population is it most prevalent in?
anaplastic carcinoma (<2%) - usually 50+ years of age
52
Which thyroid carcinoma is often a pre-existing hashimotos thyroiditis?
lymphoma
53
What is an indeterminate nodule? What is necessary?
When a nodule doesn't look completely benign or malignant; biopsy is necessary
54
What is neck mapping used to evaluate?
to evaluate lymph nodes for abnormalities post thyroidectomy such as reoccurrence of malignancy
55
What is thyroiditis?
inflammation of the thyroid gland - can be from infection or autoimmune
56
What are the 2 main types of thyroiditis?
Dequervains, Hashimoto's
57
What is dequervains thyroiditis? What is it caused by?
diffuse inflammation due to viral infection; caused by viral infection of thyroid gland
58
What is Hashimoto's thyroiditis?
chronic inflammation due to autoimmune disorder; most common form; often associated with hypothyroidism
59
What can subacute (de Quervain's) thyroiditis cause?
transient hyperthyroidism
60
What is Grave's disease?
The most common cause of hyperthyroidism. It is an autoimmune disease most often in women greater than 30
61
Graves disease is diagnosed by which findings:
hypermetabolism, diffuse toxic goiter, exophthalmos, cutaneous manifestations
62
"thyroid inferno" is known as
increased vascularity
63
What is thyrotoxic crisis?
Also known as thyroid storm; it is uncontrolled hyperthyroidism that can lead to hyperthermia, tachycardia, heart failure, & delirium
64
Thyroid storm vs Thyroid inferno:
Storm= excess hormones, Inferno= hypervascularity
65
Normal size for parathyroid glands:
4 mm
66
What hormone do the parathyroid glands secrete?
parathyroid hormone (PTH)
67
T/F? 3-5 parathyroid glands is not uncommon.
true
68
What does PTH do?
maintains normal serum calcium levels
69
How do enlarged parathyroid glands (>5mm) appear sonographically?
decreased echo texture; elongated masses between longus colli and thyroid lobe
70
PTH acts on?
bone, kidney, and intestine to enhance calcium absorption
71
What is the most common referral for parathyroid sonography?
unexplained hypercalcemia detected on routine blood chemistry screening
72
What is primary hyperparathyroidism? When does it occur?
increased function of the parathyroid glands; occurs when increased amounts of PTH produced by adenoma, primary hyperplasia, or carcinoma located in the parathyroid gland
73
What is the most common cause of primary hyperparathyroidism?
parathyroid adenoma (80% of cases)
74
What is the most common shape of parathyroid adenoma?
oval
75
Associated tumors with MENS:
pituitary adenoma, parathyroid adenoma, medullary thyroid carcinoma, pancreatic islet tumor, pheochromocytoma
76
What is secondary hyperparathyroidism?
chronic hypocalcemia from renal failure
77
Hyperparathyroidism is most common manifestation of which MEN syndrome?
type 1
78
What are other neck masses that can develop in the neck?
developmental cysts, abscess, adenopathy
79
What are two developmental cysts in the neck?
thyroglossal cyst, brachial cleft cyst
80
Which cyst often occurs in preschoolers or mid-adolescence or often after an upper respiratory infection?
thyroglossal
81
Where are brachial cleft cysts usually located?
lateral to thyroid in neck
82
What is an adenopathy?
lymph node that is round instead of oval
83
How does a normal lymph node appear in ultrasound?
oval in shape with homogeneous texture with central core echo complex
84
If a node is more rounded, taller than wide, what can that indicate?
malignancy

ABDOMEN 2 (2 decks)

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