Thyroid, Parathyroid, Salivary Glands Flashcards
(111 cards)
1
Q
What muscle is located anterior to the thyroid?
A
Sternohyoid muscle
2
Q
How many pairs of parathyroid hormones do the majority of people have?
A
Two pairs — four total
3
Q
What is the structure that lies posterior and medial to the left thyroid gland?
A
Esophagus
4
Q
What is produced by the parathyroid glands?
A
Parathormone
5
Q
Name three diseases which produce diffuse enlargement of the thyroid:
A
Graves’ disease, Hashimoto disease, and acute thyroiditis
(Note: adenoma does not cause enlargement of the thyroid)
6
Q
What pathology is typically located lateral to the neck near the carotid arteries?
A
Branchial cleft cyst
7
Q
What pathology is generally identified by a halo surrounding it?
A
Follicular adenoma
8
Q
Hyperthyroidism associated with a diffuse goiter is associated with:
A
Graves disease
9
Q
A slow growing thyroid malignancy that occurs in young adults and children and accounts for 75% — 90% of all thyroid cancers:
A
Papillary carcinoma
10
Q
Thyroid function(s) include:
A
Affecting the body metabolism growth and development
11
Q
What is the largest endocrine gland?
A
Thyroid gland
12
Q
What thyroid variant is present in approximately 10% — 40% of the population?
A
Pyramidal lobe
13
Q
The thyroid is composed of follicles filled with a substance called:
A
Colloid
14
Q
Which hormones help maintain a steady level of serum calcium in the blood?
A
Parathormone
15
Q
What mineral must be ingested for proper thyroid hormone production?
A
Iodine
16
Q
Name three “normal” variants found within the thyroid gland:
A
Ectopic location, pyramidal lobe, & agenesis
(Note: cyst is not a normal variant, it is a pathological finding)
17
Q
Which salivary gland contains intraparenchymal lymph nodes?
A
Parotid gland
18
Q
Name three clinical presentations for salivary gland malignancy:
A
Rapid growth, tenderness, and facial nerve paralysis
(Note: swelling during eating is not a clinical presentation for salivary gland malignancy)
19
Q
Sialithiasis is most common in which salivary gland?
A
Submandibular
20
Q
Retroflexion of the head may be required to image which salivary gland?
A
Sublingual
21
Q
What percentage of patients have accessory parotid glands?
A
20%
22
Q
What is the most common benign tumor seen in parotid gland?
A
Pleomorphic adenoma
23
Q
Name three common sonographic appearances of acute parotiditis:
A
- Multiple hypoechoic areas
- Increased vascularity noted with color Doppler
- possible shadowing from abscess formation
(Note: calcifications will not be seen within the duct. This is more commonly associated with chronic conditions like sialadenitis or sialothiasis)
24
Q
Name four optimization techniques used for imaging the salivary glands:
A
- use of multiple focal zones
- use standoff pad for superficial structures
- Adjust gain setting so gland tissue is homogeneous
- Use a LOWER frequency transducer for LARGER pathology to allow sound to penetrate deeper.
25
What is the most common malignancy of salivary glands?
Mucoepidermoid carcinoma
26
Which salivary gland is located at the angle of the mandible adjacent to the masseter muscle?
Parotid gland
27
What best describes a chronic autoimmune disease predominantly affecting women over 40 that presents with xerostomia and dry eyes?
SjOgren’s syndrome
28
What is the most common, benign, vascular mass seen in infants?
Hemangioma
29
Which major salivary glands is/are derived from ectoderm tissue?
Parotid gland
30
What vascular structure separates the parotid gland into superficial and deep lobes?
Retromandibular vein
31
What is the most common disease to affect the major salivary glands?
Sialadentitis
32
What do the superior and middle thyroid veins drain directly into?
Jugular veins
33
A patient comes in for a thyroid ultrasound. Before scanning, the patient says they were diagnosed 4 months ago with multiple endocrine hyperplasia type 1. While scanning you find two round hypoechoic nodules at the posterior aspect of the thyroid gland measuring 0.8 mm. What is the most likely diagnosis?
Parathyroid hyperplasia
34
Your patient presents with pain and swelling when she eats. What is the most likely diagnosis?
Sialolithiasis
35
Which hormone controls the secretion of thyroid hormones and is produced by the anterior pituitary gland?
Thyroid stimulating hormone (TSH)
36
A patient comes in for a parathyroid ultrasound after abnormal lab results showing elevated parathyroid hormone (PTH) and Hypercalcemia. They report high blood pressure and recurrent kidney stones. Ultrasound reveals a small, homogeneous, round, and solitary mass on the left parathyroid gland. What is the most likely differential diagnosis?
Parathyroid adenoma
37
A 42-year old woman comes in with a history of chronic dry mouth and recurrent dental cavities. A neck ultrasound reveals a heterogeneous parotid gland with multiple small hypoechoic oval areas and increased vascularity. What is the most likely diagnosis?
Sjögren’s syndrome
38
A 45 year old woman comes for an ultrasound exam with a palpable neck mass and complaints of hoarseness. During the exam, you see a hypoechoic, irregular shapes nodules with gland enlargement and microcalcification on the right lobe of the thyroid. When using color Doppler there was an increase in vascularity. What is the most likely diagnosis?
Papillary carcinoma
39
A 60 year old patient presents with elevated serum calcium levels with a history of hypertension and possible renal stones. What pathology is suspected?
Parathyroid adenoma
40
Which vein is responsible for draining the submandibular gland?
Facial vein
41
A 44 y/o female patient presents with dry skin, hoarseness, bradycardia, and lethargy. Labs come back with abnormal T3 and T4 levels. She also states that she is deficient in iodine. What diagnosis best fits?
Hypothyroidism
42
A 53 year old female came into the ER with symptoms of abdominal pain, hypertension, and elevated PTH levels. The sonographer performed a soft neck tissue exam and visualized a 1cm homogeneous, hypoechoic mass with calcification posterior to the middle left thyroid. What is the most likely diagnosis?
Parathyroid adenoma
43
While scanning the mid portion of a patients left parotid, you image a fine, linear structure with tin echogenic walls. Color Doppler demonstrates absence of color flow. What structure did you visualize?
Stensen’s duct
44
You have an 11 year old female patient who comes in for a thyroid ultrasound. While scanning, you notice the entire thyroid is enlarged, hypoechoic, has microcalcifications, and hypervascularity. No nodules were found. What is the ost likely cause of this?
Hashimoto’s disease
45
What is the main function of the parathyroid glands?
Maintain proper levels of calcium
46
You have a 50 year old male patient that comes in for an examination of the salivary glands due to swelling; they have a history of cirrhosis. On the right side of the face above the mandible, you find an enlarged, hyperechoic parotid gland with normal vascularity. What is the most likely diagnosis?
Sialosis
47
Hypervascularity in the thyroid gland is a key sign of which disease?
Graves’ disease
48
What is a main function of the parathyroid?
Maintain proper and steady levels of serum calcium in the blood
49
What benign thyroid mass represents 10% — 15% of solitary thyroid nodules?
Cyst / cystic nodules
50
A patient presents to the ER with the following symptoms: tachycardia & palpitations, frequent urination, renal pain, mental confusion, hypertension, and nausea & vomiting. They are not on any medication and not not have any significant medical history. Which hormone is most likely dysregulated and how? Too much or too little?
Hypercalcemia
51
A 2 month old male is having an ultrasound on his neck. He presents with a painless mass on the side of his face. You find the following image on ultrasound. What pathology is most likely being demonstrated?
Hemangioma
52
Which hormone is primarily responsible for regulating the basal metabolic rate and is produced by the thyroid gland?
Thyroxine (T4)
53
What lab findings are most consistent with parathyroid hormone (PTH) overproduction?
Hypercalcemia and hypophosphatemia
54
A patient presents with dry mouth and difficulty swallowing. Which salivary glands is most likely affected if imaging reveals a blockage near the angle of the mandible?
Parotid gland
55
The thyroid is the largest endocrine gland in the body. Which of the three hormones secreted by the thyroid plays a key role in calcium metabolism and may influence smooth muscle function?
Calcitonin
56
A 45 year old woman diagnosed with multiple endocrine neoplasia type 1 presents to the ER with bone pain and recurrent kidney stones. Laboratory findings reveal elevated serum calcium, elevated parathyroid hormone (PTH), and low serum phosphate. Imaging shows enlargement of all four parathyroid glands. What is the most likely diagnosis?
Parathyroid hyperplasia
57
What symptoms are most commonly associated with sjogrens syndrone affecting the salivary glands?
Xerostomia and dry eyes
58
Mr. Smith presents to the ER with fever and a palpation on her neck that is painful to the touch. He states the pain radiated to his ear and jaw area, and that he was recently treated for a viral infection. The u/s exam shows an enlargement of the right thyroid with decreased vascularity and hypoechoic focal areas. What is the most likely diagnosis?
Subacute granulomatous thyroiditis
59
Brad is a 35-year-old ale who arrives for his thyroid ultrasound exam for elevated blood work. His lab results indicate elevated calcium in the urine and elevated serum levels of parathyroid hormone (PTH). Brad states he has a history of gallstones but is healthy otherwise. The u/s shows a single, small, oblong homogeneous mass with calcifications that measure less than 1 cm. What is the most likely diagnosis?
Parathyroid adenoma
60
What gland is shaped like a small oval?
Sublingual gland
61
Which muscle is located posterior to the thyroid gland and common carotid arteries and can be mistaken for an enlarged parathyroid?
Longus Colli
62
A patient comes in with pancreatitis, Hypercalcemia, and elevated serum calcium levels of PTH (hyperparathyroidism). While scanning you find a small, oblong, homogeneous hypoechoic mass adjacent the thyroid/ What is the possible diagnosis?
Parathyroid adenoma
63
A 3 month old female presents with a compressible, painless mass and blue coloring of the skin below the ear. While scanning you see the image below, what is the most likely diagnosis?
Parotid hemangioma
64
A 30 year old female presents to her outpatient appointment with nervous energy, tremors, and complains of palpations and a fast heart rate. The patients blood work shows an increase in TSH (thyroid stimulating hormone). The image below was taken for a thyroid ultrasound, when the color was turned on, there was a high vascularity seen within the thyroid gland. What is the most likely diagnosis?
Graves’ disease
65
In the presence of a parathyroid adenoma, what else might you see?
Hypercalcemia
66
A 68 year old male presents with recurrent, bilateral painless swelling of his cheeks. He has no history of fever or recent infection. His medical history includes alcoholism and poor nutritional diet. His u/s reveals enlarged, hyperechoic parotid glands with no increased vascularity. What is the most likely diagnosis?
Sialosis
67
A 45 year old patient presents with pain and swelling in the submandibular region that worsens during meals. Ultrasound reveals an echogenic foci with posterior acoustic shadowing and ductal dilation. What is the most likely diagnosis?
Sialolithiasis
68
What parathyroid pathology is hard to differentiate from asymmetric parathyroid hyperplasia?
Adenomas
69
A 45 year old woman presents with tiredness, feeling cold, and mild weight gain. On examination, her thyroid gland is enlarged, slightly uneven, and painless. Blood tests show elevated TSH and low free T4. What is the most likely diagnosis?
Hashimoto’s thyroiditis
70
A patient presents for a thyroid ultrasound with a history of excessive sweating, nervousness, and weight loss. Sonographic evaluation reveals an enlarged, inhomogeneous thyroid gland with increased vascularity. Which of the following is the most likely diagnosis?
Hyperthyroidism
71
A 55 year old man presents with elevated serum calcium and parathyroid hormone (PTH) levels. Neck ultrasound reveals enlargement of all four parathyroid glands, each appearing hypoechoic and mildly lobulated without signs of invasion. What is the most likely diagnosis?
Parathyroid hyperplasia
72
A 55 year old man with a history of chronic alcoholism presents with painless, bilateral enlargement of the parotid glands. Ultrasound shows diffusely enlarged glands with a homogeneous, Hyperechoic texture and no evidence of ductal obstruction or stones. What is the most likely diagnosis?
Sialosis
73
An 89-year-old patient presents to her primary care physician with complaints of a hard mass on her neck that has been rapidly increasing in size. She says it is painful and has been affecting her breathing. Upon sonographic examination of the mass, her thyroid lobe presents as hypoechoic with irregular borders. You also visualize the area extending into her trachea. What is the most likely diagnosis?
Anaplastic carcinoma
74
A female patient presents to her annual appointment following her history of being diagnosed with pancreatitis and hypertension. Her primary care physician notices that her recent lab values displayed elevated serum levels of PTH. The physician then orders a thyroid ultrasound. Her right thyroid lobe shows a round solitary, homogenous, hypoechoic area measuring 1 cm in the inferior portion of the lobe. What is most likely the area visualized?
Parathyroid adenoma
75
This exocrine gland measures about 6-7 cm in length and is the only gland to contain intraparenchymal lymph nodes. What is the vascular landmark that separates the superficial and deep lobes of this gland?
Retromandibular vein
76
Explain the spread of follicular carcinomas:
spread hematogenously, especially to bone, liver and lungs.
77
The parathyroid gland produces what hormone?
Parathyrin (not parathyroxine)
78
Patient presents to the ER with painful swelling of the mouth and jaw, and says they can feel a lump under their tongue on the floor of their mouth. Labs show a slightly elevated WBC and when scanning you notice the gland appears enlarged, heterogeneous and hypervascular with echogenic foci that shadow. The wharton's duct appears to be dilated. What gland is the main focus for this exam?
Submandibular
79
What is the relationship between the sternothyroid muscle and the thyroid?
The thyroid is posterior to the sternothyroid muscle
80
What parathyroid pathology is hard to differentiate from asymmetric parathyroid hyperplasia?
Adenomas
81
A patient presents with a hard, palpable mass that is tender. Patient states they have a pins and needle feeling in their face. These symptoms are associated with which pathology?
Mucoepidermoid carcinoma
82
What neck mass communicates with skin, producing draining sinuses found midline of the neck and anterior to the trachea, associated with spontaneous rupture, hemorrhaging, and necrosis?
Thyroglossal duct cyst
83
What is a fifth gland, known as supernumerary, often associated with the thymus?
2 paired sets of parathyroid glands
84
What structure is visualized at mid portion of the parotid gland?
Stensens duct
85
What condition can cause hypothyroidism?
Hashimoto thyroiditis
86
A patient comes in with a suspected parathyroid condition. Hypoparathyroidism is suspected when decreased values are present with which laboratory test?
Fasting blood PTH
87
While scanning the mid portion of a patient's left parotid, you image a fine, linear structure with thin echogenic walls. Color Doppler demonstrates absence of color flow. What structure did you visualize?
Stensens duct
88
A 35-year-old female comes to the doctor to discuss a raspiness to her voice that has for about 3 months that doesn't seem to be going away. The doctor ordered a soft neck tissue ultrasound. The ultrasound tech reported a well encapsulated mass with irregular margins and a think irregular halo surrounding it. What is the most likely diagnosis?
Follicular Adenocarcinoma (minimally invasive)
89
A 47-year-old female came into the ER with symptoms of abdominal pain, hypertension, and elevated PTH levels. The sonographer performed a soft neck tissue exam and visualized a 1 cm, homogeneous, hypoechoic mass with calcification posterior to the middle-left thyroid. What is the most likely diagnosis?
Parathyroid Adenoma
90
How do you best optimize your image while scanning the salivary gland?
Adjust gain setting to appropriate level so gland tissue is homogenous
91
A 46 y/o female patient presents dry skin, hoarseness, bradycardia, and lethargy. Labs came back with abnormal T3 and T4 levels. What diagnosis best fits?
Hypothyroidism
92
A 24 y/o female is scheduled for an ultrasound of her thyroid following some abnormal lab results. Her lab results came back demonstrating hypercalcemia, elevated PTH, hypophosphatemia. Upon examination, you find the hypoechoic lesion imaged below. What diagnosis best fits?
Parathyroid adenoma
93
Wharton's duct is the excretory ducts for which salivary gland?
Submandibular gland
94
A 40-year-old female patient presents with symptoms of tachycardia and dramatic weight loss. Her medical history also discloses that she recently had a molar pregnancy. An ultrasound exam has been ordered to evaluated the thyroid. Upon sonographic evaluation, you notice an enlarged thyroid gland with a heterogeneous echo texture. Color Doppler also demonstrates hypervascularity. What pathology is being demonstrated?
Hyperthyroidism
95
What pathology is also associated with Turners syndrome and has the sonographic appearance of a thin wall cystic lesion found in the posterior aspect of the neck?
Cystic hygroma
96
When imaging the salivary glands, the retromandibular vein and facial nerve course between the superficial and deep lobes of what gland?
Parotid gland
97
What is also known as the false thyroid capsule?
Pretracheal fascia
98
What muscles create the “strap muscle” group?
Sternothyroid, sternohyoid, omohyoid
99
What is the sternocleomastoid muscle located?
Lateral to thyroid and lateral to sternohyoid and sternothyroid
100
Where is the Longus colli muscle located?
Posterior and adjacent to the trachea
101
Where does the pyramidal lobe arise from?
Isthmus
102
What is the largest endocrine gland of the body?
Thyroid
103
The thyroid maintains what in the body?
Metabolism, growth, and development
104
What are two other names for parathyroid hormone?
Parathyrin and parathormone
105
PTH functions to maintain what?
A proper and steady level of serum calcium in the blood
106
Where is TSH produced?
Anterior pituitary gland
107
How much iodine must be ingested per week to maintain thyroid function?
100-200 mg per week
108
Hypervascularity is key for diagnosing which thyroid disease?
Graves’ disease
109
Graves’ disease is also known as…
Toxic multinodular goiter
110
What is another name for subacute granulomatous thyroiditis?
De quervains disease
111
What is the most common reason for thyroid enlargement in children?
Hashimoto’s thyroiditis
