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URR 57 Flashcards

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1
Q

The normal parathyroid gland measures __-__ mm in width

A

3
4

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2
Q

The normal parathyroid gland measures __-__ mm in AP dimension

A

1
2

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3
Q

Parathyroid hormone and calcitonin control calcium absorption/excretion in the ___ and ___

A

intestines
kidneys

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4
Q

Increased serum levels of calcium leads to ___ and ___

A

hypercalciuria
hypercalcemia

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5
Q

Low calcium in the blood leads to:

A

increase in release of PTH
decrease in release of calcitonin
reduced excretion of calcium in intestinal tract to increase level of calcium in blood
kidneys increase resorption of calcium during blood filtration

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6
Q

Parathyroid exam transducer

A

> 8 MHz linear array

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7
Q

Scan the area extending from the ____ superiorly to the ___ inferiorly to locate the parathyroid glands

A

carotid artery bifurcation
thoracic inlet

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8
Q

____ is usually located posterior to the midsegment of the thyroid lobe

A

superior parathyroid gland

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9
Q

____ is usually located close to the lower pole of the thyroid lobe

A

inferior parathyroid gland

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10
Q

Parathyroid glands may be found ___, ___, ____, or ___ in location

A

below the clavicles
in the lower neck
upper mediastinum
retrotracheal

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11
Q

___ may assist in identifying small adenomas in the parathyroid glands

A

Graded compression

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12
Q

____ aids in detecting hypervascular adenomas

A

Color Doppler

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13
Q

It may be helpful to have the patient ___ during real-time imaging of the parathyroid glands

A

swallow

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14
Q

normally appear as a subtle hypoechoic area adjacent to the lower 2/3 of the thyroid gland

A

parathyroid glands

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15
Q

increased function of parathyroid glands

A

hyperparathyroidism

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16
Q

Hyperparathyroidism is most common in ___

A

women after menopause

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17
Q

most commonly occurs due to a single adenoma in one parathyroid gland

A

primary hyperparathyroidism

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18
Q

Primary hyperparathyroidism is associated with __, __, ___, ___, ___, ____, ___, ___

A

hypertension
nephrolithiasis
osteopenia
weakness
malaise
dyspepsia
constipation
polyuria

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19
Q

Primary hyperparathyroidism is the most common manifestation of ____

A

multiple endocrine neoplasm (MEN) syndrome

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20
Q

____ is constantly induced by the adenoma, which causes parathyroid gland hyperplasia

A

PTH secretion

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21
Q

Hyperparathyroid shows increased levels of ___ and ___ in the blood

A

PTH
calcium

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22
Q

Parathyroid hormone will counteract the production of ___

A

calcitonin

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23
Q

hormone produced by the parafollicular cells of the thyroid that is responsible for calcium metabolism and excretion

A

calcitonin

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24
Q

Increasing PTH ___ serum calcium levels

A

increases

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25
Increasing calcitonin ___ serum calcium levels
reduces
26
Increased PTH = reduced calcitonin =
hypercalcemia
27
Primary hyperparathyroidism is associated with ___ formation due to chronic serum hypercalcemia in the blood that is constantly being filtered by the kidneys
renal calculi
28
Increased PTH reduces ___ storage, causes deficiency
vitamin D
29
Increased levels of PTH caused increased renal excretion of phosphate =
reduce serum phosphate levels (hypophosphatemia)
30
all 4 glands hyperfunctioning
secondary hyperparathyroidism
31
Secondary hyperparathyroidism is usually caused by ___, also ____, ___
renal failure vitamin D deficiency malabsorption syndromes
32
Failing kidneys cannot remove phosphorus from the blood which causes ___
calcium levels to drop
33
PTH production is increased as the body tries unsuccessfully to raise:
calcium levels
34
___ seen early in secondary hyperparathyroidism progression
low serum calcium with high PTH levels
35
In advanced stages of hyperparathyroidism, the treatment for the kidney disease can cause ___ levels to return
high calcium
36
____ found in 15-20% population
ectopic parathyroid tissue
37
__% of ectopic parathyroid tissue can be found near the thymus gland near the heart
75
38
Ectopic parathyroid tissue can be found within the ___ tissue
thyroid
39
Parathyroid tissue may also fail to descend far enough and remain by ___ and/or ___
carotid arteries esophagus
40
most common cause of primary hyperparathyroidism
parathyroid adenoma
41
benign nodule varying in size, usually less than 3cm, average is 1cm; usually occur in a single gland
parathyroid adenoma
42
____, ___, and __ exams can also be used to localize parathyroid adenomas
Scintigraphy MRI CT
43
____ can be used to definitively diagnose the presence of an adenoma
FNA biopsy
44
____ or ___ can be performed to remove a parathyroid adenoma
percuteaneous ethanol ablation surgical excision
45
oval shaped, hypoechoic, encapsulated; hypoechoic, homogeneous solid mass; may resemble thyroid adenomas, but protrude off the posterior surface of the thyroid
parathyroid adenoma
46
vascularity surrounds 90-270 degrees around the mass
vascular arc
47
False positives for parathyroid adenomas
cervical lymph nodes prominent blood vessel esophagus longus colli muscle
48
There is an increased risk of parathyroid carcinoma with ___ and ___
MEN syndrome neck radiation
49
symptoms of hyperparathyroidism
bone pain constipation fatigue frequent thirst frequent urination kidney stones muscle weakness nausea poor appetite vomiting
50
Sonographic appearance of parathyroid carcinoma
small, irregular, firm masses usually larger than benign adenomas taller than wide shape correlates with malignancy may adhere to surrounding tissues varied echogenicity metastasis to regional nodes or distant organs may occur
51
Enlarged nodes are a ___ finding
non-specific
52
Enlarged lymph nodes are seen with __, ___, __
infection lymphadenopathy metastasis
53
Patients with prior history of thyroid cancer and/or thyroidectomy due to cancer should be evaluated regularly for ___ and ___
tumor recurrence lymphadenopathy
54
Normal sonographic appearance of lymph nodes
thin disk of bean shaped <1cm diameter hypoechoic rim with echogenic center (hilum) do NOT exhibit posterior enhancement
55
sonographic appearance of abnormal lymph nodes
rounded or plump appearance cortex will become more hypoechoic or may even be anechoic due to increased fluid edematous nodes exhibit posterior enhancement blood flow to hilum increased
56
largest saliva gland
parotid glands
57
The ___ are located anterior to the ear, wrapped around the mandibular ramus
parotid glands
58
The ____ duct carries saliva into the mouth from the parotid glands
Stensen
59
The ____ glands are located under the mandible
submandibular
60
The ___ duct carries saliva into the mouth from the submandibular glands
Wharton
61
The ___ glands are located under the tongue
sublingual
62
The salivary glands are supplied with blood by branches of the ___
external carotid artery
63
The salivary glands drain blood into the ____
internal jugular vein
64
Saliva contains ___
amylase
65
A _____ transducer is preferred for evaluating superficial structures
high frequency linear
66
stones form within the gland or duct to oral cavity; may see posterior shadowing; if stone is causing obstruction, the duct will be dilated within the gland
sialolithiasis
67
Infection causes ___ gland and ____ echogenicity
enlarged decreased
68
most common infection of the salivary glands and affects the parotid glands
mumps
69
Bilateral enlargement of the salivary glands usually indicates __
infection
70
Unilateral enlargement usually indicates ____
mass formation
71
most common malignancy seen in the salivary glands
Mucoepidermoid carcinoma
72
immune system disorder that causes a reduction in saliva production
Sjrogen syndrome
73
Sjogren syndrome is associated with ___ and ___
rheumatoid arthritis lupus
74
Primary symptoms of sjogren syndrome
dry eyes dry mouth
75
Sjogren syndrome usually affects the ___ and ___ glands
parotid submandibular
76
Sjogren syndrome may cause:
swelling of the salivary glands
77
There are usually ___ parathyroid glands. a. 2 b. 4 c. 6 d. 8
b
78
As levels of parathyroid hormone increase, how are serum calcium levels affected? a. no change b. increased c. decreased
b
79
As levels of calcitonin increase, how are serum calcium levels affected? a. no change b. increased c. decreased
c
80
Scan the area extending from the __ superiorly to the ___ inferiorly to locate the parathyroid glands a. carotid artery bifurcation, thoracic inlet b. mandible, maxilla c. ear. chin d. clavicle, sternum
a
81
Which of the following can assist in localizing the parathyroid glands? a. ask the patient to swallow b. place the focal zone deep to the thyroid c. use graded compression d. all the above
d
82
Primary hyperparathyroidism most commonly occurs due to: a. 4 hyperfunctioning glands b. 2 hyperfunctioning glands c. single adenoma in one parathyroid gland d. an associated multinodular goiter
c
83
Secondary hyperparathyroidism most commonly occurs due to: a. 4 hyperfunctioning glands b. 2 hyperfunctioning glands c. single adenoma in one parathyroid gland d. an associated multinodular goiter
a
84
Hypophosphatemia is associated with: a. increased calcitonin levels b. increased PTH levels c. increased blood sugar levels d. increased blood pressure
b
85
Which of the following indicates secondary parathyroidism? a. high serum calcium with high PTH levels b. low serum calcium with high PTH levels c. low serum calcium with low PTH levels d. high serum calcium with low PTH levels
b
86
Which of the following describes the sonographic appearance of a parathyroid adenoma? a. fascial plane separating it from the thyroid b. vascular arc c. hypervascularity d. all the above
d
87
Which of the following causes an increased risk of parathyroid cancer? a. Nutcracker or Ehlers-Danlos syndrome b. Diabetes and hypertension c. MEN syndrome and neck radiation d. polycystic disease and portal hypertension
c
88
Which of the following is a symptom of primary parathyroidism? a. frequent thirst b. lack of urination c. kidney cysts d. all the above
a
89
The parotid gland is located __ a. under the mandible b. posterior to the clavicle c. under the tongue d. anterior to the ear
d
90
Sialolithiasis refers to: a. cyst formation in the salivary gland b. stone formation in the salivary gland c. cancer formation in the salivary gland d. infection in the salivary gland
b
91
What is the most common infection of the parotid gland? a. HIV b. mononucleosis c. mumps d. streptococcus
c
92
What is the immune system disorder that causes a reduction in salive production? a. Sialolithiasis b. mucoepidermoid carcinoma c. mumps d. sjogren syndrome
d
93
flattened, cone-shaped, retroperitoneal organ
prostate
94
The prostate is bordered by the ___ superiorly
bladder
95
The prostate is bordered by the ___ inferiorly
urogenital diaphragm
96
The prostate is bordered by ___ anteriorly
pubic bone
97
The prostate is bordered posteriorly by the ___
rectum
98
____ separates the prostate anteriorly from the pubic bone
anterior prostatic fat/fascia
99
__ and __ muscles support the prostate laterally
levator ani obturator internus
100
The ____ separates the prostate from the rectum
Denonvillier fascia

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