endocrine Flashcards

Question

MEN syndromes

Answer 1

*Multiple Endocrine Neoplasia 1) Piter Pan Parts from Menhood-pituitary, pancreas (gastrinoma MC), para HP (90%) 2A) Adrenal (pheo), Aggressive thyroid (medullary), A lot of Ca (parathyroid) 2B) it's a wanaBe, so it's the same But it has Beef with Ca so instead of parathyroid it decided to Be a Gangster (ganglioneuroma)

Answer 2

ocreotide (MIBG also positive but <25%), Gallium+ but not spect

Answer 3

serotonin degrades R heart valves

Answer 4

micro=HM for papillary | macro=medullary

Answer 5

- per=benign | - central=mal

Answer 6

locate recurrent laryngeal n (n is medial to it)

Answer 7

No but mal tumors >1.5cm

Answer 8

colloid thyroid cyst

Answer 9

infection of 4th brachial cleft anomaly (usually L) travel via pyriform fistula --> thyroid

Answer 10

- nodule (benign, mal) - goiter (MN, graves, Hashimoto, low iodine in 3rd world) - subacute thyroiditis/de quervains thyroiditis - acute suppurative thyroiditis - reidels thyroiditis - thyroglassal duct cyts - ectopic lingual thyroid

Answer 11

- young woman, painful s/p URI | - pregnant, painless

Answer 12

- suprahyoid 25% - at the hyoid 30% - infrahyoid 45%

Answer 13

- papillary | - 3%

Answer 14

1) giraffe skin 2) white knights (hyperechoic nodules that are actually regenerative nodules) Features vary with different stages of disease and extent of involvement (i.e., diffuse vs. focal) 1) Acute, focal: Discrete nodules occur in equal frequency against normal or altered background thyroid parenchyma 2) Acute, diffuse: Diffuse, hypoechoic, heterogeneous, micronodular echo pattern involving entire gland * diffuse gland enlargement/hypoecho w/ micronodular pattern + bright linear fibrous septa 3) Chronic: Enlarged, hypoechoic, micronodular gland with lobulated outlines; diffuse, hypoechoic, parenchymal echoes (ghost-like thyroid) ± echogenic fibrous septa 4) Atrophic/end stage: Small, hypoechoic gland with heterogeneous echo pattern

Answer 15

- nodes ant to thyroid - enlarged w/ Hashimoto - sick looking=laryngeal met

Answer 16

1) papillary 2) follicular 3) medullary 4) anapestic 5) Hurthle cell

Answer 17

1) papillary- microCa, Lymph spread 2) follicular-Hematog spread resp less to I-131, but still good. - hyper echo + hypoechoic rim - no Ca 3) Hurthle cell (follicular variant)-elderly. doesn't respond well to I-131 (FDG-PET for surveillance) - indist from follicular. Can be more hypo echo (unlike other follicular) 4) medullary- MEN (calcitonin). Local invasion, L/H. Doesn't respond well to I-131. - macroCa 5) anaplastic-elderly s/p Rad rx. Fast growing. Lymph spread. Doesn't respond well to I-131. - diffuse, avascular/necrotic, ugly

Answer 18

- microCa in a LN - hyperechoic, hyerenchancing, T1+ - miliary pattern in lungs (pulmonary fibrosis is a risk of treating w/ I-131 if you have diffuse mets)

Answer 19

- super: 4th branchial pouch | - inf: 3rd branchial pouch. Most likely to be ectopic

Answer 20

- hyperfunctioning parathyroid (90%) | - Hyperplasia (8-10%)

Answer 21

-early arterial wash in and delayed wash out

Answer 22

``` carcinoma uncommon (1% hyperPTH) -looks v sim to adenoma BUT cervical adenopathy, invasion of adjacent structure ```

Answer 23

anti thyroid peroxidase (TPO) and anti thyroglobulin

Answer 24

hypoechoic solid microCa

Answer 25

hyperechoic thick irregular halo ø Ca

Answer 26

hypoecho | ø Ca

Answer 27

N1a=level 6=central/visceral | N1b=all others

Answer 28

pre-sacral (indistinguishable from liposarcoma)

Answer 29

T1-uterus T2-parametrium, upper 2/3 vag T3-lower 3rd vag or pelvic wall T4-rectum, bladder mucosa

Answer 30

- benign lesion w.o malignant potential - unilocular thin walled cyst w/ comet-tail artifact - thicker wall/multiseptated if debris/hemorrhage

Answer 31

Invasive hypoechoic thyroid mass, ± focal calcification, ± necrosis against background of multinodular goiter (MNG) in elderly female patient, ± nodal or distant metastases - Ill-defined, hypoechoic tumor diffusely involving entire lobe or gland * Background of MNG or differentiated thyroid carcinoma (DTCa) -Necrosis (78%), dense amorphous calcification (58%) Extracapsular spread with infiltration of trachea, esophagus, and perithyroid soft tissues and nerves Thrombus in internal jugular vein (IJV) and carotid artery (CA), causing expansion and occlusion of vessels Nodal or distant metastases in 80% of patients Color Doppler shows prominent, small, chaotic intratumoral vessels

Answer 32

Acute phase: Focal, ill-defined, nodular, hypoechoic, avascular/hypovascular area in subcapsular region Subacute phase: Diffuse enlargement of 1 lobe or entire thyroid gland with multifocal, patchy/confluent, ill-defined, hypoechoic, avascular/hypovascular areas Radioactive iodine uptake test or Tc-99m pertechnetate thyroid scan: Focal defect or large area of ↓/absent uptake due to failure of iodine trapping

Answer 33

Ddx de quervians - rapid-onset painful goiter ± preceding history of URI with repeated coughing - Well-defined, predominantly cystic nodule with internal debris and fluid level ± thick, avascular septa - FNAC for decompression invariably yields altered blood

Answer 34

*follicular lesions tend to be iso/hyper True adenoma: Benign neoplasm of thyroid glandular epithelium with fibrous encapsulation -Solid, homogeneous, noncalcified, well-defined, haloed, isoechoic or hyperechoic; hypoechoic is less common and has ↑ risk of malignancy Adenomatous nodule: Focal adenomatous hyperplasia with incomplete capsule; cold nodule US features that raise suspicion of malignant FN: Ill-defined, hypoechoic component in otherwise iso-/hyperechoic nodule, thick irregular capsule Hürthle cell neoplasms have similar imaging characteristics to follicular nodule (FN)

Answer 35

oval (or flat developing long in fascial planes) hypoecho to thyroid +/-cystic thin echo capsule

endocrine Flashcards

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