Thyroid Cancer Quiz
Thyroid Cancer Quiz
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1. Question
Which of the following is not a recommended test for the initial evaluation of thyroid nodules?
CorrectIncorrectConsider which test is insensitive and nonspecific for thyroid cancer.
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2. Question
When should a radionuclide thyroid scan be performed?
CorrectIncorrectThink about when a thyroid nodule is more likely to be hyperfunctioning.
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3. Question
What does focal 18FDG-PET uptake within a sonographically confirmed thyroid nodule indicate?
CorrectIncorrectConsider the relationship between 18FDG-PET uptake and malignancy risk.
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4. Question
What should be the course of action if diffuse 18FDG-PET uptake is detected in conjunction with sonographic and clinical evidence of chronic lymphocytic thyroiditis?
CorrectIncorrectConsider the benign nature of the condition and the recommendations for imaging and FNA.
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5. Question
Which imaging study is not indicated for patients with known or suspected thyroid nodules?
CorrectIncorrectRecall which imaging technique is specifically recommended for evaluating thyroid nodules.
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6. Question
In the diagnostic ultrasound of a thyroid nodule, which of the following features is not evaluated?
CorrectIncorrectConsider which information is not related to the characteristics of a thyroid nodule in ultrasound imaging.
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7. Question
For which type of thyroid nodule is ultrasound-guided FNA preferred over palpation-guided FNA?
CorrectIncorrectThink about which type of nodule is more likely to result in nondiagnostic cytology or sampling error.
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8. Question
What is the recommended size for fine-needle aspiration (FNA) in a nodule with an intermediate suspicion pattern?
CorrectIncorrectReview the recommendations for diagnostic FNA of a thyroid nodule based on sonographic pattern.
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9. Question
What is the recommended size for fine-needle aspiration (FNA) in a thyroid nodule with a high suspicion sonographic pattern?
CorrectIncorrectReview the recommendations for diagnostic FNA of a thyroid nodule based on sonographic patterns.
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10. Question
Which ultrasound feature has the highest specificity for thyroid cancer?
CorrectIncorrectRecall which sonographic feature is most specific to thyroid cancer.
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11. Question
Which of the following is not consistently associated with thyroid cancer?
CorrectIncorrectIdentify which sonographic feature is not consistently related to thyroid cancer.
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12. Question
Which sonographic feature is strongly correlated with benignity in mixed cystic solid nodules?
CorrectIncorrectConsider the sonographic feature that indicates a lower risk of malignancy in mixed cystic solid nodules.
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13. Question
What is the recommended management for nodules that are purely cystic?
CorrectIncorrectRecall the recommendation for managing purely cystic nodules.
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14. Question
A 48-year-old female with a history of hypertension presents with a thyroid nodule. Ultrasound reveals a solid hypoechoic nodule with irregular margins and microcalcifications. What is the malignancy risk and recommended management for this nodule?
CorrectIncorrectThe nodule has irregular margins and microcalcifications, which are associated with a high suspicion of malignancy.
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15. Question
A 35-year-old male presents with a thyroid nodule that is isoechoic, solid, and without microcalcifications or irregular margins. What is the malignancy risk and recommended management for this nodule?
CorrectIncorrectThe nodule is isoechoic and solid, without microcalcifications or irregular margins, which are associated with a low suspicion of malignancy.
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16. Question
A 50-year-old female with a history of diabetes presents with a purely cystic thyroid nodule. What is the malignancy risk and recommended management for this nodule?
CorrectIncorrectPurely cystic nodules are very unlikely to be malignant
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17. Question
A 35-year-old woman presents with a thyroid nodule. Upon ultrasound examination, the nodule is solid hypoechoic with microcalcifications and irregular margins. Which of the following categories of ultrasound patterns best describes this nodule?
CorrectIncorrectReview the ultrasound patterns described in the text.
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18. Question
A 42-year-old man has a partially cystic nodule with eccentric uniformly solid areas without microcalcifications or extrathyroidal extension. Which of the following categories of ultrasound patterns best describes this nodule?
CorrectIncorrectReview the ultrasound patterns described in the text.
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19. Question
Which of the following clinical risk factors for thyroid cancer has NOT been incrementally included in multivariate analyses of gray-scale sonographic features and thyroid cancer risk?
CorrectIncorrectConsider the clinical risk factors mentioned in the text.
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20. Question
In the context of thyroid nodule evaluation, which of the following statements about ultrasound elastography (USE) is true?
CorrectIncorrectReview the information about ultrasound elastography in the text.
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21. Question
According to the Bethesda System for Reporting Thyroid Cytopathology, which category is associated with the highest risk of malignancy?
CorrectIncorrectConsider the malignancy risks associated with each Bethesda category.
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22. Question
A 45-year-old female with a history of childhood radiation therapy presents with a thyroid nodule. Which of the following clinical risk factors is associated with an increased risk of thyroid cancer in patients with thyroid nodules?
CorrectIncorrectConsider the clinical risk factors mentioned in the text.
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23. Question
Which of the following is NOT a limitation of ultrasound elastography (USE) for assessing thyroid cancer risk in nodules?
CorrectIncorrectLook for the statement about the applicability of USE to all thyroid nodules.
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24. Question
According to the Bethesda System for Reporting Thyroid Cytopathology, which diagnostic category has the highest discordance rates?
CorrectIncorrectLook for the diagnostic categories with the highest discordance rates in the text.
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25. Question
In the case of a thyroid nodule with an initial nondiagnostic cytology result, what is the recommended next step?
CorrectIncorrectLook for the recommendation related to nondiagnostic cytology results.
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26. Question
A 45-year-old patient with a thyroid nodule has cytology diagnostic for primary thyroid malignancy. Which of the following is NOT a reason to consider active surveillance as an alternative to immediate surgery?
CorrectIncorrectConsider which option would not be a reason to delay surgery.
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27. Question
What is the definition of papillary thyroid microcarcinoma (PTMC)?
CorrectIncorrectRemember the size cutoff for PTMC.
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28. Question
In the study by Ito et al., what percentage of patients with PTMC showed evidence of lymph node metastases at 10-year follow-up?
CorrectIncorrectConsider the findings of the study by Ito et al.
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29. Question
Which of the following is NOT a reliable clinical feature to differentiate PTMC patients destined to develop clinically significant progression from those with indolent PTMC?
CorrectIncorrectConsider which features are reliable in differentiating PTMC patients with significant progression.
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30. Question
Which of the following markers has a relatively high specificity but low sensitivity for cancer detection in indeterminate cytology thyroid nodules?
CorrectIncorrectThe marker mentioned is an immunohistochemical stain.
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31. Question
Which molecular test has been proposed as a rule-out test in indeterminate cytology thyroid nodules due to its relatively high sensitivity and negative predictive value (NPV)?
CorrectIncorrectThis test is based on the mRNA expression of 167 genes.
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32. Question
What is the primary limitation of BRAFV600E single mutation testing for indeterminate cytology thyroid nodules?
CorrectIncorrectThe limitation is related to the test's ability to detect true positive cases.Q 🙂 What type of genetic alterations does next-generation sequencing of an expanded panel include for indeterminate cytology thyroid nodules?
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33. Question
What is the recommended setting for molecular testing intended for clinical use?
CorrectIncorrect -
34. Question
What is the risk of cancer for patients with AUS/FLUS nodules who underwent surgery based on the Bethesda System?
CorrectIncorrectRefer to the text on AUS/FLUS cytology.
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35. Question
In the context of AUS/FLUS cytology, what is the recommended action after considering worrisome clinical and sonographic features?
CorrectIncorrectRefer to Recommendation 15(A).
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36. Question
What is the sensitivity of mutational testing for BRAF in AUS/FLUS samples?
CorrectIncorrectRefer to the text on molecular testing using mutational panels.
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37. Question
What is the negative predictive value (NPV) of the 167-gene expression classifier (GEC) for cancer in AUS/FLUS cytology nodules?
CorrectIncorrect -
38. Question
A 45-year-old female patient is undergoing thyroidectomy due to malignant cytology. Which preoperative imaging modality is recommended for cervical lymph node evaluation?
CorrectIncorrectThink about the imaging modality that is commonly used for evaluating cervical lymph nodes in thyroid cancer patients.
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39. Question
What is the most specific ultrasonographic feature for detecting malignant involvement in cervical lymph nodes?
CorrectIncorrectConsider the ultrasonographic feature that has the highest specificity for identifying malignant involvement in lymph nodes.
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40. Question
Which lymph node levels are most likely to have malignant involvement in differentiated thyroid carcinoma (particularly papillary carcinoma)?
CorrectIncorrectThink about the cervical lymph node levels with a higher likelihood of malignant involvement in differentiated thyroid carcinoma.
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41. Question
In a patient undergoing thyroidectomy for malignant or suspicious cytology, what is the recommended approach for sonographically suspicious lymph nodes ≥8-10 mm in the smallest diameter?
CorrectIncorrectConsider the approach that helps confirm malignancy in suspicious lymph nodes and can potentially change management.