DMS 225 ALL TEST QUESTIONS

milk is produced within the ____ and carried to the ducts

• mammary layer

• areola

• subcutaneous layer

• acini

acini

ch 21

most breast masses that arises during adolescent years are:

• malignant

• carcinoma in situ

• fibroadenomas

• epithelial hyperplasia

fibroadenomas

ch 21

the overgrowth of a fibroadenoma is stimulated by:

• progesterone

• HCG

• estrogen

• oxytocin

estrogen

ch 21

the physical stimulation of suckling by the baby initiates the release of ____

• pitocin

• oxytocin

• estrogen

• prolactin

oxytocin

ch 21

the hormone produced by the pituitary gland that stimulates the acini to produce and excrete milk is called:

• prolactin

• oxytocin

• pitocin

• estrogen

prolactin

ch 21

The breast is sonographically divided into 3 layers. Which of the following is incorrect?

• skin, nipple, subareolar

• pectoralis major

• subcutaneous layer

• parenchyma

pectoralis major

ch 21

the functional portion of the breast consist of ____ lobes.

• 3-5

• 5-19

• 15-20

• 25-30

15-20

ch 21

which one of the following form(s) of a fibrous "skeleton" that is responsible for maintaining the shape of a breast?

• acini

• pectoralis major muscle

• glandular layer

• cooper's ligaments

cooper’s ligaments

ch 21

as a woman ages, the glandular breast tissue is replaced with:

• fat

• cysts

• fibrous tissue

• cooper's ligaments

fat

ch 21

cooper's ligaments are best characterized as which one of the following?

• low reflectivity in retromammary layer

• highly reflective in retromammary layer

• echogenic line interfaces in subcutaneous layer

• homogenous reflections in parenchyma

echogenic line interfaces in subcutaneous layer

ch 21

the retromammary layer is sonographically imaged as which one of the following?

• hyperechoic

• hypoechoic

• dense

• high reflectivity

hypoechoic

ch 21

the most important signs to look for in determining a cystic lesion of the breast include all of the following EXCEPT:

• well defined borders

• good through transmission

• anechoic

• disruption of architecture

disruption of architecture

ch 21

clinical findings of lumpy, painful, tender breast that vary with monthly cycles usually represent which of the following?

• carcinoma

• fibrocystic disease

• cysts

• adenomas

fibrocystic disease

ch 21

the most common solid benign tumor of the breast is which of the following?

• fibrocystic disease

• fibroadenoma

• papilloma

• lipoma

fibroadenoma

ch 21

select the sonographic characteristic of fibroadenomas:

• poorly defined border

• uniform, low level homogenous echoes

• increased through transmission

• disruption of architecture

uniform, low level homogenous echoes

ch 21

lymphatic drainage from all parts of the breast generally flows to the ____ lymph nodes.

• interpectoral

• axillary

• supraclavicular

• internal mammary

axillary

ch 21

the most common malignant neoplasm of the breast is which one of the following?

• lobular carcinoma in situ

• invasive ductal carcinoma

• invasive lobular carcinoma

• ductal carcinoma in situ

invasive ductal carcinoma

ch 21

characteristic findings of breast carcinoma include all of the following EXCEPT:

• attenuation of sound

• irregular margins

• strong posterior margin

• inhomogeneous low level echo patterns with calcifications

strong posterior margins

ch 21

skin dimpling may be caused by which of the following?

• old age

• retraction of tissue secondary to tumor infiltration

• enlarged ducts

• thrombosis of arterial vessels

retraction of tissue secondary to tumor infiltration

ch 21

the most common clinical sign of breast carcinoma is:

• skin dimpling

• skin discoloration

• palpable lump

• pain

palpable lump

ch 21

what layer of the breast tissue contains the ducts and glandular tissue?

• subcutaneous layer

• mammary layer

• retromammary layer

• pectoral layer

mammary layer

ch 21

the midportion of the right medial and left lateral breast would be annotated as which?

• 3:00

• 6:00

• 9:00

• 12:00

3:00

ch 21

a normal extension of breast tissue into the axillary region is called ____.

• lobular neoplasm

• tail of spence

• peau d'orange

• terminal ductal lobular unit

tail of spence

ch 21

which one of the following arteries is responsible for supplying blood to more than half of the breast?

• intercostal

• thoracodorsal

• internal mammary

• lateral thoracic

internal mammary

ch 21

a condition of the male breast in which the ductal elements hypertrophy is called:

• mastitis

• galactocele

• gynecomastia

• paget's disease

gynecomastia

ch 21

characteristics of possible breast cancer include all of the following EXCEPT:

• irregular or spiculated mammographic mass and solid on ultrasound

• clustered pleomorphic, microcalcifications on mammogram

• focal distention on mammogram and an area of distortion on breast ultrasound

• a smooth, low-density mass on mammogram, and solid lesion that has not changed in over 3 years on ultrasound

a smooth, low-density mass on mammogram, and solid lesion that has not changed in over 3 years on ultrasound

ch 21

why are radial and anti-radial planes preferred for breast imaging?

• because the breast tissue is very superficial, it is better imaged in these planes

• the lactiferous ducts are arranged in a radial pattern, so will be better demonstrated if scanned along the same planes

• when the patient is positioned in an oblique position the tissue lies perpendicular to the longitudinal plane

• it is just a convention, no rational for it

the lactiferous ducts are arranged in a radial pattern, so will be better demonstrated if scanned along the same planes.

ch 21

which one of the following statements is FALSE?

• breast ultrasound is the imaging tool of choice to evaluate a breast mass in a teenage girl

• ultrasound of the breast is the primary imaging tool of choice in evaluating a breast mass in a pregnant woman

• breast ultrasound is the primary imaging tool of choice for screening a 45 year old woman for any evidence of possible breast cancer

• in the case of a benign fibroadenoma, the sonographic features of a smooth, sharply circumscribed hypoechoic mass with homogenous
  echogenicity and mildly posterior acoustic enhancement will usually be seen

breast ultrasound is the primary imaging tool of choice for screening a 45 year old woman for any evidence of possible breast cancer.

ch 21

ultrasound of the breast is often performed as an adjunctive imaging tool including all of the following situations EXCEPT:

• to assess a smooth mammographic mass as a cystic or solid

• to further evaluate a palpable breast lump in a patient with very dense breast tissue and a negative mammogram

• to further evaluate a palpable breast lump in a patient with breast implants

• to further evaluate an asymptomatic patient with large fatty replaced breast and a negative mammogram

to further evaluate an asymptomatic patient with large fatty replaced breast and a negative mammogram

ch 21

in the case of a mammographic mass that is highly suggestive of malignancy, the correlating sonographic mass will likely show
which of the following features?

• irregular margin and taller than wide

• anechoic

• irregular margin and wider than tall

• posterior acoustic enhancement

irregular margin and taller than wide

ch 21

in the case of a smooth mammographic mass that is highly suggestive of cystic, the correlating sonographic mass will likely show which
of the following?

• irregular margins

• anechoic and posterior enhancement

• taller than wide

• echogenic and posterior acoustic enhancement

anechoic and posterior enhancement

ch 21

what test is indicated with nipple drainage?

• large core biopsy

• galactography

• MRI

• fine needle aspiration

galactography

ch 21

a breast sonogram on a lactating female demonstrated a focal fluid collection with internal echoes and enlarged lymph nodes. What is the most likely diagnosis?

• mastitis

• breast abscess

• gynecomastia

• galactocele

breast abscess

ch 21

surface erosion of the nipple characterized by redness with flaking and crusting of skin from the nipple by underlying breast cancer is called:

• fibroadenoma

• peau d'orange

• paget's disease

• epithelial hyperplasia

paget's disease

ch 21

breast cancer involves 2 main types of cells:

• ductal and lobular

• cystic and solid

• acini and delta

• acini and lobular

ductal and lobular

ch 21

represents the first lymph node along the axillary node chain:

• fremitus node

• internal mammary node

• adenosis

• sentinel node

sentinel node

ch 21

fingerlike extension of a malignant tumor:

• tail of Spence

• sentinel node

• apocrine metaplasia

• spiculations

spiculations

ch 21

breast cancer occurring in different quadrants of the breast at least 5 cm apart:

• multifocal breast cancer

• multicentric breast cancer

• atypical hyperplasia

• apocrine neoplasia

multicentric breast cancer

ch 21

near the chest wall is called:

• axilla

• areola

• juxta thoracic

• cooper's ligaments

juxta thoracic

ch 21

the pathologist recognizes some, but not all, of the features of a ductal carcinoma in situ is called:

• atypical hyperplasia

• atypical ductal hyperplasia

• epithetical hyperplasia

• lobular neoplasia

atypical ductal hyperplasia

ch 21

common features of the intracapsular or extracapsular silicone rupture include all except:

• sandwich sign

• linguine sign

• stepladder sign

• teardrop sign

sandwich sign

ch 21

which of the following statements is true regarding focal zone setting in breast sonography?

• the focal zone should be set above the level of the lesion being imaged

• the focal zone should be set at the level of the lesion being imaged

• there should only be one focal zone used for maximum image optimization

• the focal zone placement is not critical in sonographic breast imaging

the focal zone should be set at the level of the lesion being imaged.

ch 21

what breast lesion is an acoustic standoff pad most helpful?

• deep within the breast tissue

• axillary location

• superficially positioned in the breast

• mobile upon palpation

superficially positioned in the breast

ch 21

which of the following best describes the thickness of the normal skin overlying the breast?

• 2-3 cm

• 1-2 cm

• 5-10 mm

• 2-3 mm

2-3 mm

ch 21

the appearance of hazy, echogenic material with posterior acoustic shadowing seen in an augmented breast should raise the suspicion for which of the following?

• malignancy

• scar

• fibrocystic disease

• implant rupture

implant rupture

ch 21

an asymptomatic patient receives a breast sonogram as an additional workup. the exam reveals a mass with multiple internal punctuate echogenic foci. what do these foci most likely represent?

• calcifications

• gas

• artifact

• fat

calcifications

ch 21

sonography is the recommended initial imaging modality for the evaluation of an area of palpable interest in patients younger than what age?

• 30

• 40

• 50

• 60

30

ch 21

____ is a tumor that initially arises as an intraductal mass and has a more favorable prognosis than other types of carcinoma.

• papillary carcinoma

• comedocarcinoma

• inflammatory carcinoma

• tubular carcinoma

papillary carcinoma

ch 21

which two characteristics are most helpful to establish concordance between a lesion seen on ultrasound and mammography?

• margins and density

• echogenicity and distance from the nipple

• margins and echogenicity

• size and location

size and location

ch 21

what is the approximate chance of a woman developing invasive breast cancer in her lifetime?

• 1 in 8

• 1 in 15

• 1 in 40

• 1 in 100

1 in 8

ch 21

which bi-rads category is a 6 month follow up required?

• category 1

• category 2

• category 3

• category 4

category 3

ch 21

a benign category for breast implants is:

• category 0

• category 1

• category 2

• none of the above

category 2

ch 21

a rare type of ductal carcinoma seen primarily in patients older than 75 years old.

• scirrhous carcinoma

• tubular carcinoma

• cyst sarcoma phyllodes

• colloid/mucinous carcinoma

colloid/mucinous carcinoma

ch 21

which category is where concern for breast cancer risk begins to increase?

• bi rads 2

• bi rads 3

• bi rads 4

• bi rads 5

bi rads 4

ch 21

which term is seen throughout bi rads 5?

microcalcifications

fibro glandular

granuloma

benign

microcalcifications

ch 21

the thyroid is an endocrine gland that regulates metabolic function through the production of all of the following hormones EXCEPT:

• thyroxine

• triiodothyronine

• thyrocalcitonin

• thyroliberin

thyroliberin

ch 22

the thyroid gland consists of ____ lobes.

• 3

• 4

• 2

• 6

2

ch 22

the approximate dimensions of the normal thyroid gland are:

• 5cm x 2cm x 2cm

• 4cm x 5cm x 2cm

• 3cm x 5cm x 2cm

• 6cm x 2cm x 2cm

5cm x 2cm x 2cm

ch 22

the lobes of the thyroid gland are connected by:

• ismel tissue

• the isthmus

• island tissue

• parathyroid tissue

the isthmus

ch 22

all of the following structures form neighboring structures for the thyroid gland EXCEPT:

• longus coli muscle

• parotid muscle

• strap muscle

• sternocleidomastoid muscle

parotid muscle

ch 22

the pyramid lobe of the thyroid gland extends from the;

• superior right lobe

• inferior left lobe

• superior isthmus

• inferior right lobe

superior isthmus

ch 22

which of the following is NOT a strap muscle near the thyroid?

• sternocleidomastoid muscle

• omohyoid

• sternohyoid

• sternothyroid

sternocleidomastoid muscle

ch 22

the thyroid gland develops at the floor of which structure?

• primitive pharynx

• trachea precursor

• maxilla

• nasopharynx

primitive pharynx

ch 22

the most common cause of thyroid disorders worldwide is:

• hypothyroidism

• iodine deficiency

• iron deficiency

• autoimmune process

iodine deficiency

ch 22

which disorder of the thyroid usually results in hypothyroidism?

• parathyroid hyperplasia

• thyroiditis

• anaplastic carcinoma

• adenoma

thyroiditis

ch 22

which one of the following sonographic features of a thyroid adenoma is most common?

• complex echo pattern

• hyperechoic mass

• hypoechoic peripheral halo

• irregular margins

hypoechoic peripheral halo

ch 22

the parathyroid glands produce a hormone that affects the:

• liver, colon, & kidneys

• kidneys, bones, and gastrointestinal tract

• gastrointestinal tract, breast, scrotum

• kidneys, heart, and colon

kidneys, bones, and gastrointestinal tract

ch 22

The normal parathyroid glands are located on the ____ and the ____ surface of the thyroid glands.

• posterior, lateral

• anterior, lateral

• posterior, medial

• anterior, medial

posterior, medial

ch 22

usually ____ parathyroid glands exist.

• 2

• 3

• 4

• 5

4

ch 22

a solitary thyroid nodule in the Prescence of ipsilateral lymphadenopathy suggest which one of the following?

• adenoma

• grave's disease

• follicular carcinoma

• hashimoto's thyroiditis

follicular carcinoma

ch 22

the most common course of hyperparathyroidism is which of the following?

• thyroid adenoma

• parathyroid adenoma

• parathyroid cyst

• parathyroid hemorrhagic cyst

parathyroid adenoma

ch 22

a ____ is a palpable, anterior, midline mass between the hyoid bone and the isthmus of the thyroid gland.

carotid aneurysm

parathyroid adenoma

thyroglossal duct cyst

brachial cleft cyst

thyroglossal duct cyst

ch 22

which one of the following structures lies posterior to the thyroid gland?

• esophagus

• sternocleidomastoid muscle

• longus coli muscle

• omohyoid muscle

longus coli muscle

ch 22

hyperfunction of all parathyroid glands with no apparent cause occurs with which one of the following?

• primary hyperplasia of parathyroid glands

• secondary hyperplasia of thyroid glands

• primary hyperparathyroidism

• secondary hyperplasia of parathyroid glands

primary hyperplasia of parathyroid glands

ch 22

increased vascularity with color Doppler, termed the thyroid inferno, is observed in ____.

• hashimoto's disease

• grave's disease

• de Quervian's thyroiditis

• both a & b

both a & b

ch 22

the most common cause of thyroid malignancy is ____ carcinoma.

• papillary

• medullary

• anaplastic

• follicular

papillary

ch 22

an abnormal lymph node demonstrates which of the following?

• homogenous texture

• central echogenic complex

• oval contour

• round contour

round contour

ch 22

a cystic formation located lateral to the thyroid gland in the neck is typically which of the following?

• thyroglossal duct cysts

• brachial cleft cyst

• cystic hygroma

• sublingual cyst

brachial cleft cyst

ch 22

a cystic formation located lateral to the thyroid gland in the neck is typically which of the following?

• thyroglossal duct cysts

• brachial cleft cyst

• cystic hygroma

• sublingual cyst

brachial cleft cyst

ch 22

an enlargement of the thyroid gland is a(n) ____ which is often visible on the anterior neck.

• adenoma

• goiter

• euthyroid

• papillary carcinoma

goiter

ch 22

what lab value is elevated with hyperparathyroidism?

• TSH

• parathyroid hormone (PTH)

• serum calcium

• T4

serum calcium

ch 22

occurs as a solitary malignant mass in the thyroid gland:

• anaplastic carcinoma

• papillary carcinoma

• follicular carcinoma

• hashimoto's

follicular carcinoma

ch 22

what modality evaluates thyroid function?

• CT scan

• nuclear medicine

• ultrasound

• x-ray

nuclear medicine

ch 22

the hormones of the thyroid gland that maintain body metabolism, growth, and development are:

• TSH, calcium

• PTH, calcitonin

• calcitonin and iodine

• T3, T4, calcitonin

T3, T4, calcitonin

ch 22

the thyroid glands are the calcium sensing organs of the body.

• true

• false

false

ch 22

on sonographic examination, which of the following describes the appearance of thyroiditis?

• multiple cyst within the thyroid

• a diffuse, enlarged thyroid with decreased echogenicity

• a small echogenic thyroid

• multiple complex masses withing the thyroid

a diffuse, enlarged thyroid with decreased echogenicity

ch 22

parathyroid adenomas may be associated with which of the following?

• hypercalcemia

• hypertension

• bloating

• acne

hypercalcemia

ch 22

which of the following is a sonographic feature of normal cervical lymph nodes?

• a central, echogenic core

• oblong shape

• <6 mm in height

• all of the above

all of the above

ch 22

which of the following statements is true regarding thyroglossal duct cysts?

• they are typically midline

• they need to be aspirated

• they are malignant

• they should be biopsied to confirm diagnosis

they are typically midline

ch 22

subacute granulomatous thyroiditis is called:

• de quervian's disease

• hashimoto's disease

• grave's disease

• thyrotoxicosis

de quervian's disease

ch 22

a normal lymph node will not measure greater than:

5mm

8 mm

10mm

12mm

10mm

ch 22

which vascular structure is located closest to the thyroid lobes?

• external carotid vein

• external carotid artery

• internal jugular vein

• common carotid artery

common carotid artery

ch 22

the fluid produced by the thyroid gland that contains thyroid hormones is called?

• thyroxine

• calcitonin

• colloid

• triiodothyronine

colloid

ch 22

which of the following would more likely be a malignant thyroid nodule?

• cold nodule

• hot nodule

• spongiform nodule

• simple cystic nodule

cold nodule

ch 22

a 45 year old female presents to the sonography department with a palpable neck mass 6 months following a thyroidectomy for papillary carcinoma. Which of the following would be most likely etiology of the palpable mass?

• torticollis

• lymphadenopathy

• sialadenitis

• graves disease

lymphadenopathy

ch 22

patient with hypercalcemia presents to the sonography department for a neck sonogram. What abnormality should be suspected?

• parathyroid adenoma

• parotid gland enlargement

• thyroid papillary carcinoma

• hashimoto thyroiditis

parathyroid adenoma

ch 22

a thyroid isthmus that measures greater than __ is indicative of thyroid enlargement.

• 8mm

• 5mm

• 12mm

• 10mm

10mm

ch 22

psammoma bodies are:

• hypoechoic structures

• comet-tail artifacts from inside a colloid mass

• punctate calcific deposits

• mural or wall nodules within a solid mass

punctate calcific deposits

ch 22

which of the following is the duct that drains the submandibular gland?

• stensen duct

• wharton duct

• seigle duct

• partridge duct

wharton duct

ch 22

which of the following is an autoimmune disease that affects the glands that produce moisture, leading to dysfunction of the salivary glands, and dryness of eyes, nose, skin, and mouth?

• wharton syndrome

• sjogren syndrome

• stenson syndrome

• sialadenitis syndrome

sjogren syndrome

ch 22