1. Advantages of ultrasound imaging include: A. Imaging modality of choice for thyroid B. Doppler...

1. Advantages of ultrasound imaging include:A. Imaging modality of choice for thyroidB. Doppler sonography can be used for

assessment of blood flowC. Scanning in the sagittal plane offers

optimal visualizationD. A and BE. All of the above

2. Features suggestive of malignancy in a thyroid nodule include all of the following EXCEPT:

A. HyperechoicB. MicrocalcificationsC. Increased blood flow on DopplerD. Tail shapeE. Irregular border

3. Parathyroid imaging on ultrasound:A Is less accurate than sestamibi scans in

localizing a solitary adenomasB. Normal parathyroid glands can be visualized

with high resolution ultrasonographyC. Parathyroid adenomas are hyperechoic

relative to the thyroid glandD. Superior parathyroid glands are on a deeper

plane than the inferior glandsE. Ectopic parathyroid gland may be visualized

on ultrasound in the posterior mediastinum

4. Ultrasound imaging of salivary glands:A. Is useful for differentiating sialadenitis

from neoplasms and lymphadenopathyB. Is useful for imaging deep lobe parotid

tumorsC. Shows similar echogenicity to the thyroidD. A and CE. All of the above

5. Ultrasound characteristics of salivary malignancies include:

A. CalcificationsB. Smooth shapeC. Increased vascularity on Doppler

imagingD. Ovoid lesion with short axis less than 5

mmE. Homogeneous echostructure

6. Ultrasound imaging for head and neck cancer:A. Can detect metastatic lymph nodes not

detected by CT or MRIB. Round shape of lymph node suggests

malignancyC. Intranodal cystic degeneration suggests

malignancyD. Can be used to avoid elective neck

dissection in NO necksE. All of the above

7. Ultrasound-guided fine needle aspiration:

A. Is done using a 27 gauge needleB. Aspiration is performed firstC. Bevel of the needle is pointed away from

the transducerD. Needle should be irrigated with fixative

prior to insertionE. The needle should be used to shave cells

along the needle path

Punctate echogenicities in thyroid nodules.

Frates M C et al. Radiology 2005;237:794-800

©2005 by Radiological Society of North America

8. Normal paraganglia contain all of the following EXCEPT:

A. Sustentacular cellsB. Cells which stain positively with S-100C. Schwann cellsD. Chief cellsE. Catecholamine-containing cells

9. The following is true about paragangliomas:

A. The most common type is the pheochromocytoma

B. 10% occur in the head and neckC. Secretion of epinephrine from head and

neck paragangliomas may occurD. Vagal paragangliomas are more common

than jugulotympanic paragangliomas.E. Familial paragangliomas occur in MEN 1,

Carney’s triad, and von Hippel-Lindau disease

10. Carotid body tumorsA. A positive Fontaine’s sign indicates

movement of a lateral neck mass laterally but not vertically

B. Increased mitotic rate and capsular invasion indicate malignancy

C. Malignancy is determined by histologyD. Diagnosis can be made radiographically

by posterior displacement of the internal and external carotid arteries

E. Classification of tumors is based on size

11. Recommended treatment of carotid body tumors:A. Requires preoperative embolization before

surgical removalB. Results in permanent cranial nerve

deficit(s) in 50% of casesC. Observation is an option for some patients

with carotid body tumors.D. Radiation therapy can reduce the size of

the tumor.E. Surgical resection is preferred over

radiation therapy for multicentric tumors

12. Vagal paragangliomas:

A. Arise from the inferior vagal ganglionB. Arise from the nodose ganglionC. Arise from the jugular ganglionD. A and BE. All of the above

13. Peripheral nerve neoplasms:A. Neurofibromas are encapsulated and may

occur singly or multiplyB. Schwannomas most commonly occur in the

head and neck regionC. Antoni type A areas contain loosely

arranged hypocellular zonesD. Malignant transformation is more common

in multiple neurofibromas than in solitaryE. Cranial neuropathies are rare following

resection of schwannomas

14. Metastatic disease to the neck:A. Location of the metastatic node in level 5

are most commonly associated with a hypopharyngeal primary

B. Fine needle aspiration biopsy diagnosis of adenocarcinoma indicates a primary in a salivary gland

C. The most common distant site to metastasize to the neck is from a lung primary

D. B and CE. All of the above

15. Sarcomas of the neck:A. 80% of head and neck sarcomas are derived

from soft tissues of the neckB. Occur most commonly in childrenC. Staging for bone sarcomas is based on sizeD. Staging for soft tissue sarcomas is based

on site of originE. The most common sarcoma in the head and

neck is the malignant fibrous histiocytoma

16. Rhabdomyosarcoma

A. Accounts for 50% of sarcomas in all age groups

B. Most common site in the head and neck is in the neck

C. Metastatic disease is present in 80% of cases at presentation

D. Primary treatment is surgical resectionE. Highest incidence occurs in first decade

of life

17. Rare sarcomas of the neck:

A. Osteosarcoma of the mandible frequently metastasizes to the neck

B The most common site of fibrosarcoma in the head and neck is in the neck

C. Alveolar soft part sarcoma is associated with the fusion gene ASPL-TFE3

D. Epithelioid hemangioendothelioma exhibits extremely aggressive behavior

E. Liposarcoma is the most common soft tissue sarcoma in the head and neck in adults

18. Rarer sarcomas of the neck:A. Malignant hemangiopericytoma (MPC) arise

from the cells of Zimmerman, around capillaries and postcapillary venules

B. Majority of HPCs occur in the paranasal sinuses

C. Malignant peripheral nerve sheath tumor (MPNST) can occur either spontaneously or with NF-1

D. MPNST has recurrence rates of more than 40% despite aggressive treatment

E. All of the above

19. Review these before the in-serviceA. Synovial sarcoma

Typically arises in the hypopharyngeal and retropharyngeal region

B. Malignant giant cell tumorRadiation induced after treatment for a benign giant

cell tumor, sinonasal region and mandible most common sites

C. Ewing’s sarcomaDerived from primitive neuro-ectoderm, 2nd most

common bone tumor in children, mandible, maxilla, skull

D. Solitary Fibrous TumorDesmoid fibromatosis frequent in head and neck, in

children, high local recurrence rate but low mortality