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Endocrine Week 3 2017/18 > 2: Pathology of the thyroid gland > Flashcards

2: Pathology of the thyroid gland Flashcards

1
Q

At what level is the thyroid gland found?

A

C5 - T1

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2
Q

Where does the thyroid gland start out during development?

Through which hole in the tongue does it move inferiorly?

Which passage carries it to the neck?

A

Tongue

Foramen caecum

Thyroglossal duct

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3
Q

What is a thyroid called when it fails to descend through the thyroglossal duct?

A

Lingual thyroid

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4
Q

If the thyroid gland descends too much during development, where can it end up?

A

Mediastinum

behind the sternum

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5
Q

What is a thyroglossal duct cyst?

A

Benign growth which moves with swallowing

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6
Q

The thyroid gland is an endocrine organ composed of ___, where the thyroid hormones are produced.

A

follicles

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7
Q

What chemical is found in thyroid follicles?

A

Thyroglobulin

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8
Q

Which cells produce T3 and T4?

A

Follicular cells

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9
Q

Which cells are found next to follicles and secrete calcitonin?

A

C cells (parafollicular cells)

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10
Q

hypothalamus

trh

anterior pituitary

tsh

thyroid gland

t3 and t4

target cells

A
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11
Q

When T3 / 4 levels are high, the secretion of hormones along the h.p.t axis is (increased / suppressed).

A

suppressed

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12
Q

What type of receptor are TSH receptors?

A

G protein receptors

Release of T3 and T4 are controlled by cyclic AMP

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13
Q

What do the thyroid hormones do?

A

Regulate metabolic rate

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14
Q

What happens to the size of the thyroid gland when it is

a) hyperactive
b) underactive?

A

hyperactive - enlarged

underactive - atrophied

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15
Q

What is thyroiditis?

A

Inflammation of the thyroid gland

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16
Q

Which type of thyroiditis causes hypofunction?

A

Hashimoto’s

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17
Q

What kind of thyroiditis causes hyperfunction?

A

Graves disease

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18
Q

Hashimoto’s disease causes ___thyroidism.

A

hypothyroidism

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19
Q

Graves disease causes ___thyroidism.

Why?

A

hyperthyroidism

Disease stimulates thyroid gland

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20
Q

Autoimmune thyroiditis has a large ___ component.

A

genetic

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21
Q

What are some genes associated with autoimmune thyroiditis?

A

CTLA-4

PTPN-22

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22
Q

What state occurs as a result of excess thyroid hormone in hyperthyroidism?

A

Thyrotoxicosis

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23
Q

Apart from hyperthyroidism, what else can cause thyrotoxicosis?

A

Thyroiditis

Ectopic thyroid gland

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24
Q

What is the most common cause of hyperthyroidism?

A

Graves disease

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25
Apart from Graves disease, hyperthyroidism can also be caused by \_\_\_.
**tumours** of both thyroid and other organs e.g pituitary
26
Graves disease is more common in **(men / women)**.
**women**
27
What antibody is associated with Graves disease?
**TSH receptor antibodies**
28
What are the three main features seen in Graves disease?
**Hyperthyroidism** **Eye changes** **Pretibial myoxedema** (leg swelling)
29
What is the main cause of hypothyroidism?
**Hashimoto's thyroiditis**
30
As with Graves and other thyroid diseases, Hashimoto's thyroiditis mainly affects \_\_\_.
**women**
31
What are some other causes of hypothyroidism apart from Hashimoto's?
**Iodine deficiency** **Drugs** **Congenital** **Tumours**
32
Hashimoto's thyroiditis involves a **(sudden / gradual)** change in thyroid function.
**gradual failure**
33
Which autoantibodies are raised in Hashimoto's thyroiditis?
**Anti-PTO antibodies** (main ones) **Anti-thyroglobulin**
34
Which cells are responsible for autoimmune destruction of the thyroid gland in Hashimoto's thyroiditis?
**T lymphocytes**
35
Why are autoimmune thyroid conditions sometimes paradoxical?
**Often there are short periods of** HYPO in Graves **and** HYPER in Hashimoto's
36
What cancer are people with Hashimoto's thyroiditis at risk of?
**Non-Hodgkins lymphoma** of thyroid
37
What is a goitre?
**Enlargement of thyroid gland**
38
What commonly causes goitre?
**Iodine deficiency**
39
How do goitres occur in terms of iodine deficiency?
**Reduced T3 / T4 production** **Increased levels of TSH** **Thyroid enlargement**
40
Goitre is commonly associated with (hypo / hyperthyroidism).
**hypothyroidism**
41
What types of benign neoplasm can arise in the thyroid gland?
**Adenomas** - glandular tumours
42
Adenomas of the thyroid are derived from the ____ epithelium.
**follicular**
43
What type of **malignant neoplasm** arises in the thyroid?
**Carcinomas**
44
papillary follicular medullary - from c cells anaplastic - wild, poor prognosis
45
What do thyroid adenomas look like?
**Discrete** **Solid**
46
Benign thyroid adenomas are surrounded by a thick sheet of ___ which is well circumscribed.
**collagen**
47
Do thyroid adenomas function like normal thyroid tissue?
**Usually non-functional**
48
Are thyroid carcinomas common?
**No** 1.5% of all cancers
49
Most thyroid carcinomas come from the follicular epithelium. Where do medullary carcinomas come from?
**C cells**
50
What is the most common type of thyroid carcinoma?
Papillary carcinoma
51
What are some associations with a) papillary carcinoma b) follicular carcinoma?
**a)** Ionising radiation e.g Chernobyl disaster **b)** Iodine deficiency
52
**Papillary** carcinomas commonly spread through which system? What may you find on general examination?
**Lymphatic system** **Enlarged lymph nodes**
53
What symptoms do papillary carcinomas cause when enlarged?
**Hoarseness** **Dysphagia** **Cough** **Dyspnoea**
54
Onset of symptoms suggest a (basic / advanced) papillary carcinoma.
**advanced**
55
Papillary carcinomas usually have a (good / bad) prognosis.
**Good** 95% live beyond 10 years
56
What is the second most common thyroid cancer?
**Follicular carcinoma**
57
Do follicular carinomas spread via the lymphatic system?
**No, via bloodstream**
58
Which type of thyroid carcinoma is derived from C cells?
**Medullary carcinoma**
59
What type of thyroid tumour is extremely aggressive and is least common?
**Anaplastic carcinoma**
60
What is the mortality of anaplastic carcinoma?
**100%**

Endocrine Week 3 2017/18 (11 decks)

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