B8.058 Prework 2: Thyroid Gland Pathology Flashcards

1
Q

exogenous goitrogenic agents that cause hypothyroidism

A

calcium and fluorides in water

foods: cabbage, cassave, cauliflower, brussels sprouts, turnips

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2
Q

endemic cretinism

A

hypothyroidism in newborns and in infancy, esp in endemic areas (central africa, new guinea)

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3
Q

sporadic cretinism

A

agenesis or metabolic defects of the thyroid during infancy

iodine deficiency during intrauterine life and in infancy

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4
Q

what is myxedema

A

connective tissue accumulation in subcutaneous space

  • nonpitting
  • hard
  • NOT fluid (polysaccharides)
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5
Q

clinical presentation of Hashimoto’s

A

goitrous enlargment of the thyroid gland
midcourse - hyperthyroidism
long standing - hypothyroidism
F:M, 5:1

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6
Q

hashimoto on histo

A

thyroid gland starts looking like a lymph node

inflammatory cell infiltrate

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7
Q

pathogenesis of Hashimotos

A
type 2(ish) hypersensitivity
IgG autoAb against colloid and thyroid cells + autoreactive T cells
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8
Q

clinical course of inflammatory hypothyroidism conditions

A

De Quervains & Riedel’s

  • may be accompanied by pain in the neck and fever
  • initial hyperthyroidism, followed by a transient period of hypothyroidism
  • usually recover without treatment
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9
Q

histo of inflammatory hypothyroidism conditions

A

fibroblasts
lymphocytes
bands of collagen

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10
Q

cause of death in Graves

A

high output cardiac failure
-increased HR, atria don’t have time to fill
treat with B blockers (propranolol)

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11
Q

gross appearance of a thyroid w Graves

A

more than 2x normal weight

large, nodular appearing

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12
Q

Graves on histo

A

white areas where colloid is rapidly reabsorped (resorptive droplets)
this is due to rapid metabolism of colloid to produce T3 and T4

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13
Q

benign thyroid adenoma

A

solitary, discrete, small nodule (<4 cm)
usually a cold nodule
typically well circumscribed by a pseudocapsule
rarely a hot nodule

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14
Q

follicular adenoma on histo

A

glandular looking structures, follicular appearance
surrounded by capsule, separated from normal thyroid tissue
DOES NOT infiltrate capsule

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15
Q

epidemiology of papillary carcinoma

A

most common

70-80% of all malignant thyroid tumors

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16
Q

course of papillary carcinoma

A

indolent growth (psammoma bodies, calcification)
metastasis to local cervical lymph nodes
90-95% survival at 20 yrs

17
Q

histo of papillary carcinoma

A

papillary structures

cytological abnormalities

18
Q

course of follicular carcinoma

A

15-20% of thyroid cancers
distant metastasis via hematogenous spread
80-95% survival at 10 yrs

19
Q

histo of follicular carcinoma

A

invades pseudocapsule
infiltrating margin
washed out nuclei

20
Q

characterize medullary carcinoma or the thyroid

A

5-10% of thyroid malignancies
derived from parafollicular (C) cells
releases calcitonin and other peptides
part of MEN 2 syndrome > can screen for RET mutations

21
Q

histo of medullary carcinoma

A

stromal amyloid composed of altered calcitonin molecules
B-pleated sheets
large, clear cells

22
Q

medullary carcinoma prognosis

A

65-95% survival at 5 years

23
Q

characterize anaplastic carcinoma

A
2-7% of thyroid malignancies
most aggressive type of thyroid cancer
worst prognosis, 5 year survival < 5%
commonly invades trachea
grows fast af
24
Q

anaplastic carcinoma on histo

A

small blue cells with hemorrhage
DOESNT LOOK LIKE THYROID TISSUES
poorly differentiated