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USMLE > DIT XVI: Endocrine > Flashcards

DIT XVI: Endocrine Flashcards

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USMLE® Step 1 flashcards
1
Q

Name given to thyroid hormone-secreting teratoma

A

Struma ovarii

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2
Q

S&S of hypothyroidism

A

wt gain, cold intolerance, constipation, lowering of voice, menorrhagia, slowed mental & physical fxn, dyr skin with coarse brittle hair, reflexes showing slow return ohase, facial/periorbital myxedema

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3
Q

Myxedema of hyper vs hypothyroidism

A

Hyperthyroidism: pretibial myxedema
Hypothyroidism: facial/periorbital myxedema

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4
Q

Rx for hypothyroidism

A

Levothyroxine (synthetic T4 analogue), triiodothyronine (T3)

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5
Q

Causes of cretinism

A

Iodine-deficient diet (in mom or baby). thyroid-related enzyme def, thyroid develop’tl defect, failure of thyroid descent, transfer of anti-thyroid Abs during gestation

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6
Q

Clinical findings in congenital hypothyroidism

A

Cretinism = “6 P’s”: Pot-bellied, Pale, Puffy-faced, Protruding umbilicus, Protuberant tongue, Poor brain develop’t

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7
Q

Painless vs painful goitre

A

Painless: Hashimoto’s thyroiditis, Riedel’s thyroiditis
Painful: Subacute (de Quervain) thyroiditis

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8
Q

Dx test for Hashimoto’s thyroiditis

A

antithyroglubulin, antithyroid peroxidase Abs

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9
Q

Genes assoc with Hashimoto’s thyroiditis

A

HLA-DR5, HLA-B5

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10
Q

What cancer is associated with Hashimoto’s thyroiditis

A

B-cell lymphoma

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11
Q

What diseases are associated with Hashimoto’s thyroiditis?

A

DM, pernicious anemia, Sjogrens

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12
Q

Most common type of thyroid cancer

A

Papillary carcinoma

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13
Q

Second most common type of thyroid cancer

A

Follicular carcinoma

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14
Q

Thyroid cancer assoc with activation of receptor tyrosine kinases

A

Papillary and medullary carcinomas

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15
Q

Cancer arising from parafollicular C cells

A

Medullary carcinoma

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16
Q

Thyroid cancer commonly assoc with either RAS mutation or PAX8-PPAR gamma I rearrangement

A

follicular carcinoma

17
Q

Thyroid cancer commonly assoc with rearrangments in RET oncogene or NTRKI

A

papillary carcinoma

18
Q

Thyroid cancer associated with mutation in BRAF gene (serine/threonine kinase)

A

papillary carcinoma

19
Q

MOA of propylthiouracil (PTU)

A

Inhibits peroxidase and 5’-deiodinase: blocks addition of iodide onto tyrosine groups of thyroglobulin, decreases periph conversion of T4 –> T3

20
Q

ADRs of propylthiouracil and methimazole

A

rash, agranulocytosis, aplastic anemia

21
Q

MOA of methimazole

A

Inhibits peroxidase: blocks addition of iodide onto tyrosine groups of thyroglobulin

22
Q

Risk factor for subacute (de Quervain) thyroiditis

A

recent viral infection: cocksackievirus, measles, mumps, etc

23
Q

Findings in subacute (de Quervain) thyroiditis

A

painful goitre, fever, focal destruction with granulomatous inflammation, raised ESR

24
Q

Findings in Riedel’s thyroiditis

A

Macrophages, eosinophils, painless goitre, fibrous tissue that can extend into airway (can mimic anaplastic carcinoma)

25
Q

“Orphan Annie eye”

A

empty appearing nucleus, associated with papillary carcinoma of thyroid

26
Q

Histological findings in papillary carcinoma of thyroid

A

“Orphan Annie eye”, psammoma bodies, nuclear grooves

27
Q

Risk factors for papillary carcinoma of thyroid

A

RET & BRAF mutations, childhood irradiation, NTRK1

28
Q

Follicular carcinoma vs follicular adenoma of thyroid

A

Carcinoma: invades thyroid capsule
Adenoma: doesn’t go through fibrous capsule

29
Q

Mode of spread of follicular carcinoma of thyroid

A

Hematogenous spread

30
Q

Risk factors for follicular carcinoma of thyroid

A

RAS mutation, PAX8-PPAR gamma 1 mutation

31
Q

Findings in medullary carcinoma of thyroid

A

increased calcitonin, sheets of cells in amyloid stroma

32
Q

Risk factors for medullary carcinoma

A

MEN2A & 2B (RET mutations)

33
Q

Complications of thyroidectomy

A

Damage to parathyroid glands (decr Ca2+) and recurrent laryngeal nerve (hoarseness)

34
Q

Enlarged thyroid cells with ground glass appearance

A

“Orphan Annie” eye nuclei (papillary carcinoma)

USMLE (23 decks)

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