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Endo - Meg Deck > Endo II - Thyroid Disorders > Flashcards

Endo II - Thyroid Disorders Flashcards

1
Q

bradycardia, HTN
cold intolerance
constipation
anaemia
carpel tunnel syndrome
dry skin, delayed DTR
myxoedema

A

hyperthyroidism

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2
Q

TSH high
fT4 low
fT3 low/n

A

primary hypothyroidism (thyroid gland)

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3
Q

TSH low
fT4 low
T3 low

A

secondary / tertiary hypothyroidism (pituitary)

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4
Q

TSH normal
T4 normal
T3 decreased
associated with acute illness

A

Euthyroid sick syndrome
T4 not converted to T3
associated with cytokines; IL-1, IL-6, TNF-a, IFN-b

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5
Q

child
iodine deficiency
thyroid hypoplasia
pale, puffy face
protruding umbilicus
poor brain development
protuberant tongue
pot bellied

A

congenital hypothyroidism - Cretinism

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6
Q

hashimotos thyroiditis is type ____ hypersensitivity

A

type 4 HS

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7
Q

What are the 3 phases of hashimitos thyroiditis

A

thyrotoxic phase
hypothyroid phase
euthyroid phase

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8
Q

damage to follicular cells, release colloid
increased T3, T4
decreased TSH

A

Thyrotoxic phase - hashimoto thyroiditis

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9
Q

last 2-8 weeks
permanent subacute granulomatous thyroiditis
low T3, T4
high TSH

A

hypothyroid phase - hashimoto thyroiditis

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10
Q

what antibodies are seen in hashimoto thyroiditis

A

thyroid peroxidase (TPOAb)
thyroglobulin (TgAb)
antimicrosomal Ab

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11
Q

low T3
high TSH
anti-TPOAb (+)
anti-TgAb (+)
painless diffuse thyroid enlargement
lymphocytic infiltration
Hurthle cells

A

hashimoto thyroiditis

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12
Q

complications of hashimoto thyroiditis

A

hashitoxicosis
increased risk B cell lymphoma
myxoedema coma

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13
Q

severe hypothyroidism
Decreased CNS
Hypothermia
Bradycardia
Hyponatraemia
Hypoglycaemia
Hypotension
Precipitating illness

A

myxoedema coma
(hypothyroidism)

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14
Q

iodine induced hypothyroidism
excess iodine - inhibited organification
normal thyroid function
escape phenomena present

A

Wolf-Chaikoff effect

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15
Q

iodine induced hyperthyroidism
iodine deficient hypothyroidism
increased iodine exposure - excessive hormone sythesis
not occur in euthyroid individuals

A

Jod-Basedown phenomenon

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16
Q

tremor, tachycardia, anxiety, HTN, weight loss
hyperdefecation
warm, smooth skin
hyperpigmentation
heat intolerance, normo-anaemia, oligo-amenorrhoea
madarosis (eyebrows)

A

hyperthyroidism

17
Q

low/absent
Radioactive iodine uptake seen in:

A

hasimoto thyroiditis
thyroid drug ingestion

18
Q

high/normal
radioactive iodine uptake seen in:

A

Graves disease
toxic adenoma
toxic multinodular goiter

19
Q

focal, high uptake RIU

A

toxic adenoma

20
Q

diffuse high uptake RIU

A

Graves disease

21
Q

female
diffuse goitre
exophthalmos
dry eyes, lig lag
myxoedema

A

graves disease

22
Q

Graves disease is type ____ hypersensitivity

A

type 2 HS

23
Q

what is the pathogenesis of Grave disease

A

autoimmune
auto-AB (IgG) against TSH receptor

24
Q

haplotypes HLA-B8 and DR3 associated with

A

Graves disease

25
Q

diffuse symmetric
enlarged meaty appearance thyroid gland

A

Graves disease

26
Q

pseudopapillary infolding
scalloping of colloid
hyperplastic follicular cells

A

Graves disease

27
Q

process behind exophthalmos

A

activated B/T cell infiltrate –>
TNF-a, IFN-y inflammatory response –>
fibroblast proliferation, adipocyte differentiation –>
production hyaluronic acid & GAG –>
increased volume intraorbital fat & muscle tissue –> exophthalmous

28
Q

hyperthyroidism
goitre
dysphagia, dyspnoea
multinodular
arely assoc. eye signs

A

toxic multinodular goitre

29
Q

female
30-50yo
following viral infection or drug use (lithium/amiodorone)
transient pathcy inflammation of thyroid gland

A

subacute thyroiditis

30
Q

2 types of subacute thyroiditis

A

subacute granulomatous thyroiditis (de Quervains)
subacute lymphocytic thyroidits

31
Q

treatment of subacute thyroiditis

A

NSAIDS
steriods if severe

32
Q

follows viral URTI
CD8 T cells damage follicles
colloid leakage & macropahe infiltrate
severe neck pain - radiate to ear/jaw
inflammatory infiltrate - multinucleated giant cells, disruptive follcies

A

de Quervains
subacute granulomatous thyroiditis

33
Q

inherited
HLA-DR3, HLA-DR5
painless, silent
lymphocytic infiltration
sparse germinal centres

A

subacute lymphocytic thyroiditis

34
Q

thyroid dysfunction within first year post-partum

A

post-partum thyroiditis

35
Q

goitre - iron collar
stony hard fibrosis
tan-grey woody thyroid
fibrosclerotic changes
pathcy lymphocytic & eosinophilic infiltration

A

Riedel syndrome

36
Q

what thyroid condition can mimic anaplastic carcinoma

A

Riedel syndrome

37
Q

acute onset
aggitation, delirium
fever, coma
diarrhoea, Afib, high output HF
upregulation B1-adrenergic receptors
low TSH, high T3/T4
recent stresor - infection, surgery, withdrawal antithyroid drugs

A

thyroid storm
life threatening hypermetabolic state

Endo - Meg Deck (11 decks)

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