Endocrine Disorders

Question 1

Know autocrine, paracrine, endocrine

Answer 1

ok

Question 2

Site of origin of the thyroglossal duct?

Answer 2

Foramen Caecum…part of the tongue

Question 3

What is an ectopic thyroid or lingual thyroid?

Answer 3

A mass in the foramen caecum of the tongue. Most common in women.

Question 4

What can a lingual thyroid lead to

Answer 4

Dysphagia, Dyspnea, Dysphonia….trouble swallowing, trouble breathing, etc

Question 5

The problem with taking out a lingual thyroid is that that may be the only functioning thyroid tissue they have.

Answer 5

They’ll have hypothyroidism 70% of the time.

Question 6

Thyroglossal duct cyst

Answer 6

Tends to cause repeat infection

Question 7

Ectopic thyroid-substernal goiter may cause what

Answer 7

dyspnea, dysphagia, hyperthyroid, hypothyroid

Question 8

Lateral Abberant Thyroid

Answer 8

Thyroid that rests in the lateral neck, sometimes in the lymph nodes.

Question 9

In adults, what does lateral aberrant thyroid most commonly represent?

Answer 9

Metastatic follicular thyroid carcinoma

Question 10

What are some other odd ball locations of ectopic thyroids?

Answer 10

Supra/infrahyoid thyroid

Struma Cordis- Ectopic thyroid tissue in the heart, usually rt. ventricle

Question 11

KNOW THIS—- Struma ovarii

Answer 11

struma (term just applies to thyroid tissue) thyroid in the ovary. Not a true Ectopy (failure of thyroid to arrive in the right place)! Its a TERATOMA…a monodermal teratoma

May cause thyrotoxitosis, if a woman has thyrotoxicosis but a normal thyroid, may be due to strma ovariis

5% malignant

Question 12

Symptoms/signs of Hyperthyroidism (Grave’s Dz)

Answer 12

eopthalmos (bulging eyes), NON-PITTING edema, wt. loss, fatigue, tachycardia, muscular weakness

Question 13

Graves disease pathophys

Answer 13

TSH receptor antibodies attach to the TSH receptor and cause unending thyroid stimulation.

Question 14

What causes the exopthalmos and shin edema

Answer 14

The antibodies binding to other tissue sites and causing increased glycosaminoglycan production

Question 15

Thyroid histo in graves disease looks like?

Answer 15

hyperplastic…look for scalopped colloid and hyperplastic epithelium

Question 16

Commonest cause of hypothyroidism in North America is?

Answer 16

Hashimoto thyroiditis

Question 17

What is the principle defect in Hash?

Answer 17

T cell defect

Question 18

Histology of Hash?

Answer 18

Looks like intense lymphocytic infiltration with tissue destruction and fibrosis.

Question 19

Early hyperthyroidism

Answer 19

Hash….late= hypothyroidism

Most women tend to present later in the hypothyroid phase.

Question 20

DeQuervain thyroiditis (subacute granulomatous thyroiditis)

Answer 20

More common in women. Season peak in summer. Probably post-viral. Self-limited b/c it is not autoimmune.

Histo shows prominent Giant cell formation

Question 21

Riedel Thyroditis

Answer 21

Fibrosis of the thyroid and other neck structures

Question 22

Subacute Lymphocytic Thyroiditis

Answer 22

Also more frequent in women. NOT GRANULOMATOUS.

-more frequently post-partem

Question 23

Miliary TB often ends up in the thyroid. Why?

Answer 23

It is highly vascularized (over a quarter of the circulation goes through the thyroid at some point.)

Question 24

What is the definition of a goiter

Answer 24

a chronic enlargement of the thyroid gland, not due to neoplasm, occuring endemically in certain locations. Especially regions where the soil is low in iodine and sporadically elsewhere.