Endocrine Disorders Flashcards
Know autocrine, paracrine, endocrine
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Site of origin of the thyroglossal duct?
Foramen Caecum…part of the tongue
What is an ectopic thyroid or lingual thyroid?
A mass in the foramen caecum of the tongue. Most common in women.
What can a lingual thyroid lead to
Dysphagia, Dyspnea, Dysphonia….trouble swallowing, trouble breathing, etc
The problem with taking out a lingual thyroid is that that may be the only functioning thyroid tissue they have.
They’ll have hypothyroidism 70% of the time.
Thyroglossal duct cyst
Tends to cause repeat infection
Ectopic thyroid-substernal goiter may cause what
dyspnea, dysphagia, hyperthyroid, hypothyroid
Lateral Abberant Thyroid
Thyroid that rests in the lateral neck, sometimes in the lymph nodes.
In adults, what does lateral aberrant thyroid most commonly represent?
Metastatic follicular thyroid carcinoma
What are some other odd ball locations of ectopic thyroids?
Supra/infrahyoid thyroid
Struma Cordis- Ectopic thyroid tissue in the heart, usually rt. ventricle
KNOW THIS—- Struma ovarii
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
Symptoms/signs of Hyperthyroidism (Grave’s Dz)
eopthalmos (bulging eyes), NON-PITTING edema, wt. loss, fatigue, tachycardia, muscular weakness
Graves disease pathophys
TSH receptor antibodies attach to the TSH receptor and cause unending thyroid stimulation.
What causes the exopthalmos and shin edema
The antibodies binding to other tissue sites and causing increased glycosaminoglycan production
Thyroid histo in graves disease looks like?
hyperplastic…look for scalopped colloid and hyperplastic epithelium
Commonest cause of hypothyroidism in North America is?
Hashimoto thyroiditis
What is the principle defect in Hash?
T cell defect
Histology of Hash?
Looks like intense lymphocytic infiltration with tissue destruction and fibrosis.
Early hyperthyroidism
Hash….late= hypothyroidism
Most women tend to present later in the hypothyroid phase.
DeQuervain thyroiditis (subacute granulomatous thyroiditis)
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
Riedel Thyroditis
Fibrosis of the thyroid and other neck structures
Subacute Lymphocytic Thyroiditis
Also more frequent in women. NOT GRANULOMATOUS.
-more frequently post-partem
Miliary TB often ends up in the thyroid. Why?
It is highly vascularized (over a quarter of the circulation goes through the thyroid at some point.)
What is the definition of a goiter
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.