Endocrine Pathology 2 Flashcards
functional thyroid diseases
Euthyroid sickness syndrome
hyperthyroidism
hypothyroidism
What are the congenital thyoid diseases
Throglossal duct cyst
-throid aplasia
Anatomical thyroid diseases
Goiters
Thyroid nodules
Thyroid cancer
What is goitre and main cause
Enlargement of the thryroid gland
-due to iodine def
pathology of sporadic goiter
- female predominance; young adults
- Low levels of thyroid hormones-> increased level of TSH-> TSH-> hyperplasia and hypertrophy of follicular cells
Mc condition fo hyperthyroidism
Graves disease, Toxic goiter
-hyperthyroidism increases the basal metabolic rate and increaes the organs sensitivity to catechlamies
Pathogenesis of Graves disease
Production of anti TSH receptor antibody that stims the receptor, resulting in increased prod of T3/4
thyroid gland itself is diffusely enlarged but not nodular
some mc s/s of graves disease
exophthalmos- protrusion of eye due to retro orbital soft tissue
Pretibial myxedema- scaling and thickening of dermis`
what is a major complication of hyperthyroidism and cause. pres
Thyroid storm (abrupt onset of severe hyperthyroidism)
cause- Secondarily increase levels of catecholamines due to surgery and acute infection
clinical pres- hyperthermia out of proportion, fever, flushing, sweating etc
Hypothyroidism major signs, 2 causes
decreased metabolic rate
-weight gain, cold intolerance, cool skin, thinning hair
Cretinism + myxedema
Lab findings for primary hypothyroidism and secondary hypothyroidism
primary- increased TSH-> body is trying to increase thyroid hormones
Secondary- Decreased TSH-> decreased T3/4
What is cretism
hypothyroidism occurring during infancy/childhood
What is myxedema and causes
Hypothyroidism occurring in older children + adults
Causes
-Hashimoto thyroditis, iodine def and idiopathic
What is myxedema coma
severe complication of hypothyroidism occurring mostly in older pts.
Characterized by altered mental status with or without coma
-Altered mentation, hypothermia, hypotension
Hashimoto thyroiditis pathogenesis, diagnosis
primary hypothyroidism
-inflammatory autoimmune destruction of the thyroid
Dx- high TSH, antithyroid peroxidase, ant-thyroglobulin antibodies in 90% of cases
What is thyroiditis and two types
inflammation of the thyroid gland
- acute syppurative thyroiditis
- Subacute thyroiditis (associated w HLA B35)
what are the 5 common types of thyroid neoplasms
Papillary carcinoma follicular adenoma follicular carcinoma medullary carcinoma anapaestic carcinoma
epidemiology and look of follicular adenoma and carcinoma
older pts.
Capsular invasion or blood vessel invasion distinguishes a follicular carcinoma from follicular adenoma
-not multifocal
Medularry thyroid carcinoma- epidemiology, what does it mc produce
occurs in pts older than 50
-mc produces hormones-> mc calcitonin
What is a anapaestic carcinoma and important points on it
Older pts
Very rapidly growing, highly malignant, poor prog
increase in PTH stims increase in calcium via what 3 ways
increased bone resorption
increased renal resorption of calcium
increased synthesis of calcitriol (stims go to increase calc resorption)
complications of primary hyperparathyroidism
Osteiits fibrosa cystica
Brown tumor
Nephrolithiasis (kidney stones)
What is secondary hyperparathyroidsism due to result
Normal parathyroid gland histological and morphologically, however parathyroid gland is producing increased PTH in response to hypocalcemia
causes: renal failure, vit d def
What is tertiary hyperparathyroidism
tertiary hyperparathyroidism is secondary that becomes automous
-no longer requires the stim of renal failure to undergo hyperplasia
