Non Neoplastic Thyroid disease Flashcards

1
Q

Ectopic or pathologic thyroid may seen anywhere along what pathway in adult life?

A

thyroglossal duct

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2
Q

Where does the thyroglossal duct begin?

A

Foramen cecum

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3
Q

Where is lingual thyroid?

A

Mass in foramen cecum of tongue

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4
Q

How may lingual thyroid present?

A

dysphagia, dyspnea, dysphonia

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5
Q

Is lingual thyroid rare or common?

A

Rare, but the most common location of functioning ectopic thyroid

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6
Q

Does lingual thyroid present in the presence or absence of cervical thyroid?

A

70% associated with abscence of thyroid

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7
Q

Where does thyroglossal duct cyst usually present?

A

midline between isthmus and hyoid

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8
Q

When does thyroglossal duct cyst usually present?

A

At birth or childhood

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9
Q

What risks are present with thyroglossal duct cyst usually present?

A

repeated infection. Big ones can cause obstruction

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10
Q

Are thyroglossal duct cysts hormonally active?

A

No

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11
Q

Describe substernal goiter. What is it? How does it present?

A

thyroid tissue that has “dropped” into anterior mediastinum; seen with cervical goiter.
May be symptomatic (dyspnea, dysphagia, hyperthyroid, hypothyroid) or not

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12
Q

A lateral aberrant thyroid is more likely to be what?

A

metastatic follicular thyroid carcinoma

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13
Q

Describe suprahyoid/infrahyoid thyroid?

A

Similar location to thyroglossal duct cyst. Often hypothyroid with absent cervical thyroid.

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14
Q

Describe struma cordis

A

Ectopic thyroid tissue in heart, usually right ventricle. Usually functions and is usually found by accident.

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15
Q

What is struma ovarii?

A

Monodermal teratoma of ovary, composed mainly (>50%) of adult thyroid tissue

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16
Q

Struma ovarii may functionally cause ____.

A

thyrotoxicosis

17
Q

How might struma ovarii presents?

A

woman with labs showing thyrotoxicosis but normal thyroid on exam, may be small

18
Q

Is struma ovarii malignant?

A

Adenomas are common, only 5% are malignant

19
Q

What hormonal changes are associated with early/late Hashimoto’s?

A

Early: hyperthyroid
Late: hypothyroid

20
Q

T or F. 85% of hyperthyroidism is associated with diffuse hyperplasia with Grave’s.

A

T

21
Q

How may someone with Grave’s present?

A

exopthalmos, non-pitting edema, fatigue, weight loss, increased appetite, tachycardia, muscular weakness

22
Q

Pathophys of Grave’s disease

A

Immune mediated production of TSH receptor antibodies that cause thyroid stimulation without negative feedback. Binding of Ab to other tissues causes increased GAGs with resultant tissue effects (exopthalmos, myxedema)

23
Q

How does Grave’s look on histo?

A

Hyperplastic, too many cells, heaped up epi looking like papillary, scalloped colloid due to vacuoles from increased colloid turn over

24
Q

_____ is the most common cause of hypothyroidism in north america. _____ is most common world wide.

A

Hashimotos; iodine insufficiency

25
Q

What is the automimmune etiology of Hashimotos?

A

T cell defect

26
Q

Epidemiology of Hashimoto’s

A

F:M 10:1-20:1

27
Q

Hashimoto thyroiditis on histo

A

There is intense lymphocytic infiltration with tissue destruction and early fibrosis

28
Q

What is subacute thyroiditis? Epidemiology, pathophys, etc…

A

Also known as DeQuervain thyroiditis
F:M is 3:1 to 5:1; season peak in summer
Probably a postviral inflammatory process
Not autoimmune, therefore self limited
Mixed inflammatory reaction with prominent giant cell formation.

29
Q

Describe subacute lymphocytic (painless) thyroiditis

A

More common in females, without granulomas or giant cells, can be postpartum, may have HLA susceptiblity genes, could be a sub-acute hashimotos

30
Q

Describe Riedel thryoiditis

A

Unusual disorder of unknown cause
Characterized by fibrosis of thyroid and other neck structures
Fibrosis in distant sites (retroperitoneum) may be seen. Can be confused with cancer.

31
Q

Define goiter

A

A chronic enlargement of the thyroid gland, not due to a neoplasm, occurring endemically in certain locations, especially regions where glaciation occurred and the soil is low in iodine, and sporadically elsewhere.

32
Q

What is an endemic goiter?

A

Occurs in areas where the enviorment is low in naturally occurring iodine. Other causative factors lead to incomplete expression. Starts as diffuse enlargement but generally progress to multinodular state

33
Q

What may a big mutlinodular goiter look like grossly?

A

encase trachea, focally fibrotic and hemorrhagic suggesting multiple episodes of proliferation, hemorrhage, regression, and fibrosis

34
Q

What may a colloid nodule look like histologically?

A

internal regression with cyst formation. Band of fibrosis separates nodules.