Parathyroid hormone and other thyroid issues Flashcards

1
Q

Most common type of thyroid carcinoma?

A

Papillary (makes up 80%)
Then follicular (10-20%)
Then medullary (5%)
Then anaplastic<5%

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2
Q

Who gets papillary thyroid carcinomas?

A

Usually women between the age of 35-45.

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3
Q

Risk factor for papillary thyroid carcinoma?

A

Ionising radiation as a child

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4
Q

Histology of papillary thyroid carcinoma?

A

Comprised of papillae lined by cells with clear, orphan Annie eye nuclei and nuclear grooves.
Associated with psammona bodies.

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5
Q

Prognosis of papillary thyroid carcinoma?

A

Often spreads by cervical lymph nodes but prognosis is excellent
10 year survival >90%

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6
Q

Follicular carcinoma histology?

A

Malignant proliferation of follicles surrounded by a fibrous capsule with invasion through the capsule.

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7
Q

How would you distinguish between follicular adenoma and follicular carcinoma?

A

The invasion through the capsule wall is characteristic of carcinoma.

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8
Q

Investigations into follicular carcinoma?

A

Carcinoma must be examined microscopically. FNA only takes cells and therefore you cannot distinguish between adenoma and carcinoma.

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9
Q

How does follicular carcinoma metastasise?

A

via blood.

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10
Q

Describe a follicular adenoma?

A

Benign proliferation of follicles surrounded by a fibrous capsule. Usually non-functional.

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11
Q

Describe a medullary carcinoma?

A

Malignant proliferation of parafollicular C cells. Associated with MEN.
Calcitonin often deposits in the tumour as amyloid.

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12
Q

What do C cells secrete?

A

Calcitonin.

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13
Q

What does calcitonin do?

A

Lowers serum calcium.

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14
Q

Describe an anaplastic carcinoma?

A

Undifferentiated malignant tumour of the thyroid. Usually in the elderly.

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15
Q

How do anapaestic carcinomas usually present?

A

Often by invading local structures causing dysphagia.

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16
Q

Prognosis of anaplastic carcinoma?

A

POOR

17
Q

What is myxoedema coma?

A

Typically affects old ladies with long standing unrecognised or untreated hypothyroidism.
ECG- bradycardia
-low voltage complexes
varying degrees of heart block

Type 2 respiratory failure

18
Q

Treatment of myxoedema coma?

A

ABCDE
Passively rewarm- aim for slow rise in body temp
Monitoring- fluids- broad spectrum AB

19
Q

What is thyroid storm?

A

Medical emergency almost always caused by graves disease.
Severe hyperthyroidism- respiratory and cardiac collapse
-hyperthermia
-exaggerated reflexes
-may require ventilation
-could be associated with underlying infection

20
Q

Treatment of thyroid storm?

A

Fluid resus if dehydrated
Give propanolol (beta blockers)
Lugois iodine
Glucocorticoids

21
Q

What can amiodarone induce?

A

Thyrotoxicosis-occurs more frequently in areas with low iodine intake.
hypothyroidism- high iodine intake

22
Q

What cells are the parathyroid glands composed of?

A

Chief cells- secrete PTH.