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Endocrine > Path Thyroid > Flashcards

Path Thyroid Flashcards

Describe the clinicopathologic features of the inflammatory thyroid disorders (acute, granulomatous, Hashimoto, lymphocytic, Reidel thyroiditis) Compare and contrast the causes of thyroid enlargement (goiter) Compare and contrast the clinicopathologic features of the most common tumors of the thyroid (papillary, follicular, medullary and anaplastic) Describe the pathologic causes and clinical findings in Graves Disease

1
Q

signs of hyperthyroidism

A

soft warm skin, heat intolerence, weight loss despite appitite, diarrhea, heart palp, proximal muscle weakness, wide-eyed staring gaze,

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2
Q

caused by actute elevation of catecholine levels, usually by underlying Graves disease

A

thyroid storm

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3
Q

blunted sx of thyrotoxicosis in elderly

A

Apatheric hyperthyroidism

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4
Q

most useful single screening test for hyperthyroidism

A

TSH levels

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5
Q

TSH levels in pituitary/hypothalamic secondary hyperthyroidism

A

elevated

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6
Q

whole-gland uptake of radioactive iodine indicates

A

Graves

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7
Q

decreased uptake of radioactive iodine indicates

A

thyroiditis

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8
Q

increased nodular uptake of radioactive iodine indicates

A

toxic adenoma

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9
Q

hypothyroidism in infancy or early childhood

A

cretinism

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10
Q

impaired development of skeletal and CNS with severe MR, short stature, protuding tounge and umbilical hernia

A

cretinism

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11
Q

hypothyroidism in older children and adults

A

myxedema

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12
Q

generalized apathy and mental sluggishness, listless, cold-intolerent and gaining weight, and edema

A

myxedema

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13
Q

risk in late stage myxedema

A

Heart failure

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14
Q

most sensitive test for suspected hypothyroidism

A

serum TSH (increased)

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15
Q

most common cause of hypothyroidism when iodine levels are ok

A

hashimotos

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16
Q

gradual hypothyroidism in woman 45-60

A

hashimotos

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17
Q

gradual autoimmune thyroid failure

A

hashimotos

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18
Q

pathenogenesis of hashimotos

A

autobodies against thyroid antigens deplete epithelial cells in thyroid and replace with fibrosis

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19
Q

most significant gene defect in hashimtos

A

CTLA4

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20
Q

mononuclear inflammatory infiltrate with well developed germinal centers and atrophic follicles. Cells with numerous prominent mitochondria

A

hashimotos

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21
Q

hurthle/oxyphill cells

A

hashimotos

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22
Q

risk of other diseases with hashimotos

A

other autoimmune diseases and B cell lymphoma arising in the thyroid gland

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23
Q

rarer thyroidism in women 30-50

A

subacute granulmatous thyroiditis

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24
Q

thyroiditis triggered by viral infections

A

subacute granulmatous thyroiditis

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25
Q

enlarged thyroid with disruption of folicles leading to inflammatory cells

A

subacute granulmatous thyroiditis

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26
Q

pain in the neck while swallowing, fever and malaise after viral infection

A

subacute granulmatous thyroiditis

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27
Q

painless neck mass and hyperthyroidism with lymphocytic inflammation

A

subacute lymphocytic thyroiditis

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28
Q

subacute granulmatous thyroiditis often occurs after

A

pregnancy

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29
Q

hyperthyroidism, eyes bugging out, and pretibial myxedema

A

Graves Disease

30
Q

most common cause of endogenous hyperthyroidism

A

Graves Disease

31
Q

peaks in women between 20-40

A

Graves disease

32
Q

antigen occuring in Graves

A

HLA DR3

33
Q

Graves antibodies attack

A

TSH receptors

34
Q

autoantibodies created in Graves

A

Thyroid stimulating immunoglobulin
Thyroid growth-stimulating immunoglobulins
TSH-binding inhibitor immoglubulins

35
Q

causes the eye bulging in Graves

A

infiltration of T cells in retroorbital spaces
inflammatory edema and swelling in extraocular muscles
accumulation of hyaluronic acid and chrondrotin sulfate
increased number of adipocytes behind eyes

36
Q

diffuse hypertrophy and hyperplasia of thryroid follicular epithelial cells with crowded follicular epithelial cells projecting into the follecular lumen. Pale colloid and lypmocytic infiltrates

A

Graves

37
Q

difference between Graves and papillary carcinoma

A

graves has papillae WITHOUT fibrovascular cores

38
Q

elevated T4 and T3, depressed TSH with diffuse uptake of iodine

A

graves

39
Q

cause of endemic of goiter

A

living in a area with low iodine in food supply

40
Q

cause of sporadic goiter

A

excessive calcium, cabbage-like veg, or hereditary enzymatic defects in thyroid hormone defects

41
Q

when to worry about a goiter turning malignant

A

sudden change in size, hoarseness

42
Q

instances when thyroid nodules are more likely to be cancerous

A

solitary, nodules, nodules in younger patients, nodules in males, hx of radiation, nodules that take up a lot of iodine

43
Q

definitive test for thyroid malignancy

A

FNA + histologic study of surgically resected thyroid parenchyma

44
Q

adenomas derived from

A

follicular epithelium

45
Q

most common thyroid carcinoma

A

papillary

46
Q

most thyroid carcinomas arise frome

A

thyroid epithelium

47
Q

most common oncogenic pathway in papillary thyroid carcinomas

A

MAP kinase

48
Q

protein found in most papillary thyroid carcinomas

A

RET/PTC

49
Q

RET/PTC or BRAF should point to

A

papillary thyroid carcinomas

50
Q

mutation in follicular thyroid carcinomas

A

PI-3K/AKT

51
Q

translocation in follicular thyroid carcinomas

A

q13;p25

52
Q

highly aggressive and lethal thyroid tumor

A

anaplastic carcinoma

53
Q

arise from parafollicular C cells

A

medullary thyroid carinomas

54
Q

medullary thyroid carinomas occur in what genetic syndrome

A

MEN-2

55
Q

mutation associated with MEN-2

A

RET

56
Q

environmental risks in thyroid cancer

A

ionizing radiation and iodine deficnecy

57
Q

ground glass nuclei with pseudoinclusions

A

papillary carcinomas

58
Q

psammoma bodies

A

papillary carcinomas

59
Q

empty appearing “orphan annie” nuclei

A

papillary carcinomas

60
Q

nonfunctional tumor presenting with painless mass or cervical lymph node

A

papillary carcinomas

61
Q

thyroid carcinoma presenting most in older women

A

follicular carcinomas

62
Q

more frequent thyroid carcinoma in iodine def, areas

A

follicular carcinoma

63
Q

carcinoma with solitary cold thyroid nodues

A

follicular carcinomas

64
Q

thyroid that mets easily through bloddstream

A

folliciular carcinoma

65
Q

thyroid cancer associated with older pts and hx of previous well-differentiated carcinomas

A

anaplastic

66
Q

large pleomorphic cells, spindle cells

A

anaplastic

67
Q

prognosis with anaplastic carcinoma

A

dead within a year

68
Q

derivation of medularry carcinomas

A

parafollicular/C cells

69
Q

secrete calcitonin

A

medullary carcinoma

70
Q

genetic syndrome often in medularry carcinomas

A

MEN2

71
Q

amyloid depoits and multicentric C cell hyperplasia

A

medullary carcinoma

72
Q

dyphagia, hoarseness, possible diarrhea

A

medullary carcinoma

Endocrine (13 decks)

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