Pathology IV Flashcards
What are the clinical findings in a patient with subacute thyroiditis (de Quervain’s)?
Elevated ESR, jaw pain, early inflammation, very tender thyroid (p.298)
What is the pathology associated with Riedel’s Thyroiditis?
Thryoid is replaced by fibrous tissue (hypothyroid). It is considered a manifestation of IgG4 related systemic disease (p.298)
What are the clinical findings in a patient with Riedel’s Thyroiditis?
Fixed, hard (rock-like), and painless goiter (p.298)
Name five causes of hypothyroidism that are not associated with a specific disease or syndrome.
Congenital hypothyroidism, iodine deficiency, goitrogens, Wolff-Chaikoff effect, painless thyroiditis (p.298)
What are the three most common causes of hyperthyroidism?
Toxic multinodular goiter, Graves’ disease, thyroid storm (p.299)
What is the pathology associated with Toxic multinodular goiter?
Mutation in TSH receptor causing focal patches of hyperfunctioning follicular cells working independently of TSH. Hot nodules are rarely malignant (p.299)
What lab finding is consistent with toxic multinodular goiter?
Increased release of T3 and T4 (p.299)
What is the Jod-Bassedow phenomenon?
Thyrotoxicosis in a patient with an iodine deficiency goiter who is given significant amounts of iodine (p.299)
What is the pathology associated with Graves’ Disease?
Autoimmune hyperthyroidism with thyroid stimulating immunoglobulins. It often presents during stress (childbirth, etc) (p.299)
What are the clinical findings in a patient with Graves’ disease?
Opthalmopathy (proptosis, EOM swelling), pretibial myxedema, increased connective tissue deposition, diffuse goiter (p.299)
What is characteristic in histology of a multinodular goiter?
Follicles distended with colloid and lined by flattened epithelium with areas of fibrosis and hemorrhage (p.299)
What are the five cancers of the thyroid?
Papillary carcinoma, follicular carcinoma, medullary carcinoma, undifferentiated/ anaplastic, lymphoma (p.299)
Which thyroid cancer is the most common and has the best prognosis?
Papillary carcinoma (p.299)
What increases risk of papillary carcinoma of the thyroid?
Childhood irradiation (p.299)
What is characteristic of the histology of papillary carcinoma of the thyroid?
Empty appearing (orphan Annie’s eyes), psammoma bodies, nuclear grooves (p.299)
What is characteristic of the histology of follicular carcinoma of the thyroid?
Uniform follicles; it has a good prognosis (p.299)
What is medullary carcinoma of the thyroid derived from?
Parafollicular ‘C-Cells’ (p.299)
What conditions are associated with medullary carcinoma of the thyroid?
MEN types 2A and 2B (p.299)
What is characteristic in histology of medullary carcinoma of the thyroid?
Sheets of cells in amyloid stroma (p.299)
What do medullary carcinomas of the thyroid produce?
Calcitonin (p.299)
What demographic patient group is most likely to have undifferentiated/anaplastic thyroid cancer and what is its prognosis?
Older patients; has a very poor prognosis (p.299)
What condition presidposes patients to lymphoma of the thyroid?
Hashimoto’s thyroiditis (p.299)
What causes primary hyperparathyroidism?
Usually an adenoma (p.300)
What lab findings are consistent with a diagnosis of primary hyperparathyroidism?
Hypercalcemia, hypercalcuria (renal stones), hypophosphatemia, increased PTH, increased alkaline phosphatase, increased cAMP in urine (p.300)
What is the most common presentation in a patient with primary hyperparathyroidism?
Often asymptomatic. May present with weakness and constipation (p.300)
What is osteitis fibrosa cystica?
A condition where cystic bone spaces are filled with brown fibrous tissue. This causes bone pain (p.300)
