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endocrine > pathology of thyroid > Flashcards

pathology of thyroid Flashcards

1
Q

what are some embryological abnormalities of thyroid

A
  • failure of descent
  • excessive descent
  • thyroglossal duct cyst
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2
Q

what is the thyroid composed of

A

lobules

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3
Q

what is in the centre of each follicle

A

dense amorphous pink material containing thyroglobulin

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4
Q

thyroid function

A
  • TRH from hypothalamus stimulates release of TSH from cells in anterior pituitary gland.
  • TSH binds to TSH receptor on surface of thyroid epithelial cells.
  • G proteins activated with conversion of GTP to GDP and production of cAMP.
  • cAMP increases production and release of T3 and T4.
  • T3 and T4 circulate in bound and free forms
  • On release T3 and T4 bind to receptor in target cells
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5
Q

what comes under thryoiditis

A

hypo and hyperthyroidism

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6
Q

what autoimmune disease presents with hypofunction

A

hashimoto thyroiditis

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7
Q

what autoimmune disease presents with hyperfunction

A

grave’s disease

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8
Q

which genes are involved in autoimmune thyroiditis

A
  • CTLA-4

- PTPN-22

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9
Q

which haplotype is autoimmune thyroiditis associated with

A

HLA

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10
Q

what is Hashimoto’s thyroiditis

A

gradual destruction of thyroid tissue

  • 45-60yrs
  • genetic
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11
Q

what is present in Hashimoto’s that characterises it

A

anti-thyroid antibodies

-CD8 +ve T cells may mediate destruction of thyroid epithelium

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12
Q

signs of hashimoto’s

A
  • thyroid may be enlarged
  • prominent lymphoid infiltrate
  • thyroid follicles atrophy
  • may see progressive fibrosis
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13
Q

what are symptoms and signs due to in hypothyroidism

A

low levels of T3 and T4

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14
Q

who usually gets hashimoto’s

A

middle aged women

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15
Q

other causes of hypothyroidism

A
  • iodine deficiency
  • drugs
  • post therapy
  • congenital abnormalities
  • in born errors of metabolism
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16
Q

what may hashimoto’s be preceded by

A

transient hyperfunction

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17
Q

what are people with hashimotos at increased risk of

A
  • other autoimmune disease

- B cell NHL in the thyroid gland (lymphoma)

18
Q

what antibodies are present in Grave’s disease

A
  • antibodies to TSH receptor, thyroid peroxisomes and thyroglobulin
  • anti TSH receptor antibodies
19
Q

what are symptoms due to in hyperthyroidism

A

excess T3 and T4

20
Q

other causes of hyperthryoidism

A
  • thyroiditis
  • ectopic production
  • Factitious
21
Q

features of Grave’s

A
  • Hyperthyroidism with diffuse enlargement of the thyroid
  • Eye changes (exophthalmos)
  • Pretibial myxoedema.
22
Q

what is Goitre

A

any enlargement of the thyroid gland

23
Q

what causes Goitre

A

-reduced T3/T4 production which causes rise in TSH, stimulating gland enlargement

24
Q

what is there high levels of in diffuse Goitre

A

TSH

25
Q

effects of a multi-nodular goitre

A
  • cosmetic
  • airway obstruction
  • dysphagia
  • compress vessels
26
Q

adenoma of thyroid gland

A

follicular adenoma

27
Q

carcinomas of thyroid gland

A
  • papillary
  • follicular
  • anaplastic
  • medullary
28
Q

what are the adenomas encapsulated by

A

Encapsulated by a surrounding collagen cuff

29
Q

what can adenomas secrete

A

thyroid hormones - thyrotoxicosis

30
Q

where are mutations in adenomas

A

TSHR signalling pathway

31
Q

who gets thyroid cancer

A

any age

mainly female

32
Q

most common carcinoma of thryoid

A

papillary

33
Q

where are most of the carcinomas derived from

A

follicular epithelium

medullary carcinoma is from C cells

34
Q

what are the environmental associations with carcinoma

A 
Ionising radiation (papillary carcinoma)
Iodine deficiency (follicular carcinoma)
35
Q

metastases of papillary carcinoma

A

lymph nodes

36
Q

presentation of papillary carcinoma

A
  • lesion in thyroid gland
  • hoarseness
  • dysphagia
  • cough
  • dyspnoea
  • sometimes haematogenous spread
37
Q

features of follicular carcinoma

A
  • slowly enlarging
  • painless
  • non-functional
38
Q

what is medullary carcinoma associated with

A

multiple endocrine neoplasia

39
Q

what is medullary carcinoma composed of

A

Composed of spindle or polygonal cells arranged in nests, trabeculae or follicles
associated with amyloid deposition

40
Q

presentation of medullary carcinoma

A
  • neck mass
  • dysphagia
  • hoarsenss
  • airway compromise
  • paraneoplastic syndrome
41
Q

treatment of medullary carcinoma

A

total thyroidectomy

42
Q

is anaplastic carcinoma dangerous/associated with death

A

yes

endocrine (40 decks)

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