Pathoma: Thyroid

Question 1

Where does the thyroid develop?

Answer 1

base of the tongue (then travels along the thyroglossal duct into the anterior neck)

Question 2

“cystic dilation of thyroglossal duct remnant”

Answer 2

thyroglossal duct cyst

Question 3

“persistance of thyroid tissue at the base of tongue”

Answer 3

lingual thyroid

Question 4

Hyper or hypothyroid?

“diarrhea, bone resporption, hyperglycemia, staring gaze with lid, tachycardia. weight loss, heat intolerance, decreased muscle mass”

Answer 4

Hyperthyroid

Question 5

“autoantibody (IgG) that stimulates TSH receptor”

Answer 5

Graves disease

Question 6

Most common cause of hyperthyroidism?

Answer 6

Graves disease

Question 7

Why is there exophthalmos in Graves disease?

Answer 7

fibroblasts behind the orbit have TSH receptors

Question 8

Lab findings in primary hyperthyroidism/ Graves?

Answer 8

Increased total and free T4

Decreaseed TSH

Hypercholesterolemia

Hyperglycemia

Question 9

“Enlarged thyroid gland with multiple nodules that is due to a iodine deficiency”

Answer 9

multinodular goiter

Question 10

“Hypothyroidism in neonates and infants characterized by mental retardation, short stature, enlarged tongue, umbilical hernia”

Answer 10

Cretinism

Question 11

Hyper or hypothyroidism?

“myxedema weight gain, cold intolerance bradycardia, oligomenorrhea, constipation”

Answer 11

hypothyroidism/ myxedema

Question 12

Most common causes of hypothyroidism/ myxedema?

Answer 12

Iodine deficiency

Hashimoto thyroiditis

Drugs

Surgical removal/ ablation

Question 13

“autoimmune destruction of the thyroid gland”

Answer 13

Hashimoto thyroiditis

Question 14

What antibodies are seen in hashimoto’s?

Answer 14

Anti TG and anti thyroid peroxidase

Question 15

What does Hashimoto’s increase the risk of developing?

Answer 15

B cell (marginal zone) lymphoma

Question 16

“granulomatous thyroiditis that follows a viral infection and is self limited”

Answer 16

subacute granulomatous (De Quervian) thyroiditis

Question 17

What are the symptoms of De Querian thyroiditis?

Answer 17

Tender thyroid with transient hyperthyroidism

Question 18

“chronic inflammation with excessive fibrosis of thyroid gland”

Answer 18

Reidel fibrosing thyroiditis

Question 19

Symptoms of Reidel fibrosing thyroiditis?

Answer 19

hypothyroidism and hard, nontender thyroid

Question 20

Are thyroid nodules usually malignant or benign?

Answer 20

Benign

Question 21

“hot” vs “cold” thyroid nodule

Answer 21

Hot: increased I131 uptake (graves)

Cold: decreased I131 uptake (adenoma or carcinoma)

Question 22

“benign proliferation of follicles surrounded by a fibrous capsule”

Answer 22

follicular adenoma

Question 23

Are follicular adenomas functional or nonfunctional?

Answer 23

nonfunctional usually

Question 24

Most common type of thyroid carcinoma?

Answer 24

Papillary carcinoma

Question 25

Major risk factor for thyroid papillary carcinoma?

Answer 25

exposure to ionizing radiation in childhood

Question 26

“papillae lined by cells with clear ‘orphan annie eye’ nuclei and nuclear grooves”

Answer 26

papillary carcinoma

Question 27

“malignant proliferation of follicles surrounded by a fibrous capsule with invasion through the apsule”

Answer 27

follicular carcinoma

Question 28

how can you tell the difference between follicular carcinoma and adenoma?

Answer 28

invasion through the capsule in carcinoma

Question 29

“malignant proliferatoin of parafollicular C cells”

Answer 29

Medullary carcinoma

Question 30

Symptoms of medullary carcinoma?

Answer 30

increased calcitonin that can cause hypocalcemia and amyloid deposits

Question 31

What familial disorders is medullary carcinoma of the thyroid seen in?

Answer 31

MEN II Type A and B–> RET oncogene mutations

Question 32

“undifferentiated malignant tumor of the thyroid, usually in the elderly”

Answer 32

anaplastic carcinoma