Pathoma: Thyroid Flashcards
Where does the thyroid develop?
base of the tongue (then travels along the thyroglossal duct into the anterior neck)
“cystic dilation of thyroglossal duct remnant”
thyroglossal duct cyst
“persistance of thyroid tissue at the base of tongue”
lingual thyroid
Hyper or hypothyroid?
“diarrhea, bone resporption, hyperglycemia, staring gaze with lid, tachycardia. weight loss, heat intolerance, decreased muscle mass”
Hyperthyroid
“autoantibody (IgG) that stimulates TSH receptor”
Graves disease
Most common cause of hyperthyroidism?
Graves disease
Why is there exophthalmos in Graves disease?
fibroblasts behind the orbit have TSH receptors
Lab findings in primary hyperthyroidism/ Graves?
Increased total and free T4
Decreaseed TSH
Hypercholesterolemia
Hyperglycemia
“Enlarged thyroid gland with multiple nodules that is due to a iodine deficiency”
multinodular goiter
“Hypothyroidism in neonates and infants characterized by mental retardation, short stature, enlarged tongue, umbilical hernia”
Cretinism
Hyper or hypothyroidism?
“myxedema weight gain, cold intolerance bradycardia, oligomenorrhea, constipation”
hypothyroidism/ myxedema
Most common causes of hypothyroidism/ myxedema?
Iodine deficiency
Hashimoto thyroiditis
Drugs
Surgical removal/ ablation
“autoimmune destruction of the thyroid gland”
Hashimoto thyroiditis
What antibodies are seen in hashimoto’s?
Anti TG and anti thyroid peroxidase
What does Hashimoto’s increase the risk of developing?
B cell (marginal zone) lymphoma
“granulomatous thyroiditis that follows a viral infection and is self limited”
subacute granulomatous (De Quervian) thyroiditis
What are the symptoms of De Querian thyroiditis?
Tender thyroid with transient hyperthyroidism
“chronic inflammation with excessive fibrosis of thyroid gland”
Reidel fibrosing thyroiditis
Symptoms of Reidel fibrosing thyroiditis?
hypothyroidism and hard, nontender thyroid
Are thyroid nodules usually malignant or benign?
Benign
“hot” vs “cold” thyroid nodule
Hot: increased I131 uptake (graves)
Cold: decreased I131 uptake (adenoma or carcinoma)
“benign proliferation of follicles surrounded by a fibrous capsule”
follicular adenoma
Are follicular adenomas functional or nonfunctional?
nonfunctional usually
Most common type of thyroid carcinoma?
Papillary carcinoma
Major risk factor for thyroid papillary carcinoma?
exposure to ionizing radiation in childhood
“papillae lined by cells with clear ‘orphan annie eye’ nuclei and nuclear grooves”
papillary carcinoma
“malignant proliferation of follicles surrounded by a fibrous capsule with invasion through the apsule”
follicular carcinoma
how can you tell the difference between follicular carcinoma and adenoma?
invasion through the capsule in carcinoma
“malignant proliferatoin of parafollicular C cells”
Medullary carcinoma
Symptoms of medullary carcinoma?
increased calcitonin that can cause hypocalcemia and amyloid deposits
What familial disorders is medullary carcinoma of the thyroid seen in?
MEN II Type A and B–> RET oncogene mutations
“undifferentiated malignant tumor of the thyroid, usually in the elderly”
anaplastic carcinoma
