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Path guide chem > Thyroid > Flashcards

Thyroid Flashcards

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1
Q

TFT reference ranges

A

TSH 0.33-4.5 umol/L
free T4 10.2-22 pmol/L
free T3 3.2-6.5 pmol/L

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2
Q

High TSH, Low T4

A

Primary hypothyroidism
Atrophic, subacute, Hashimoto’s, postpartum, Riedel thyroiditis

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3
Q

High TSH, N T4

A

Treated or subclinical hypothyroidism

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4
Q

High TSH, High T4

A

TSH secreting tumour or thyroid resistance

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5
Q

Low TSH, High T4/T3

A

Primary Hyperthyroidism
Graves, Toxic multinodular goitre, toxic adenoma, drugs, ectopic

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6
Q

Low TSH, N T4/T3

A

Subclinical hyperthyroidism
May progress to primary hypo, especially if anti-TPO positive

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7
Q

High then Low TSH, Low T4/T3

A

Sick euthyroidism
Body tries to shut down metabolism as thyroid gland has reduced output

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8
Q

N TSH, abnormal T4/T3

A

Assay interference, changes in TBG, amiodarone

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9
Q

Medical management of hyperthryoidism

A

Symptom management
Carbimazole

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10
Q

Efficacy and risks of radioiodine for hyperthyroidism

A
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11
Q

Main pre-op requirement and post-op treatment of surgical hemi/total thyroidectomy

A
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12
Q

What is a thyroid storm?

A
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13
Q

Hypothyroid management

A

Thyroid replacement

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14
Q

Summarise causes of hyperthyroidism

A
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15
Q

Summarise causes of hypothyroidism

A
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16
Q

Risk factors for thyroid neoplasia

A

Solitary, solid, young, male, cold nodules

17
Q

Most common thyroid cancer

A

Papillary thyroid cancer

18
Q

Papillary thyroid cancer age of onset

A

20-40

19
Q

Papillary thyroid cancer tumour marker

A

Thyroglobulin

20
Q

Papillary thyroid cancer spread

A

LNs and lung

21
Q

Papillary thyroid cancer histology

A

Psammoma bodies
Orphan annie eyes

22
Q

Papillary thyroid cancer Mx

A

Surgery +/- radioiodine, thyroxine

23
Q

Follicular thyroid cancer age of onset

A

40-60 years

24
Q

Follicular thyroid cancer key feature

A

Well differentiated with early spread via blood

25
Q

Follicular thyroid cancer tumour marker

A

Thyroglobulin

26
Q

Follicular thyroid cancer histology

A

Small follicles
Normall thyroid appearance

27
Q

Follicular thyroid cancer Mx

A

Surgery + radioiodine + thyroxine

28
Q

Medullary thyroid cancer age of onset

A

50-60 years

29
Q

Medullary thyroid cancer key association

A

20% MEN2

30
Q

Medullary thyroid cancer definition

A

Neuroendocrine neoplasm derived from parafollicular C cells secreting calcitonin

31
Q

Medullary thyroid cancer tumour marker

A

CEA, calcitonin

32
Q

Medullary thyroid cancer histology

A

Sheets of dark cells
Amyloid deposition (product of calcitonin catabolism)

33
Q

Medullary thyroid cancer Mx

A

Screen for phaeo (MEN2) pre-op
Surgery
Node clearance

34
Q

Medullary thyroid cancer Mx

A

Screen for phaeo (MEN2) pre-op
Surgery
Node clearance

35
Q

Anaplastic thyroid cancer age of onset and prognosis

A

Elderly, most die within a year

36
Q

Anaplastic thyroid cancer spread

A

very aggressive
local, LNs, blood

37
Q

Anaplastic thyroid cancer histology

A

undifferentiated follicles
Large pleomorphic giant cells
Spindle cells with sarcomatous appearance

38
Q

Thyroid lymphoma (MALToma) key association

A

Chronic Hashimoto’s

39
Q

How to distinguish the 3 different types of MEN

A

Path guide chem (19 decks)

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