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Ch. 15 Endocrine Pathology > Thyroid > Flashcards

Thyroid Flashcards

1
Q

Graves disease etiology

A

type II hypersensitivity
anti-TSH receptor IgG that stimulates TSH receptor
causes T4 release from thyroid –> hyperthyroidism

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2
Q

Exophthalmos and pretibial myxedema classically seen in

A

hyperthyroidism

activation of fibroblasts

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3
Q

Tx of Graves disease

A

β-blockers

thiomide: inhibits peroxidase
radioiodine: ablates thyroid

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4
Q

Major complication of Grave’s disease

A

thyroid storm

arrhythmia, hyperthermia, vomiting, hypovolemic shock

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5
Q

Propylthiouracil useful in treating…

A

thyroid storm

inhibits peroxidase-mediated activities in thyroid

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6
Q

How does hyperthyroidism cause an increase in basal metabolic rate?

A

increase Na+/K+ ATPase expression

increase β1-receptor expression

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7
Q

Cholesterol and blood glucose status in hyperthyroidism

A

hypocholesterolemia

hyperglycemia

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8
Q

How does diffuse goiter occur in Graves

A

constant TSH stimulation of thyroid

=> thyroid hyperplasia and hypertrophy

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9
Q

TSH and free T4 labs in Graves

A 
high T4
low TSH (negative feedback)
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10
Q

Multinodular goiter
etiology
complications

A

often due to relative iodine deficiency

may secrete T4 independent of TSH stimulation

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11
Q

Cretinism

A

hypothyroidism in neonates and infants

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12
Q

Cretinism due to genetic mutation is most often a result of this enzyme being mutated

A

thyroid peroxidase

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13
Q

Congenital hypothyroidism worldwide is most often due to

A

iodine deficiency

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14
Q

Myxedema in hypothyroidism most classically involves what areas

A 
vocal cords (deepening of voice)
tongue (macroglossia)
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15
Q

Most common cause of hypothyroidism in adults

A

Hashimoto thyroiditis

although it may transiently cause hyperthyroidism

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16
Q

Hashimoto thyroiditis HLA association

A

HLA-DR5

17
Q

Hashimoto thyroiditis
etiology
presentation

A

autoimmune destruction of thyroid gland

presents as initial hyperthyroidism, followed by hypothyroidism

18
Q

Bx results of Hashimoto thyroiditis

A 
chronic inflammation
germinal centers (increased risk for marginal B-cell lymphomas)
19
Q

Complication of Hashimoto thyroiditis

A

marginal B-cell lymphoma

presents as enlarging thyroid in common who has normally been hypothyroid

20
Q

Presentation of subacute granulomatous DeQuervain thyroiditis

A

after viral infection commonly
*tender thyroid with transient hyperthyroidism
does not need treatment, often resolves on its own

21
Q

Reidel fibrosing thyroiditis may present similar to

A

anaplastic carcinoma of thyroid
both may be hard and invade local structures
Reidel more common in younger, anaplastic ca in older

22
Q

Reidel fibrosing thyroiditis

presentation

A

very hard thyroid gland
invasion of local structures
often occurs in pts ~40 y/o

23
Q

Thyroid carcinoma are typically:
hot/cold
on 131I radioactive thyroid scan

A

cold

cold nodules are most often not carcinomas though as well

24
Q

Bx type when you want to look at the thyroid

A

fine-needle aspiration

because that boy bleeds like crazy

25
Q

Follicular adenoma resembles what other neoplasm

A

follicular carcinoma

but follicular carcinoma invaded through the capsule that is present

26
Q

4 types of thyroid carcinoma

A

papillary: cervical node mets
follicular: invades through capsule, hematogenous mets
medullary: calcitonin secretion, MEN2/RET association
anaplastic: bad

27
Q

Papillary carcinoma
risk factors
histology
mets

A

ionizing radiation, esp acne ablation in children
“Orphan Annie” eyes, empty nuclei
mets common to cervical nodes but very non-invasive

28
Q

Follicular carcinoma
histology
mets

A

resembles folliular adenoma but w/ invasion through capsule

mets hematogenously** (very unique)

29
Q

Medullary carcinoma

proliferation of what cell type

A

C-cells
secrete calcitonin
*may present w/ hypocalcemia

30
Q

Medullary caricinoma

histology

A

amyloid found around follicles

ie parafollicular amyloid

31
Q

MEN2/RET mutations commonly associated with this thyroid neoplasm

A

medullary carcinoma

32
Q

Anaplastic carcinoma of thyroid

A

bad news bears
invasion of local structures
bad prognosis

Ch. 15 Endocrine Pathology (5 decks)

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