thyroid martin part 2

Question 1

diffuse and multinodular goiters reflect impaired synthesis of ?

Answer 1

thyroid hormones

Question 2

what is the most common cause of goiters?

Answer 2

dietary iodine def

Question 3

pathology of a goiter

Answer 3

impaired synthesis of thyroid hormones lead to an increased TSH that acts on the the thyroid can causes hypertrophy and hyperplasia of the follicular cells

Question 4

a goiter can overcome hormone deficiency and enter a _ metabolic state

Answer 4

euthyroid metabolic state

Question 5

degree of goiter enlargement is proportional to?

Answer 5

level and duration of thyroid hormone deficiency (how long they have had hypothyroidism)

Question 6

what are the two types of goiters

Answer 6

diffuse non toxic and multinodular

Question 7

a diffuse non toxic goiter is a _ goiter

it is also known as a _ goiter

Answer 7

simple

colloid

Question 8

what are the type types of simple goiters?

Answer 8

endemic: more commo, decreased iodinem goitrogens

sporadic: in females caused by goitrogens or inborn error of thyroid hormone synthesis (AR)

Question 9

what are some examples of goitrogens

Answer 9

cabbage, cauliflower, brussel sprouts

Question 10

what are the two phases of a simple goiter

Answer 10

1. hyperplastic: with crowded columnar cells, symmetrical enlargement (follicles of different size)
2. colloid involution: decreased demand for hormone or increase in dietaary iodine that caused the epithlium to involute and fill with colloid (brown)- glassy surface

Question 11

majority of simple goiter patients are _

Answer 11

euthyroid (produce a normal level of thyroid)

Question 12

what are the symptoms of a simple goiter?

Answer 12

mass effect: dysphagia, hoarsness, stridor, SVC

Question 13

serum levels in a simple/colloid/diffuse nontoxic goiter

Answer 13

T3 and T4 are normal

TSH increased

Question 14

children with dyshormonogenetic goiter are at risk for?

Answer 14

cretinism

Question 15

what is a multinodular goiter

Answer 15

various sized nodules in goiter due to recurrent episodes of hyperplasia and involution (irregular enlargement)

Question 16

virtually all long standing simple goiters convert to _

Answer 16

multinodular goiters

Question 17

multinodular goiters are often mistaken for?

Answer 17

neoplasms (because they can get huge)

Question 18

most multinodular goiters are _ or subclinical _

Answer 18

euthyroid

subclinical hyperthyroid (decreased TSH)

Question 19

multinodular goiters have both sporadic and endemic forms but occur in a _ population

Answer 19

older

Question 20

nodules in a muntinodular goiter can become _ and continue to grow without TSH influence

Answer 20

autonomous

Question 21

both _ and _ nodules coexits in the same multinodular goiter

Answer 21

polyclonal and monoclonal

Question 22

in multinodular goiters there is uneven follicular hyperplasia and accumulation of colloid which can lead to rupture of the follicles and vessels causing

Answer 22

hemorraghes, scarring and calcifications giving it that nodular appearance

Question 23

what is a toxic multinodular goiter

Answer 23

this is known as plummer syndrome and this autonomous nodule will secrete T3 and T4 and cause hyperthyroidism

Question 24

what is a solitary thyroid nodule

Answer 24

this is the dominant nodule in the multinodular goiter

Question 25

how does a multinodular goiter uptake radioactive iodine

Answer 25

uneven uptake consitent with the various sizes and involution of the nodules

Question 26

what is a intrathoracic goiter?

Answer 26

this is a plunging goiter that gorws behind the sternum and clavicles

it has irefular nodules with variable amounts of colloid

older lesions have areas of hemorrhage, fibrosis, and calcification

goiters have flattened epithelium due to compression and dollicular hyperplasia