thyroid martin part 2 Flashcards

1
Q

diffuse and multinodular goiters reflect impaired synthesis of ?

A

thyroid hormones

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2
Q

what is the most common cause of goiters?

A

dietary iodine def

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3
Q

pathology of a goiter

A

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

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4
Q

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

A

euthyroid metabolic state

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5
Q

degree of goiter enlargement is proportional to?

A

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

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6
Q

what are the two types of goiters

A

diffuse non toxic and multinodular

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7
Q

a diffuse non toxic goiter is a _ goiter

it is also known as a _ goiter

A

simple

colloid

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8
Q

what are the type types of simple goiters?

A

endemic: more commo, decreased iodinem goitrogens

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

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9
Q

what are some examples of goitrogens

A

cabbage, cauliflower, brussel sprouts

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10
Q

what are the two phases of a simple goiter

A
  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
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11
Q

majority of simple goiter patients are _

A

euthyroid (produce a normal level of thyroid)

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12
Q

what are the symptoms of a simple goiter?

A

mass effect: dysphagia, hoarsness, stridor, SVC

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13
Q

serum levels in a simple/colloid/diffuse nontoxic goiter

A

T3 and T4 are normal

TSH increased

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14
Q

children with dyshormonogenetic goiter are at risk for?

A

cretinism

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15
Q

what is a multinodular goiter

A

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

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16
Q

virtually all long standing simple goiters convert to _

A

multinodular goiters

17
Q

multinodular goiters are often mistaken for?

A

neoplasms (because they can get huge)

18
Q

most multinodular goiters are _ or subclinical _

A

euthyroid

subclinical hyperthyroid (decreased TSH)

19
Q

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

A

older

20
Q

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

A

autonomous

21
Q

both _ and _ nodules coexits in the same multinodular goiter

A

polyclonal and monoclonal

22
Q

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

A

hemorraghes, scarring and calcifications giving it that nodular appearance

23
Q

what is a toxic multinodular goiter

A

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

24
Q

what is a solitary thyroid nodule

A

this is the dominant nodule in the multinodular goiter

25
Q

how does a multinodular goiter uptake radioactive iodine

A

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

26
Q

what is a intrathoracic goiter?

A

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