Thyroid pathology Flashcards

1
Q

Name the 4 B’s of T4 function

A

Brain development
Bone growth
Beta adrenergic effects
BMR increase

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2
Q

Patients lab results: high TSH, high T4. What is the pathology?

A

secondary/tertiary hyperthyroidism: pituitary or hypothalamus pathology

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3
Q

What are some signs and symptoms of hyperthyroidism?

A

weight loss, heat intolerance, cardiac arrhythmia, neuro-muscular problems: tremors, warm moist skin, diarrhea, lid lag, thyroid storm

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4
Q

What are the most common causes of hyperthyroidism?

A

Graves disease, multi-nodular goiter, thyroid adenoma

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5
Q

What are the symptoms of hypothyroidism?

A

weight gain, fatigue, cold intolerance, bradycardia, myxedema –> hoarse voice, myxedema coma

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6
Q

What are the two broad categories causing hypothyroidism?

A

congenital or acquired

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7
Q

Describe thyroiditis

A

inflammation of thyroid gland
F>M
acute/painful or silent/chronic

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8
Q

How do you diagnose thyroiditis?

A

decreased I (123) uptake

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9
Q

What would you see microscopically in a case of Hashimoto’s thyroiditis?

A

Hurkle cells

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10
Q

Describe the pathophysiology of Hashimoto’s thyroiditis?

A

T cell don’t recognize own thyroid antigens as self, attack thyroid, T cells stimulate B cells to produce antibodies to TSH receptors, thyroglobulin, and peroxidase

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11
Q

What is myxedema?

A

leakage of colloid out of thyroid into peripheral tissues, skin does not yield under pressure

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12
Q

Describe DeQuervain’s thyroiditis

A

large sore thyroid after URI due to increase in CD8 cells causes leakage of follicle cells and foreign body giant cell reaction, not serious

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13
Q

Why is Bullseye the horse from Toy Story the symbol for Silent Thryoiditis?

A

silent and does not cause trouble

painless, slightly large thyroid in post-partum/middle aged women

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14
Q

What is the biggest risk with Reidel’s thyroiditis?

A

rock hard woody-like mass can cause tracheal compression

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15
Q

How would you diagnose Grave’s disease?

A

decreased TSH, increased T4 (primary hyperthyroidism), radioactive scan = diffuse increased uptake, clinical triad

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16
Q

What is the clinical triad of Grave’s syndrome?

A

hyperthyroidism, opthalmopathy, dermopathy

17
Q

What micro path findings are indicative of Grave’s disease?

A

papillae and scalloped colloid

18
Q

How do you treat Grave’s disease?

A

treat sx: beta blockers or surgery

treat thyroid over-synthesis: drugs, I (131) ablation, surgery

19
Q

What are three main causes of goiters?

A

inflammatory thyroiditis
non-inflammatory T4 synthesis defect
Iodide def.

20
Q

You would see signs of cyclic involution and hyperplasia in what thyroid pathology?

A

multi-nodular goiter

21
Q

What drugs are used to treat/prevent Goiters?

A

Levothyroxine (T4 analog)

22
Q

What are the three possible pathological findings for fine needle aspirate bx of thyroid?

A

cancer- remove
just follicles- remove
thyroiditis- treat

23
Q

What is the most common benign neoplasm of the thyroid?

A

thyroid adenoma

24
Q

What are some possible genetic mutations in thyroid adenoma?

A

G protein mutation

gain of function mutation

25
Q

You see a salt-and-pepper nucleus on a cytology thyroid sample, what is it?

A

medullary thyroid carcinoma

26
Q

What differentiates medullary thyroid carcinoma from other cancers of the thyroid?

A

it is a cancer of the C cells

endocrine cancer as opposed to epithelial in origin

27
Q

What is the “worst” malignant neoplasm of the thyroid?

A

anaplastic thyroid carcinoma

< 10% 5 yr, usu mets. @ dx.

28
Q

Name 3 things about papillary thyroid carcinoma?

A

most common malignancy of the thyroid
Orphan Annie nuclei
psammoma bodies (Sand[y])