Thyroid Pathology Flashcards
What is the problem in primary thyroid disease? Secondary? Tertiary?
Primary: Thyroid itself
Secondary: Pituitary
Tertiary: Hypothalamus
What are the actions of T4?
Brain development
Bone growth
Beta-adrenergic effects
BMR increase
T4 high, TSH low.
1° hyperthyroidism
T4 high, TSH high.
2° or 3° hyperthyroidism
T4 low, TSH high
1° hypothyroidism
T4 low, TSH low
2° or 3° hypothyroidism
T4 normal, TSH high
Subclinical hyperthyroidism
T4 normal, TSH low
Subclinical hypothyroidism
Signs and symptoms of hyperthyroidism?
General: Weight loss, heat intolerance Cardiac: Rapid pulse, arrhythmias Neuromuscular: Tremor, emotional labiity Skin: Warm, moist GI: Diarrhea Eye: lid lag
Most common causes of hyperthyroidism?
Graves disease
Multinodular goiter
Thyroid adenoma
Signs and symptoms of hypothyroidism?
General: Fatigue, weight gain, cold intolerance
Cardiac: Slow pulse, impaired contraction
Nervous: Delayed reflexes, lethargy
Skin: Rough, dry, hair loss (eyebrows)
GI: Reduced appetite, constipation
Myxedema: Deepened voice, “edema”
What are causes of congenital hypothyroidism?
Iodine deficiency, genetic problems
How do you treat congenital hypothyroidism?
T4 replacement
Most common causes of acquired hypothyroidism?
Hashimotos thyroiditis
Iatrogenic
Does thyroiditis result in increased or decreased radioactive iodine uptake?
Decreased
A painless, big thyroid with eventual hypothyroidism. Most common in women.
Hashimoto thyroiditis
What antibodies are most often present in Hashimoto thyroiditis?
Anti-peroxidase antibodies
What does thyroid look like on biopsy for Hashimoto thyroiditis?
HUGE whopping lymphoid follicles
Hurthle cells: Big, granular, pink cells
What cells are messed up in Hashimoto thyroiditis?
T cells, resulting in B cells
What antibodies to B cells make in Hashimoto?
Anti-TSH-receptor
Anti-thyroglobulin
Anti-peroxidase (MOST IMPORTANT)
A big, sore thyroid after a recent URI. Get hyperthyroidism initially but self-limiting.
DeQuervain (granulomatous) thyroiditis
What do slides look like with DeQuervain thyroiditis?
lymphoid infiltrate
Degenerating follicles
Multinucleated giant cells
What are the sequence of events in DeQuervain thyroiditis?
Viral infection
Antigen causes increase in CD8 cells
Damaged follicles leak colloid
Foreign-body giant cell reaction ensues
A painless, slightly enlarged thyroid with mild hyperthyroidism in a post-partum mother.
Silent thyroiditis
