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HRM - Pathology > Thyroid Pathology > Flashcards

Thyroid Pathology Flashcards

1
Q

What is the problem in primary thyroid disease? Secondary? Tertiary?

A

Primary: Thyroid itself
Secondary: Pituitary
Tertiary: Hypothalamus

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2
Q

What are the actions of T4?

A

Brain development
Bone growth
Beta-adrenergic effects
BMR increase

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3
Q

T4 high, TSH low.

A

1° hyperthyroidism

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4
Q

T4 high, TSH high.

A

2° or 3° hyperthyroidism

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5
Q

T4 low, TSH high

A

1° hypothyroidism

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6
Q

T4 low, TSH low

A

2° or 3° hypothyroidism

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7
Q

T4 normal, TSH high

A

Subclinical hyperthyroidism

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8
Q

T4 normal, TSH low

A

Subclinical hypothyroidism

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9
Q

Signs and symptoms of hyperthyroidism?

A 
General: Weight loss, heat intolerance
Cardiac: Rapid pulse, arrhythmias
Neuromuscular: Tremor, emotional labiity
Skin: Warm, moist
GI: Diarrhea
Eye: lid lag
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10
Q

Most common causes of hyperthyroidism?

A

Graves disease
Multinodular goiter
Thyroid adenoma

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11
Q

Signs and symptoms of hypothyroidism?

A

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”

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12
Q

What are causes of congenital hypothyroidism?

A

Iodine deficiency, genetic problems

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13
Q

How do you treat congenital hypothyroidism?

A

T4 replacement

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14
Q

Most common causes of acquired hypothyroidism?

A

Hashimotos thyroiditis

Iatrogenic

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15
Q

Does thyroiditis result in increased or decreased radioactive iodine uptake?

A

Decreased

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16
Q

A painless, big thyroid with eventual hypothyroidism. Most common in women.

A

Hashimoto thyroiditis

17
Q

What antibodies are most often present in Hashimoto thyroiditis?

A

Anti-peroxidase antibodies

18
Q

What does thyroid look like on biopsy for Hashimoto thyroiditis?

A

HUGE whopping lymphoid follicles

Hurthle cells: Big, granular, pink cells

19
Q

What cells are messed up in Hashimoto thyroiditis?

A

T cells, resulting in B cells

20
Q

What antibodies to B cells make in Hashimoto?

A

Anti-TSH-receptor
Anti-thyroglobulin
Anti-peroxidase (MOST IMPORTANT)

21
Q

A big, sore thyroid after a recent URI. Get hyperthyroidism initially but self-limiting.

A

DeQuervain (granulomatous) thyroiditis

22
Q

What do slides look like with DeQuervain thyroiditis?

A

lymphoid infiltrate
Degenerating follicles
Multinucleated giant cells

23
Q

What are the sequence of events in DeQuervain thyroiditis?

A

Viral infection
Antigen causes increase in CD8 cells
Damaged follicles leak colloid
Foreign-body giant cell reaction ensues

24
Q

A painless, slightly enlarged thyroid with mild hyperthyroidism in a post-partum mother.

A

Silent thyroiditis

25
Q

What does Silent thyroiditis look like on slide?

A

Lymphoid infiltrate with absence of Herkel Cells and germinal centers

26
Q

Rock hard neck mass presenting with hypothyroidism and tracheal compression

A

Reidel Thyroiditis

27
Q

A female with Hyperthyroidism, ophthalmopathy, dermopathy. What is it?

A

Graves Disease

28
Q

What does the iodine scan show in Graves Disease?

A

Diffuse increased uptake

29
Q

What does graves disease look like on slide?

A

Papillae and scalloped colloid

30
Q

What antibodies are present in Graves Disease?

A

Anti-TSH receptor antibodies

31
Q

Where are other receptors for anti-TSH-receptor antibodies than the thyroid?

A

Retroorbital tissues

Pre-tibial fibroblasts

32
Q

What is symptomatic treatment for Graves Disease? Long term?

A

Symptomatic: Beta blocker, Surgery if necessary

Long term: Drugs, Radioactive iodine ablation, surgery

33
Q

What three ways can you get a goiter from decreased T4?

A 
No iodine
Goitrogenic foods (brussell sprouts/cauliflower)
Enzyme defects
34
Q

How do you treat a goiter?

A

Levothyroxine or thyroidectomy

HRM - Pathology (10 decks)

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