Unit 2b: Thyroid Pathology Flashcards
True or False: We can soley differentiate benign and malignant tumours on US
False: Need FNA cytology to provide diagnosis
Inflammatory/Infectious pathology, thyroiditis, and autoimmune diseases such as Grave’s disease and Hashimoto’s are examples of thyroid pathology that is ____
Diffuse
Nodules, adenomas, hyperplasias, carcinomas, lymphoma, mets, that are unilateral or bilateral are all exampls of thyroid patholgy that is _____
Focal
A normal funcitoning thyroid gland is called ____
Euthyroid
Increased thyroid funciton is known as
hyperthyroid
Decreased thyroid function is known as
hypothyroid
The most common cause of Thyrotoxicosis is _____
Hyperthyroidism
Elevated levels of free T3 and T4 cause a _______ state
Hypermetabolic state
Graves Disease is an example of Primary ______
Hyperthyroidism
The most common cause of hyperthyroidism is _________ and most commonly presents in _____ (sex)
Grave’s Disease
Women
Name 4 symptoms present in Graves Disease
1) Hyperthyroidism
2) Goiter
3) Protruding eyes
4) Pretibial Myxedema
Weight loss, sweating, heat intolerance, bulging eyes, goiter, tachycardia, mood changes, dyspnea, nervousness, tremors, menstrual irregularities are all symptoms of _____
Graves Disease (Hyperthyroidism)
What three factors make up a “Thyroid Storm”?
1) BP
2) HR
3) Body Temp
Enlarged thyroid, heterogenous texture, and “Thyroid Inferno” are commonly associated with _____
Graves Disease (Hyperthyroidism)
A useful indication of diffuse thyroid enlargement is when the isthmus measures greater than _____
1 cm
Spectral Doppler demostrate peak velocites of thyroid inferno exceeding _____ cm/sec
70 cm/sec
The most common presentation of thyroiditis is ____
hypothyroidism
A low grade fever and a sore neck are acute presentations of
Thyroiditis
Subacute thyroiditis is also known as _ _____ disease or ______ thyroiditis
De Quervain Disease
Granulomatous Thyroiditis
Thyroid enlargement, > 1 cm isthmus, hypoechoic, nodularity and normal or decreased vascularity is the sonographic appearance of _____
Acute or Subacute thyroiditis
What is the most common thyroid function disorder?
Hypothyroidism
While Primary Hypothyroidism is an abnormality affecting the gland itself, Secondary Hypothyroidism is caused by the ____ or _____ failing to stimulate the thyroid.
Hypothalamus or Pituitary
The most common cause of Primary Hypothyroidism is _______ ______
Hashimoto Thyroiditis
Weakness, fatigue, dry skin, cold intolerance, hoarseness, weight gain, constipation, menstrual irregularities, and decreased sweating are are all symptoms of ______
Hypothyroidism
Fibrotic strands, enlargement and heterogenous thyroid are all sonographic appearances of ______
Hashimoto’s Thyroiditis
Goiters can reach up to ______ g
2000 g
Non- Toxic Goiters are usually due to a defficiency in _____. Or Hypothyroid, which causes a(n) ____ in iodine, an ____ in T3 and T4, and a(n) ______ in TSH.
Iodine
Decrease
Decrease
Increase (to try and make the thyroid work)
Toxic goiters are typically ______ and can induce __________
Multi-nodular
Hyperthyroidism
A plunging goiter extends below the ___ and __
Clavicle and sternum
True or False: Multinodular goiters are only toxic
False: can be toxic or non-toxic
True or False: Thyroid size changes in pregnancy
True: due to iodine plasma reduction
What is the most common condition after abortion, miscarriage or delivery?
PPT - Postpartum Thyroiditis
Classic presentation is thyrotoxicosis followed my hypothyroidism
Decreased echogenicity
What causes the majority of nodular disease of thyroid?
Hyperplasia
Thyroid hyperplasia is usually ____ in terms of echotexture. But can turn into cysts if undergoes _____
Isoechoic
Liquification
Peripheral halo, cystic degeneration and perinodular vascularity are sonographic appearances of _____
hyperplasia
Solitary thyroid nodules are either cystic or moslty cystic due to ________ or _______
Hemorrhage
Degeneration
Percutaneous ethanol injection is used for _____ thyroid cysts.
Benign
A cyst with multiple echogenic foci with comet tail artifact is suspect of this type of cyst
Colloid Cyst
Hot nodules are often _____ and considered ____-functioning
Benign
Hyper-Functioning
Cold nodules can be _____, and _____ functioning
Malignant
Non-Functioning
Thyroid adenomas are ____
benign
Benign, slow growing, fibrous capsule, solitary nodule derived from follicular cells, usually non0 functioning are suspect of thyroid _____
Thyroid Adenoma
True or False: Follicular adenomas and follicular carcinomas can be differentiated on cytology
False
Toxic adenomas can cause _____
hyperthyroidism
“Spoke and Wheel” on colour doppler is indicative of a thyroid ____
Adenoma
The most common thyroid carcinoma is _____
Papillary
The second most common thryoid carcinoma is ______
Follicular
Solid, hypoechoic nodules with microcalcifications < 2mm are indicative of thyroid ______
carcinomas
When AP measurements are ____ than width measurement, this is suspicious for malignancy.
Greater
Papillary carcinoma can spread via the ____ system
Lymphatic
Follicular carcinoma can spread by _____
blood
True or false: follicular carcinomas and follicular adenomas can be distinguised by FNA
False: can be distinguised histologically (remove entire mass to study capsule margins)
Thick irregular halo, hypervasculaity, and irregular margins appear in _____ carcinoma
follicular
Medullary carcinoma is derived from _______ cells. AKA C-cells, which secrete ____
Parafollicular cells
Calcitonin
This carcinoma is associated with MEN syndrome
Medullary Carcinoma
This carcinoma invades nearby vasculature, is very aggressive, is widespread mets, and has no effective treatment
Anaplastic Thyroid Carcinoma
This carcinoma is most common in this sex ___ and is formed from thyroglobulin producing cells
Hurthle cell
Males
Serum calcitonin can be used as a tumour marker for which type of thyroid carcinoma?
Medullary
Most thyroid lymphoma arises from chronic _____ also known as Hashimoto
Thyroiditis
Most common mets to thyroid are ___, ___, ___ and ___ cell carcinoma.
Melanoma
Breast
Lung
Renal
Round, hypoechoic , absence of fatty hilum, cystic necrosis, and increasing size are sono appearances of ______
Lymphadenopathy
