Wk1 Thyroid Path

Question 1

High T4

Low TSH

Answer 1

primary hypERthyroidism

Question 2

High T4

High TSH

Answer 2

secondary or tertiary hypERthyroidism

Question 3

Low T4

High TSH

Answer 3

primary hypOthyroidism

Question 4

low T4

low TSH

Answer 4

secondary or tertiary hypOthyroidism

Question 5

normal T4

low TSH

Answer 5

subclinical hypERthyroidism

**TSH changes before T4 – think of the seesaw with fulcrum closer to T4

Question 6

normal T4

high TSH

Answer 6

subclinical hypOthyroidism

**TSH changes before T4

Question 7

anti-peroxidase Ab is likely:

Answer 7

Hashimoto’s thyroiditis

Question 8

anti-TSH Ab is likely:

Answer 8

Grave’s disease

Question 9

Most common cause of hyperthyroidism:

Answer 9

Graves disease

Question 10

Myedema association:

Answer 10

hypOthyroidism

Question 11

Painless

BIG thyroid

F»M

hypOthyroid

Answer 11

Hashimoto

Question 12

TFT findings in Hashimoto:

Answer 12

low T4

high TSH

Question 13

lymphoid follicles

Answer 13

Hashimoto

Question 14

Hurthle cells

Answer 14

Hashimoto

Question 15

Cells that mediate Hashimoto

Answer 15

T-cells (CD8’s)

Question 16

Acute onset

BIG, SORE thyroid

recent URI

ealry hyperthyroid

self-limiting

Answer 16

DeQuervain

granulomatous

Question 17

multinucleated giant cells

Answer 17

DeQuervain

Question 18

Painless, slightly enlarged thyroid

post-partum

mild hyperthyroid

Answer 18

Silent thyroiditis

Question 19

Rock hard neck mass “Woody”

hypOthyroid

tracheal compression

Answer 19

Reidel

fibrosing thyroiditis

Question 20

hyperthyroid

ophthalmopathy

dermatopathy

Answer 20

Graves

Question 21

TFT findings in Graves

Answer 21

high T4

low TSH

Question 22

papillae and scalloped colloid

Answer 22

Graves

Question 23

Pathogenesis of Graves:

Answer 23

anti-TSH receptor antibodies that are STIMULATORY

**follicular cell proliferation –> big thyroid

**TH release –> hyperthyroid sx

Question 24

big thyroid gland

Answer 24

Goiter

Question 25

two causes of goiters

Answer 25

1. inflammatory – thyroiditis

2. non-inflammatory – defective T4 synthesis

Question 26

Cause of multinodular goiter:

Answer 26

trauma to simple goiter

Question 27

Most common presentation of thyroid neoplasms:

Answer 27

benign Nodules

Question 28

Uncommon cause of thyroid nodule:

Answer 28

carcinoma

Question 29

Common thyroid nodule:

Answer 29

adenoma

Question 30

RF for thyroid cancer:

Answer 30

male

solitary nodule

cold nodule

hx of radiation

Question 31

Dx method for nodules:

Answer 31

fine needle aspiration

Question 32

Harmless looking fine needle aspirate that needs to be resected:

Answer 32

follicles

Question 33

Two possible genetic abnormalities of benign adenomas:

Answer 33

GPCR mutation

gain of function mutation

Question 34

Treatment for thyroid adenoma:

Why?

Answer 34

take it out!

can look like CA

Question 35

Most common thyroid carcinoma:

Answer 35

papillary

Question 36

age for papillary thyroid carcinoma

Answer 36

30-50

F>M

Question 37

Common site of metastasis for papillary CA

Answer 37

local LN

Question 38

prognosis for papillary CA

Answer 38

excellent

Question 39

Orphan Annie nuclei

Answer 39

Papillary CA

Question 40

psammoma body

Answer 40

Papillary CA

Question 41

pseudoinclusions

Answer 41

Papillary CA

Question 42

nuclear grooves

“coffee bean”

Answer 42

Pappilary CA

Question 43

Thyroid CA that mets to lung/bone

Answer 43

Follicular

Question 44

age for Follicular CA

Answer 44

40-50

Question 45

vascular invasion

**differentiates it from adenoma

Answer 45

Follicular CA

Question 46

C cells cancer

poor prog if mets

Answer 46

Medullary

Question 47

age for Medullary CA

Answer 47

50-60

Question 48

Amyloid

Answer 48

Medullary

Question 49

Bulky, fast growing, invasive

mets present at dx

very poor prog

Answer 49

Anaplastic CA