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M&M Test 3 > B6-061 Thyroid Disease > Flashcards

B6-061 Thyroid Disease Flashcards

1
Q

TSH will be […] in hypothyroidism

A

increased

**trying to compensate

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2
Q

pretibial nonpitting edema is associated with

A

longstanding hypothyroidism

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3
Q

hypothyroidism due to pituitary or hypothalamic failure is

A

secondary

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4
Q

two main types of primary hypothyroidism

A

-cretinism (peds)
-myxedema (adults)

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5
Q

maternal T3/T4 is necessary for fetal […] development

A

brain

**damage to fetal brain is most severe when maternal T3/4 is low before fetal thyroid becomes active

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6
Q

most common cause of congenital primary hypothyroidism worldwide

A

iodine deficiency

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7
Q

most common cause of primary hypothyroidism in US adults

A

Hashimoto

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8
Q

goiterogens [2]

A

PTU
iodide

**suppress T3/T4 synthesis

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9
Q

inhibits oxidation of iodide and peripheral deiodination of T4 into T3

A

PTU

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10
Q

inhibits proteolysis of thyroglobulin

A

iodide

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11
Q

CD 8 T cell mediated destruction of the thyroid

A

Hashiomotos

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12
Q

what antibodies are seen in Hashimoto’s?

A

anti-thyroglobulin
anti-thyroid peroxidase

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13
Q

Hashimotos may initially present with transient […]

A

hyperthyroidism

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14
Q

Hashimotos increases the risk of [3]

A

B cell lymphoma
thyroid cancers
other autoimmune disease

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15
Q

Hurthle cells
lymphoid aggregates with germinal centers

A

Hashimotos

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16
Q

self-limited disease preceded by viral infection
may have transient hyperthyroidism
painless goiter

A

subacute lymphocytic thyroiditis

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17
Q

painful goiter
transient hyperthyroidism

A

granulomatous (de Quervain) thyroiditis

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18
Q

jaw pain
very tender thyroid

A

granulomatous (de Quervain) thyroiditis

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19
Q

granulomatous inflammation on histology

A

granulomatous (de Quervain) thyroiditis

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20
Q

slowly enlarging
hard, fixed, nontender mass

A

Riedel thyroiditis

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21
Q

IgG4 related disease

A

Riedel thyroiditis

**in general, IgG4 is associated with fibrosis

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22
Q

thyroid replaced with fibrous tissue and inflammatory infiltrate on histology

A

Riedel

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23
Q

staring gaze, eyelid lag, proptosis

A

long standing hyperthyroidism (Graves)

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24
Q

pituitary tumor secreting TSH is […] hyperthyroidism

A

secondary

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25
Q

primary hyperthyroidism is caused by

A

thyrotoxicosis

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26
Q

thyrotoxicosis occurring due to diffuse hyperplasia

A

Graves

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27
Q

factitious hyperthyroidism is caused by

A

exogenous thyroid intake

28
Q

antibodies associated with Graves disease [2]

A

thyroid stimulating antibody
TSH-R blocking antibody

29
Q

infiltrative ophthalmopathy due to lymphocytes, edema, matrix, and fat deposition behind the eye

A

Graves disease

30
Q

hyperthyroidism
exopthalmus
dermopathy (pretibial myxedema)

A

Graves disease

31
Q

tall, crowded follicular epithelial cells
scalloped colloid

A

Graves disease

32
Q

goiter is usually

A

euthyroid

33
Q

in iodine deficiency, goiter is initially […], multinodular appearance occurs after […]

A

diffuse
multiple cycles of hyperplasia and involution

34
Q

if a patient with multinodular goiter is presenting with obstructive symptoms, what is the best next step?

A

surgery to relive pressure on airway

**due to extreme fibrosis of nodules, it will not resolve on its own

35
Q

euthyroid goiter due to cycles of hyperplasa/hypoplasia is most commonly caused by

A

iodine deficiency

**treat with iodine intake

36
Q

triple test for thyroid evaluation

A

hormonal assessment
radiographic imaging
FNA

37
Q

features that might suggest thyroid neoplasm [5]

A

solitary nodule
younger age
male
prior radiation
non-functional (cold)

38
Q

which type of nodule is closely associated with malignancy?

A

cold (non-functional)

39
Q

carcinomas arising from thyrocytes [2]

A

follicular
papillary

40
Q

medullary carcinoma comes from […] cells

A

C cells

41
Q

only definitive treatment for thyroid cancer

A

surgical removal

42
Q

benign tumor
solitary, discrete, encapsulated
euthyroid

A

adenoma

43
Q

capsular or vascular invasion
RAS or PI3K activation

A

follicular carcinoma

44
Q

FNA may be unable to distinguish follicular adenoma from […]

A

carcinoma

**lobectomy is performed and sent to path. if comes back as carcinoma, do another surgery to remove the entire thing

45
Q

mutations in what genes increase the risk of papillary carcinoma? [3]

A

RET
BRAF
NTRK1

46
Q

empty-appearing nuclei with central clearing
psamoma bodies
nuclear grooves

A

papillary carcinoma

47
Q

derived from C cells

A

medullary carcinoma

48
Q

associated with MEN2A and 2B mutations

A

medullary carcinoma

49
Q

calcitonin producing tumor

A

medullary carcinoma

50
Q

sheets of polygonal cells in an amyloid stroma

A

medullary carcinoma

51
Q

increased TSH
decreased T4

A

primary hypothyroidism

52
Q

decreased TSH
increased T4

A

primary hyperthyroidism

53
Q

most appropriate first test for evaluation of thyroid function

A

TSH

54
Q

lymphocytes, plasma cells, Hurthle cells

A

Hashimoto

55
Q

papillary clusters of cells with optically clear nuclei (orphan Annie eyes)

A

papillary carcinoma

56
Q

spindle cells and colloid

A

medullary carcinoma

57
Q

abundant colloid
scant follicular cells

A

simple goiter

58
Q

best next step in evaluation of nodule found on US?

A

FNA

59
Q

hyperthyroidism
exophthalmos
skin changes

A

Graves

60
Q

antibodies directed toward TSH receptors are associated with

A

Graves

61
Q

serum calcitonin may be elevated in

A

medullary carcinoma

62
Q

anti-thyroglobulin antibodies are found in

A

Hashimoto

63
Q

causes of smooth/diffuse goiter [4]

A

Graves
Hashimoto
iodine deficiency
TSH-secreting pituitary adenoma

64
Q

causes of nodular goiter [4]

A

thyroid adenoma
thyroid cancer
toxic multinodular goiter
thyroid cyst

**FA says iodine deficiency is smooth, Mathur says its multinodular so do with that information what you will
***Nodular if long lasting

65
Q

familial medullary thyroid carcinoma are caused by inherited […] mutations

A

RET

M&M Test 3 (16 decks)

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