Chapter 24- Thyroid Flashcards Preview

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Flashcards in Chapter 24- Thyroid Deck (76)
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1

Effects of T3/T4 on the liver

-Increased cholesterol synthesis
-Increased cholesterol reabsorption from plasma
-Conversion of cholesterol to bile acids
-increased fat oxidation/synthesis
-Increased gluconeogenesis

2

What is the affect of T3/T4 on muscle

-Increased protein catabolism
-Increased glucose utilization
-Increased fat oxidation

3

Where is thyroglobulin synthesized and stored

Synthesized and stored in the colloid

4

What is the most common cause of hyperthyroidism

Primary hyperthyroidism

5

What type of condition does diffuse hyperplasia fall into

Aka Graves’ disease

-Hyperthyroidism

6

What type of condition does hyper functioning multinodular goiter fall into

Hyperthyroidism

7

What type of condition does hyperfunctioning thyroid adenoma fall into

Primary hyperthyroidism

8

What type of condition does pituitary adenoma fall under

Secondary hyperthyroidism

9

IN the cause of suspected hyperthyroidism, which condition is suspected when the TSH level is low

Primary hyperthyroidism

10

IN the cause of suspected hyperthyroidism, which condition is suspected when the TSH level is high

Secondary hyperthyroidism, so basically pituitary adenoma

11

What are the four components of thyroid storm

-Fever
-Cardiac manifestations
-GI symptoms
-Precipitating history (drugs, pregnancy)

12

During thyroid storm, what are the cardiac manifestations that can be seen

-Tachycardia
-CHF

13

During thyroid storm, what are the GI symptoms that can be seen

-Diarrhea
-Jaundice

14

During thyroid storm, what are the past history factors that can contribute

-Pregnancy/postpartum
-Hemithyroidectomy
-Drugs, such as amiodarone

15

What are the treatments for the manifestations seen in thyroid storm

-Beta blockers (for cardiac)
-NSAIDs (for the fever)

16

What is the Wolf-Chaikoff effect

High doses of iodide will decrease the amount of thyroid production

17

What is the most common cause of hyperthyroidism

Graves disease

18

What are the clinical manifestations of Graves disease

1- Hyperthyroidism with gland enlargement
2- Infiltrative ophthalmopathy
3- Pretibial myxedema

19

What are the histological findings in the case of thyroid gland enlargement

Resorption follicles, which are basically just the hyper collection of the thyroid products

20

What is the cause of ophthalmopathy in Graves

1) Lymphocytes invade the preorbital space
2) Fibroblasts have TSH receptor, so are stimulated by TSHR Abs
3) Extraocular muscles swell
4)Hyloranadate and proteoglycans accumulates (aka matrix accumulation)
5) Adipocytes expand and fill space behind eyes

21

What is pretibial myxedema and what is it indicative for

-Infiltrative dermopathy causing scaly indurated skin on the shin area

22

What are the serum laboratory findings of TSH, T3/T4, TSI in the case of Graves

-T3/T4 high
-TSH low
-TSI high (thyroid stimulating Ig)

23

What are the clinical presentations of congenital hypothyroidism

Aka cretinism, from lack of thyroid:
-Mental retardation
-Growth retardation
-Course facial features
-Umbilical hernias

24

What are the genetic components that can cause congenital hypothyroidism

-PAX8, FOXE1, TSH receptor mutations all cause defects in thyroid development
-THRB mutations cause thyroid hormone resistance syndrome

25

What are the clinical skin findings in the case of hypothyroidism

Skin is:
-Course (follicular keratosis)
-Cool
-Dry
-yellowish (carotenemia)

26

What is the most common cause of hypothyroidism

Hashimoto thyroiditis

27

What is the pathogenesis of Hashimoto thyroiditis

-Autoantibodies against thyroglobulin and thyroid peroxidase

28

What is the process of Hashimoto hyroiditis causing hypothyroidism

1) Immune mediated insult
2) Hyperactivity and enlargement
3) Follicular cell exhaustion

29

What are the histological changes seen in Hashimoto thyroiditis

-Lymphcytic infiltrate appearance with germinal centers

-Hurthle cell metaplasia, where there are strophic follicule cells with eosinophilic changes

30

Which antibodies are present in Hashimoto thyroiditis

-antithyroglobulin AB aka hTg-Ab (80-90%)

-Antiperoxidase antibody aka hTPO-Ab (90-100%)