Endocrine Pathology 2

Question 1

functional thyroid diseases

Answer 1

Euthyroid sickness syndrome
hyperthyroidism
hypothyroidism

Question 2

What are the congenital thyoid diseases

Answer 2

Throglossal duct cyst

-throid aplasia

Question 3

Anatomical thyroid diseases

Answer 3

Goiters
Thyroid nodules
Thyroid cancer

Question 4

What is goitre and main cause

Answer 4

Enlargement of the thryroid gland

-due to iodine def

Question 5

pathology of sporadic goiter

Answer 5

• female predominance; young adults

- Low levels of thyroid hormones-> increased level of TSH-> TSH-> hyperplasia and hypertrophy of follicular cells

Question 6

Mc condition fo hyperthyroidism

Answer 6

Graves disease, Toxic goiter

-hyperthyroidism increases the basal metabolic rate and increaes the organs sensitivity to catechlamies

Question 7

Pathogenesis of Graves disease

Answer 7

Production of anti TSH receptor antibody that stims the receptor, resulting in increased prod of T3/4

thyroid gland itself is diffusely enlarged but not nodular

Question 8

some mc s/s of graves disease

Answer 8

exophthalmos- protrusion of eye due to retro orbital soft tissue

Pretibial myxedema- scaling and thickening of dermis`

Question 9

what is a major complication of hyperthyroidism and cause. pres

Answer 9

Thyroid storm (abrupt onset of severe hyperthyroidism)

cause- Secondarily increase levels of catecholamines due to surgery and acute infection

clinical pres- hyperthermia out of proportion, fever, flushing, sweating etc

Question 10

Hypothyroidism major signs, 2 causes

Answer 10

decreased metabolic rate
-weight gain, cold intolerance, cool skin, thinning hair

Cretinism + myxedema

Question 11

Lab findings for primary hypothyroidism and secondary hypothyroidism

Answer 11

primary- increased TSH-> body is trying to increase thyroid hormones

Secondary- Decreased TSH-> decreased T3/4

Question 12

What is cretism

Answer 12

hypothyroidism occurring during infancy/childhood

Question 13

What is myxedema and causes

Answer 13

Hypothyroidism occurring in older children + adults

Causes
-Hashimoto thyroditis, iodine def and idiopathic

Question 14

What is myxedema coma

Answer 14

severe complication of hypothyroidism occurring mostly in older pts.
Characterized by altered mental status with or without coma
-Altered mentation, hypothermia, hypotension

Question 15

Hashimoto thyroiditis pathogenesis, diagnosis

Answer 15

primary hypothyroidism
-inflammatory autoimmune destruction of the thyroid

Dx- high TSH, antithyroid peroxidase, ant-thyroglobulin antibodies in 90% of cases

Question 16

What is thyroiditis and two types

Answer 16

inflammation of the thyroid gland

• acute syppurative thyroiditis
• Subacute thyroiditis (associated w HLA B35)

Question 17

what are the 5 common types of thyroid neoplasms

Answer 17

Papillary carcinoma
follicular adenoma
follicular carcinoma
medullary carcinoma
anapaestic carcinoma

Question 18

epidemiology and look of follicular adenoma and carcinoma

Answer 18

older pts.

Capsular invasion or blood vessel invasion distinguishes a follicular carcinoma from follicular adenoma
-not multifocal

Question 19

Medularry thyroid carcinoma- epidemiology, what does it mc produce

Answer 19

occurs in pts older than 50

-mc produces hormones-> mc calcitonin

Question 20

What is a anapaestic carcinoma and important points on it

Answer 20

Older pts

Very rapidly growing, highly malignant, poor prog

Question 21

increase in PTH stims increase in calcium via what 3 ways

Answer 21

increased bone resorption
increased renal resorption of calcium
increased synthesis of calcitriol (stims go to increase calc resorption)

Question 22

complications of primary hyperparathyroidism

Answer 22

Osteiits fibrosa cystica

Brown tumor

Nephrolithiasis (kidney stones)

Question 23

What is secondary hyperparathyroidsism due to result

Answer 23

Normal parathyroid gland histological and morphologically, however parathyroid gland is producing increased PTH in response to hypocalcemia

causes: renal failure, vit d def

Question 24

What is tertiary hyperparathyroidism

Answer 24

tertiary hyperparathyroidism is secondary that becomes automous
-no longer requires the stim of renal failure to undergo hyperplasia

Question 25

What happens in hypoparathyroidism

Answer 25

Reduction in function of parathyroid glands leading to underpaid of PTH
-leads to decreased serum calcium levels and increased phosphate levels

Question 26

causes of hypoparathyroidism

Answer 26

mc is iatrogenic- removal during thyroidectomy

Question 27

Symptoms of hypocalcaemia

Answer 27

Trousseu sign- contraction of forearm mm when the blood pressure cuff is placed around the arm

Chvostek sign- twitching of facial mm w facial nerve is tapped