Flashcards in EXAM #1: PATHOLOGY OF THYROID Deck (48)
What are the signs and symptoms of hyperthyroidism?
2) Enhanced epinephrine effect (tremulous and anxiety)
3) Lid lag
5) Thyroid storm
What is "lid lag?"
A delay in the downward movement of the upper eyelid
A young female patient is sweaty with a-fib. What do you need to rule out?
What is thyroid storm?
- This is an acute, life-threatening, hypermetabolic state
- Induced by excessive release of thyroid hormones (THs) in individuals with thyrotoxicosis (Grave's Disease)
*Typically from surgery of childbirth*
What is Graves' Disease?
Autoimmune disease with production of IgG antibody vs. TSH receptor
What is the sex-predominance in Graves' Disease?
What are the labs that are seen in Graves' Disease?
High T3/T4 with LOW TSH
What are the ophthalmologic consequences of Grave's Disease?
What is myxedema?
Swelling of the skin and underlying tissues of the shin giving a waxy/doughy consistency
*This is due to TSH stimulation of fibroblasts with TSHR
What is myxedema most commonly associated with?
HYPOthyroid--however, sometimes it is seen in HYPER; be sure to associate with other symptoms
*Iodine deficiency leads to increased TSH release OR, TSH antibodies in graves
What is the gross appearance of the thyroid gland in Grave's Disease?
Diffuse, symmetrically beefy red gland
What is the histologic appearance of Grave's Disease?
- Pale colloid with resporption vacuoles i.e. "scalloping"
- Hyperplastic follicles with papillary infoldings
What are the signs and symptoms of Hypothyroid?
1) Slowing of mind and body
2) Myxedema (accumulation of hydrophilic ground substance in connective tissue)
What is the name of the disease that occurs when a child has hypothyroid?
What are the clinical features of cretinism?
1) Stunted growth
2) Retarded mental development
3) Delayed bone and tooth development (2-4 months is normal)
Also, facial swelling, puffy eyelids, protruding tongue, low hair line, and altered eyebrows.
When does thyroid hormone need to be replaced to reverse the course of cretinism?
Before the 3rd week
*Note that legally you are abound to screen for cretinism
What is Hashimoto Thyroiditis?
Chronic progressive thyroid disease
*Presents as hyperthyroid then progresses to hypothyroid
What causes Hashimoto Thyroiditis?
Autoimmune destruction of the thyroid gland associated with HLA-DR5
What is the gross appearance of Hashimoto Thyroiditis?
- Diffusely enlarged
What is the histologically pathognomonic for Hashimoto Thyroiditis?
Hurtle Cells and chronic inflammation with germinal centers
What is a Hurtle Cell?
Metaplasia of the cells that line the thyroid follicle due to autoimmune attack
What is De Quervain Thyroiditis?
Transient granulomatous hyperthyroidism secondary to viral infection
What causes De Quervain Thyroiditis?
Viral infection esp. by coxsackie and adenovirus
What is the sex predominance of De Quervain Thyroiditis?
What is the unique clinical aspect of De Quervain Thyroiditis?
What is a Goiter?
Thyroid enlargement, usually due to relative iodine deficiency
What causes Goiter?
Impaired ability of thyroid to produce thyroid hormone
What happens to TSH with goiter?
What causes Goiter?
- Decreased iodide
- Compensatory increase in TSH leads to enlargement