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Flashcards in Hypothyroidism Deck (26):
1

what types of myxedema are seen in hypo and hyperthyroidism?

Hypo: myxedema (facial/periorbital)
Hyper: pretibial myxedema

2

What are the drugs used to treat hypothyroidism?

levothyroxine (synthetic T4)
triiodothyronine (synthetic T3)

3

Which antibodies are seen in Hashimoto thyroiditis?

anti-thyroid peroxidase
antimicroscomal
antithyroglobulin

4

Those w/ Hashimoto have increased risk for what?

Non-hodgkin (b cell) lymphoma

5

Which genetic associations are there w/ Hashimoto's?

HLA-DR5
HLA-B5

6

What is the genetic association for Grave's?

HLA-DR3, HLA-B8

7

What are the gross findings in Hashimoto's?

painless goiter
hypothyroidism symptoms

8

What is found on histo w/ Hashimoto's?

Hurthle cells
lymphoid aggregate w/ germinal centers

9

What are the stages of Hashimoto's?

Euthyroid, see antibodies only
Inflammation: hyperthyroid
Destruction of thyroid: hypothyroid. Shrunken goiter. Histo looks like lymph nodes, lymphocytes etc.

10

What are some meds that can cause hypothyroidism?

amiodarone
tyrosine kinase inhibitors (chemo)
lithium

11

What are the 6Ps of congenital hypothyroidism/cretinism?

6Ps
Pot-bellied
Pale
Puffy-faced
Protruding umbilicus
Protuberant tongue
Poor brain development (ID)

12

Describe the course of subacute thyroiditis/de Quervain?

triggered by viral URI
early on: hyperthyroidism
then: hypothyroidism

13

What is the physical manifestation of subacute thyroiditis?

hypothyroidism symptoms
painFUL goiter

14

What is the histo of subacute thyroidits?

granulomatous inflammation

15

What is the genetic connection w/ subacute thyroiditis?

HLAB35

16

Which types of viral URIs can trigger subacute thyroiditis?

coxsackie virus
echovirus
adenovirus
measles
mumps

17

What is the treatment for subacute thyroidits?

NSAIDs and corticosteroids for pain
levothyroxine, once you have hypothyroidism

18

What happens in Riedel thyroiditis?

thyroid tissue replaced by fibrous tissue
this fibrosis can extend into other tissues (invasive)

see fixed hard painLESS goiter

19

What do you see on histo w/ Riedel thyroiditis?

macrophages eosinophils

20

What is the histo of the most common thyroid cancer?

Papillary Carcinoma
orphan anne nuclei (cleared out)
psammoma bodies

21

Which genetic mutations are associated w/ papillary carcinoma?

RET
BRAF
tyrosine kinase receptors

22

Thyroidectomy followed by high dose radioactive iodine therapy is recommended for the treatment of which thyroid cancers?

papillary carcinoma
follicular carcinoma
NOT medullary carcinoma b/c this is a cancer of C cells!

23

Aside from papillary carcinoma, which other thyroid cancer has a RET mutation & also has MEN2A&2B mutations?

Medullary carcinoma

24

What's the deal with follicular carcinoma?

same as follicular adenoma, except that it invades the capsule

thank goodness has different genetic markers than follicular adenoma b/c can't tell capsule invasion w/ FNA. Now, fewer unnecessary surgeries

25

Why is it important to check patients w/ medullary carcinoma for pheochromocytoma before taking them to surgery?

b/c they have MEN2A & 2B mutations. High likelihood of pheochromocytoma

remember--this is a cancer of the C cells of the thyroid, high calcitonin

26

You see invasive thing originating from the thyroid. Young pt what do you suspect? old pt?

Young-Riedel thyroiditis
Old-Anaplastic Carcinoma, sad b/c poor prognosis