Introduction to Thyroid Pathology Flashcards Preview

Endo/Repro Exam 1 > Introduction to Thyroid Pathology > Flashcards

Flashcards in Introduction to Thyroid Pathology Deck (55):
1

What is a primary endocrinopathy?

Thyroid disorder

2

What is a secondary endocrinopathy?

Pituitary disorder

3

What is a goiter?

State of enlargement of the thyroid gland

4

What are Goitrogens?

Chemical agents that suppress thyroid function

5

What are C cells?

Parafollicular cells

6

What do parafollicular (C cells) release?

Calcitonin

7

Where are parafollicular cells located?

Within the wall of follicles around follicular cells

8

What is a medullary thyroid carcinoma?

Parafollicular neoplasm

9

What occurs in medullary thyroid carcinoma?

Increased serum calcitonin

10

What is thyrotoxicosis?

Hyperthyroidism

11

What can occur in hyperthyroidism in patients with underlying heart issues?

Low-output hear failure due to dilated cardiomyopathy (left ventricle too dilated so not large ejection fracture)

12

What occurs with lid lag?

Superior tarsal muscle pulls the lid too high so eyes appear to bulge but are not

13

What is true thyroid ophthalmopathy associated with?

Grave's disease

14

What is cretinism?

Low iodine levels due to insufficient levels in diet; early childhood or mothers diet

15

What diseases can occur due to hypothyroidism?

Cretinism
Myxedema

16

Three differential diagnosis of goiters?

Inflammatory or immune-mediated disease
Non-neoplastic parenchymal enlargement
Neoplasms

17

What is the most useful screening test for hyper and hypothyroidism?

TSH levels

18

TSH levels in hyper:

Low (due to T4/T3 feedback to decrease release)

19

TSH levels in hypo:

High (no T3/T4 to turn it off)

20

What do hot nodules show?

Activity in thyroid

21

What do cold nodules show?

Inactivity due to neoplasms

22

Four thyroid disease categories:

Thyroiditis
Graves disease
Diffuse and Nodular goiter
Neoplasm

23

Four types of thyroiditis:

Hashimoto thyroiditis
Subacute lymphocytic thyroiditis
Granulomatous thyroiditis
Reidel thyroiditis

24

What is Hashimoto thyroiditis?

Hypothyroidism where iodine levels are sufficient

25

What type of goiter does Hashimoto cause?

Painless symmetric and diffuse

26

What causes Hashimoto thyroiditis?

Autoimmune disease with destruction of thyroid gland

27

Why can Hashimoto initially present as hyperthyroidism?

Inflammatory destruction of epithelial cells causing a spillage of T3/T4

28

What cells can be found in Hashimoto thyroiditis?

Hurthle cells

29

What is Subacute lymphocytic thyroiditis?

Autoimmune disease against antithyroid peroxidase

30

What is the goiter in Subacute lymphocytic thyroiditis?

Painless

31

What is a variant of Subacute lymphocytic thyroiditis?

Post-partum thyroiditis

32

What is granulomatous thyroiditis?

Most common cause of thyroid pain; self-limiting; transient inflammation

33

What does granulomatous thyroiditis cause?

Hyperthyroidism from destruction of cells and T3/T4 release

34

What occurs to iodine uptake in granulomatous thyroiditis?

Decreased radioactive iodine uptake

35

What occurs in Reidel thyroiditis?

Extensive fibrosis; maybe associated with pathologic progressive fibrosis

36

How is the thyroid seen in Reidel thyroiditis?

Hard and fixed thyroid that mimics carcinoma

37

What causes Graves disease?

Antibodies against the TSH receptors thus stimulating the receptors

38

What are the underlying cause of Graves disease?

Thyroid stimulating immunoglobulins (TSI)

39

What triad characterizes Graves disease?

Thyrotoxicosis
Ophthalmopathy
Dermopathy

40

What are the three types of goiters?

Diffuse (simple)
Multinodular
Dyshormonogenetic

41

What characterizes a diffuse goiter?

Uniform enlargement; TSH elevated but person is euthyroid

42

Two types of diffuse goiters?

Endemic goiter
Sporadic goiter

43

What causes endemic goiters?

Goitrogens or low iodine

44

What causes sporadic goiters?

Young people with unknown cause

45

Diffuse goiter pathology?

None it is non-toxic

46

What characterizes a multinodular goiter?

Numerous discrete nodules

47

Symptoms of multinodular goiters?

Most are euthyroid or can develop autonomous nodules that produce excessive thyroid hormones

48

What is dyshormonogenetic goiter?

Rare but familial goiter

49

What are the general statistics of thyroid neoplasms?

Solitary are more likely to be neoplastic
Nodules in younger patients and males are more likely to be neoplastic
Hot nodules are more likely to be benign than malignant

50

Four major types of carcinomas:

Papillary carcinoma
Follicular carcinoma
Anaplastic carcinoma
Medullary carcinoma

51

Papillary carcinoma:

85% of cases; Tend to metastasize to cervical nodes

52

Follicular carcinoma:

5-15% of cases; Capsular invasion or vascular invasion by neoplastic cells

53

Anaplastic carcinoma:

5% of cases; Aggressive 100% mortality

54

Medullary carcinoma:

Neuroendocrine carcinoma
C cells secretes calcitonin

55

Two phases of diffuse goiter?

Hyperplastic: Response to demand for more thyroid hormone
Colloid involution: Less demand for thyroid hormone