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Path Thyroid Flashcards

Describe the clinicopathologic features of the inflammatory thyroid disorders (acute, granulomatous, Hashimoto, lymphocytic, Reidel thyroiditis) Compare and contrast the causes of thyroid enlargement (goiter) Compare and contrast the clinicopathologic features of the most common tumors of the thyroid (papillary, follicular, medullary and anaplastic) Describe the pathologic causes and clinical findings in Graves Disease

1
Q

signs of hyperthyroidism

A

soft warm skin, heat intolerence, weight loss despite appitite, diarrhea, heart palp, proximal muscle weakness, wide-eyed staring gaze,

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2
Q

caused by actute elevation of catecholine levels, usually by underlying Graves disease

A

thyroid storm

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3
Q

blunted sx of thyrotoxicosis in elderly

A

Apatheric hyperthyroidism

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4
Q

most useful single screening test for hyperthyroidism

A

TSH levels

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5
Q

TSH levels in pituitary/hypothalamic secondary hyperthyroidism

A

elevated

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6
Q

whole-gland uptake of radioactive iodine indicates

A

Graves

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7
Q

decreased uptake of radioactive iodine indicates

A

thyroiditis

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8
Q

increased nodular uptake of radioactive iodine indicates

A

toxic adenoma

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9
Q

hypothyroidism in infancy or early childhood

A

cretinism

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10
Q

impaired development of skeletal and CNS with severe MR, short stature, protuding tounge and umbilical hernia

A

cretinism

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11
Q

hypothyroidism in older children and adults

A

myxedema

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12
Q

generalized apathy and mental sluggishness, listless, cold-intolerent and gaining weight, and edema

A

myxedema

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13
Q

risk in late stage myxedema

A

Heart failure

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14
Q

most sensitive test for suspected hypothyroidism

A

serum TSH (increased)

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15
Q

most common cause of hypothyroidism when iodine levels are ok

A

hashimotos

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16
Q

gradual hypothyroidism in woman 45-60

A

hashimotos

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17
Q

gradual autoimmune thyroid failure

A

hashimotos

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18
Q

pathenogenesis of hashimotos

A

autobodies against thyroid antigens deplete epithelial cells in thyroid and replace with fibrosis

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19
Q

most significant gene defect in hashimtos

A

CTLA4

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20
Q

mononuclear inflammatory infiltrate with well developed germinal centers and atrophic follicles. Cells with numerous prominent mitochondria

A

hashimotos

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21
Q

hurthle/oxyphill cells

A

hashimotos

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22
Q

risk of other diseases with hashimotos

A

other autoimmune diseases and B cell lymphoma arising in the thyroid gland

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23
Q

rarer thyroidism in women 30-50

A

subacute granulmatous thyroiditis

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24
Q

thyroiditis triggered by viral infections

A

subacute granulmatous thyroiditis

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25
enlarged thyroid with disruption of folicles leading to inflammatory cells
subacute granulmatous thyroiditis
26
pain in the neck while swallowing, fever and malaise after viral infection
subacute granulmatous thyroiditis
27
painless neck mass and hyperthyroidism with lymphocytic inflammation
subacute lymphocytic thyroiditis
28
subacute granulmatous thyroiditis often occurs after
pregnancy
29
hyperthyroidism, eyes bugging out, and pretibial myxedema
Graves Disease
30
most common cause of endogenous hyperthyroidism
Graves Disease
31
peaks in women between 20-40
Graves disease
32
antigen occuring in Graves
HLA DR3
33
Graves antibodies attack
TSH receptors
34
autoantibodies created in Graves
Thyroid stimulating immunoglobulin Thyroid growth-stimulating immunoglobulins TSH-binding inhibitor immoglubulins
35
causes the eye bulging in Graves
infiltration of T cells in retroorbital spaces inflammatory edema and swelling in extraocular muscles accumulation of hyaluronic acid and chrondrotin sulfate increased number of adipocytes behind eyes
36
diffuse hypertrophy and hyperplasia of thryroid follicular epithelial cells with crowded follicular epithelial cells projecting into the follecular lumen. Pale colloid and lypmocytic infiltrates
Graves
37
difference between Graves and papillary carcinoma
graves has papillae WITHOUT fibrovascular cores
38
elevated T4 and T3, depressed TSH with diffuse uptake of iodine
graves
39
cause of endemic of goiter
living in a area with low iodine in food supply
40
cause of sporadic goiter
excessive calcium, cabbage-like veg, or hereditary enzymatic defects in thyroid hormone defects
41
when to worry about a goiter turning malignant
sudden change in size, hoarseness
42
instances when thyroid nodules are more likely to be cancerous
solitary, nodules, nodules in younger patients, nodules in males, hx of radiation, nodules that take up a lot of iodine
43
definitive test for thyroid malignancy
FNA + histologic study of surgically resected thyroid parenchyma
44
adenomas derived from
follicular epithelium
45
most common thyroid carcinoma
papillary
46
most thyroid carcinomas arise frome
thyroid epithelium
47
most common oncogenic pathway in papillary thyroid carcinomas
MAP kinase
48
protein found in most papillary thyroid carcinomas
RET/PTC
49
RET/PTC or BRAF should point to
papillary thyroid carcinomas
50
mutation in follicular thyroid carcinomas
PI-3K/AKT
51
translocation in follicular thyroid carcinomas
q13;p25
52
highly aggressive and lethal thyroid tumor
anaplastic carcinoma
53
arise from parafollicular C cells
medullary thyroid carinomas
54
medullary thyroid carinomas occur in what genetic syndrome
MEN-2
55
mutation associated with MEN-2
RET
56
environmental risks in thyroid cancer
ionizing radiation and iodine deficnecy
57
ground glass nuclei with pseudoinclusions
papillary carcinomas
58
psammoma bodies
papillary carcinomas
59
empty appearing "orphan annie" nuclei
papillary carcinomas
60
nonfunctional tumor presenting with painless mass or cervical lymph node
papillary carcinomas
61
thyroid carcinoma presenting most in older women
follicular carcinomas
62
more frequent thyroid carcinoma in iodine def, areas
follicular carcinoma
63
carcinoma with solitary cold thyroid nodues
follicular carcinomas
64
thyroid that mets easily through bloddstream
folliciular carcinoma
65
thyroid cancer associated with older pts and hx of previous well-differentiated carcinomas
anaplastic
66
large pleomorphic cells, spindle cells
anaplastic
67
prognosis with anaplastic carcinoma
dead within a year
68
derivation of medularry carcinomas
parafollicular/C cells
69
secrete calcitonin
medullary carcinoma
70
genetic syndrome often in medularry carcinomas
MEN2
71
amyloid depoits and multicentric C cell hyperplasia
medullary carcinoma
72
dyphagia, hoarseness, possible diarrhea
medullary carcinoma

Endocrine (13 decks)

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