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Endocrine - step > Pathology - thyroid gland > Flashcards

Pathology - thyroid gland Flashcards

1
Q

hypo or hyper thyroid has myxedema

A

both
hypo - facial and perioribtal
hyper - pretibial at graves, periorbital oedema

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2
Q

thyroid with menorrhagia

A

hypo

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3
Q

thyroid with oligomenorhea

A

hyper

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4
Q

hypercholesterolemia

A

hypo

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5
Q

hypocholesterolemia

A

hyper

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6
Q

what receptors do thyroid hormones up regulate?

A

LDL receptors and b1 recetpors

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7
Q

what is most common cause of hypothyrosim in non iodine deficient regions

A

hashimotos thyrodiits

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8
Q

auto abs in hashimotos

A

peroxidase
microsomal
thyroglobulin

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9
Q

HLA association of hashimotos

A

HLA-DR5

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10
Q

what is hashimotos associated wtih

A

increasd risk of non hodkgin lymphoma

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11
Q

type of hypersensitivity of hashimotis

A

type IV> type II

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12
Q

describe clinical course of hypothyroidism

A

hyper due to thyrotoxicosis during follicular rupture – hypo later one

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13
Q

describe the histopathos fo hashimotos

A

HURTHLE CELLS
lymphoid aggregates with germinal centres
follicles are small

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14
Q

moderately enlarged, non tender thyroid

A

hashimotos

NON TENDER

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15
Q

what is cretinism

A

severe detal hypothyroids due to a) maternal hypothyroids (befeore 7th to 12th week when thyroid develops), b) thyroid ageneis c) thyroid dysgenesis (most common at USA), d) iodine deficiency an de( dyshormonogenetic goiter

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16
Q 
pot bellined
pale
puffy faced
protruding abdomen
protebuerate tongue
poor brain development
A

cretinsim

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17
Q

cretinism presentation

A 
pot bellied
protuberant tonge
protuberant umbilicus
pale
poor brain development
puffy faced
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18
Q

diff between pit dwarfism and thyroid dwarfism

A

pit - low weight and height

thyroid - high weight and low height

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19
Q

what would you suspect with thyroid issues after a FLU LIKE ILLNESS

A

de quervain, subacute thyroiditis

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20
Q

clinical course of subacute thyroiditis/de quervains

A

may be hyper first then hypo

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21
Q

histology of subacute thyroiditis/de quervains

A

granulomatous inflammation

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22
Q

increased ESR
jaw pain
early inflammation
very tender thyroid

A

de quervain/subacute thyroiditis

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23
Q

cxpx of subacute tyroditis

A 
increased ESR
jaw pain
early inflammation
very TENDER thyroid
first hyper then hypo
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24
Q

what is ridel thyroiditis

A

replaced with fibrous tissue that can extend to local stuctures ie the airway mimicking an anaplastic acracinoma

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25
Q

what is reidle thyroiditis considered a manifestation of

A

IgG4 systemic disease – autoimmune pancreatitis, retroperitoneal fibrosis, noninfetious aorittis

26
Q

autoimmune pancreatitis
retroperitoneal fibrosis
noninfectious aortitis

A

reidel thyroiditis

27
Q

what is wolff chaifkoff effect

A

thyroid fland downregulation inr esponse to incread iodide

28
Q

what is most common cause of hyperthyroidism

A

grave disease

29
Q

what do anti TSH abs stimulate

A

a) TSH receptors on thyroid
b) retro-orbilta fibroblasts
c) dermal fibroblasts

30
Q

since graves has anti-TSH abs what sxs does it have that are unique to graves and not other thyrotoxicosis?

A

retro-orbital fibroblasts –> exophthalmos, proptosis, extraocular muscles swelling
dermal fibroblasts –> pretibial myxedema

31
Q

when does grave disease often present

A

stress

childbirth

32
Q

presentation of toxic mutlinodular goiter

A

multiple hot nodules

rarel maligi

33
Q

what causes toxic multinodular goiter

A

mutation in TSH

34
Q

pathophys of toxic multinodular goiter

A

focal patched of hyerfunctioning follicular cells working independently of TSH

35
Q

histopathos of toxic multinodular goiter

A

follicles of various sizes distended with colloid and lined by flattened epithelium with areas of fibrosis and hemorrhage

36
Q

what is a thyroid storm?

A

stress-induced catecholamine surge - thyrotocisosis due to diease and othe rhyperhtyorid disorders

37
Q 
agititation
delirium
fever
diarrhoea
coma
tachyarrhytmia
A

thyroid storm

38
Q

symptoms of thyroid storm

A 
agitiation
delirium
fever
diarrhoea
coma
tachyarrhythmia
39
Q

major cause of fatalitiesin thyroid storm

A

tacharrhythmia

40
Q

what lab marker may be increased in thyroid storm and whhy

A

ALP bc of increased bone turnover

41
Q

how to treat thyroid storm

A

THREE Ps

propranolol: beta blocker
prednisolone: corticosteroids
propylthiourail: blocks peroxidase and 5’-deiodinase

42
Q

what is jod basedow phenomenon

A

thyrotoxicosis if a patient with iodeine deficiency goiter is made iodine repelte

43
Q

thyrotoxicosis if give iodine to person with iodine deficiency goiter

A

jod basedow phenomenon

44
Q

what can cross placenta thyroid style

A

IgG TSH antibodies.

45
Q

what are complications of thyroidectomies

A

hoarsness - recurrent laryngeal nerve damage
hypocalcemia - removal of parthyroids
transection of recurrent laryngeal nerces - ligation of inferior thyroid arter
transection of superior laryngeal nerces with superior layrneal aretery ligation

46
Q

what is the most common thyroid cancer

A

papillary carcinoma

47
Q

what has the best prognosis of thyroid cancers

A

follicular carcinoma

48
Q

what thyroid cancer would you expect to see in older females

A

undifferentiated/anaplastic carcinoma

49
Q

when would you expect to see lymphoma thyroid style?

A

hashimoto thyroiditis

50
Q

psmamma bodies

A

papillary carcinoma of thyroid

51
Q

lymphatic invasion

A

papillary carcinoma

52
Q

metastasis fo papillary carcinoma

A

lymph nodes and lung

53
Q

metasaiss of follicular carcinoma

A

lung and bones

rarely cervical LN

54
Q

capsule

A

folliciluar carcinoma

55
Q

RET and BRAF mutations

A

papillary carcinoma

56
Q

childhood irradation

A

papillary carcinoma

57
Q

parafoliclular C cell tumour

A

medullaryc arcinoma

58
Q

marke for medullary carcinoma

A

calcitonin

RET mutations

59
Q

hematogenous spread

A

medullary carcinoma

60
Q

pathologies associated with medullary carcinomas

A

MEN IIa

MEN IIb

61
Q

histopathos in follicular carcinoma

A

uniform follicles

62
Q

histopathos in medullary carcinoma

A

sheets of cells in an amyloid (from calcitonin) stroma

Endocrine - step (7 decks)

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