Flashcards in Thursday - Thyroid path - Krafts Deck (28):
T4 goes up a little, what happens to TSH
Goes down a lot.
(or other way T4 down a little, TSH up a lot)
T4 and TSH labs of primary hyperthyroidism
T4 and TSH labs of primary hyporthyroidism
(problem is somewhere other than thyroid galnd)
3 antibodies that could be in Hashimotos or Grave disease
- usually hashimotos's
- either, but in Graves, it stimulates
Systemic signs of hyperthyroidism
Weight loss, warm
eyelid stays open when eyes move down
Most common cause of Hyperthyroid
Systemic signs of hyporthyroidism
fatigue, weight gain
dry skin, hair loss
Myxedema - under eyes
Congenital hypothyroidism is due to:
genetic or iodine deficient
Thyroid hormone or iodine
Autoimmune thyroiditis called:
painless, large thyroid
low T4, high TSH
Pathophys of Hashimoto's
T cells recognize thyroid as antigen --> stimulate b cells to make antibodies
De Quervain thyroiditis
Big, SORE thyroid
it's self limiting
Histo findings of hashimoto's
large germinal centers
Hürthle cells - big, pink, inflamed cells
Histo finding of Silent thyroiditis
just lots of lymphycytes
don't know, HLA, autoimmune?
Hypothyroid with a hard mass of fibrous tissue called?
Triad of symptoms seen in Graves disease
- thick skin/rash
Histo of graves disease
scalloping of colloid
Antibodies in Graves disease
why eye and skin symptoms??
anti-TSH --> proliferation of follicles
thyroid hormone released --> hyper T3,4
TSH receptor is also in retro-orbital tissue and pre-tibial tissue
What is a goiter?
big thyroid for any reason
usually decreased T4 --> increased TSH
irritation or palpation of a goiter can cause what?
Thyroid nodule. awe, it's cancer.
benign or malignant?
more likely cancer if...
Usually benign adenoma
solitary nodule, male, radiation
Biopsy a thyroid nodule. What do you see if you determine it just needs treatment, but not removed
Hürthle cells - hashimoto's
if it's just follicles, it could be cancer still
Caracteristics of thyroid adenoma
solitary, encapsulated, no invasion
gain of funtion
Why do you take out adenomas
they can look the same as follicular carcinoma
4 types of thyroid carcinoma
Papillary - 80%
Follicular - 10
medullary - 5
anaplastic - 5
Papillary Thyroid carcinoma.
Where can it metastasize
local lymph node
obviously looks papillary
"orphan annie" nuclei - chromatin pushed to sides
Follicular Thyroid Carcinoma
where does it metastasize
good, worse with age
lung and bone
Medullary Thyroid carcinoma, what cells?
where does it metastasize
C cells - make calcitonin
good if not metastisized
amyloid - bubble gum looking