Thursday - Thyroid path - Krafts Flashcards Preview

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Flashcards in Thursday - Thyroid path - Krafts Deck (28):
1

T4 goes up a little, what happens to TSH

Goes down a lot.
(or other way T4 down a little, TSH up a lot)

2

T4 and TSH labs of primary hyperthyroidism

Secondary?

T4 high
TSH low

T4 high
TSH high

3

T4 and TSH labs of primary hyporthyroidism

Secondary?
(problem is somewhere other than thyroid galnd)

T4 low
TSH high

T4 low
TSH low

4

3 antibodies that could be in Hashimotos or Grave disease

anti-peroxidase
- usually hashimotos's
anti-thyroglobulin
- either
anti-TSH receptor
- either, but in Graves, it stimulates

5

Systemic signs of hyperthyroidism

Weight loss, warm
fast heart
tremor
diarrhea
eyelid stays open when eyes move down

6

Most common cause of Hyperthyroid

others?

Graves disease

multinodular goiter
thyroid adenoma/carcinoma
pituitary adenoma
stroma ovarii

7

Systemic signs of hyporthyroidism

fatigue, weight gain
slow heart
delayed reflexes
dry skin, hair loss
no appetite
deep voice
Myxedema - under eyes
mental changes

8

Congenital hypothyroidism is due to:
treatment:

genetic or iodine deficient
Thyroid hormone or iodine

9

Autoimmune thyroiditis called:
symptom:
Labs?
antibodies?

Hashimoto's
painless, large thyroid
low T4, high TSH
anti-peroxidase
anti-thyroglobulin

10

Pathophys of Hashimoto's

T cells recognize thyroid as antigen --> stimulate b cells to make antibodies

11

De Quervain thyroiditis
symptoms

histo:

Big, SORE thyroid
recent URI
had hypERthyroid
jaw pain
it's self limiting

granulomas, lymphocytes

12

Histo findings of hashimoto's

inflammation
large germinal centers
Hürthle cells - big, pink, inflamed cells

13

Histo finding of Silent thyroiditis

cause?

just lots of lymphycytes

don't know, HLA, autoimmune?

14

Hypothyroid with a hard mass of fibrous tissue called?

Reidel thyroiditis
- painless

15

Triad of symptoms seen in Graves disease

Hyperthyroid
Opthalmopathy
Dermopathy
- thick skin/rash

16

Histo of graves disease

"busy"
scalloping of colloid

17

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

18

What is a goiter?

big thyroid for any reason
usually decreased T4 --> increased TSH

19

irritation or palpation of a goiter can cause what?

multinodular goiter

20

Thyroid nodule. awe, it's cancer.
benign or malignant?
more likely cancer if...

Usually benign adenoma

solitary nodule, male, radiation

21

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

22

Caracteristics of thyroid adenoma

solitary, encapsulated, no invasion

gain of funtion

23

Why do you take out adenomas

they can look the same as follicular carcinoma

24

4 types of thyroid carcinoma

Papillary - 80%
Follicular - 10
medullary - 5
anaplastic - 5

25

Papillary Thyroid carcinoma.
Prognosis
Where can it metastasize

histo finding

good prognosis

local lymph node

obviously looks papillary
"orphan annie" nuclei - chromatin pushed to sides
psammoma bodies

26

Follicular Thyroid Carcinoma
prognosis
where does it metastasize

good, worse with age
lung and bone

27

Medullary Thyroid carcinoma, what cells?
prognosis
where does it metastasize
Histo?

C cells - make calcitonin

good if not metastisized

amyloid - bubble gum looking

28

Anaplastic Thyroid Carcinoma
prognosis

Real bad
it's rare, grows quickly, usually metastasizes