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Flashcards in thyroid and parathyroid pathology Deck (43):
1

What are the major signs and symptoms of hyperthyroidism

Hypermetabolism: weight loss, increased appetite, heat intolerance (always feeling hot)

-always feeling irritated, anxiety, short tempered
-Atrial fibrillation****
-"lid lag" --delay in downward movement of the upper eyelid
-Thyroid storm: thyrotoxic crisis-critical can lead to death

2

what is an indication of hyperthryoidism that it is critical and deathly?

thyroid storm

3

what is sometimes the only sign of hyperthyroidism symptom present?

atrial fibrillation

4

Graves disease

Autoimmune disease that produce autoantibody against TSH receptor and continues to bind to receptor to produce more T3 and T4.

high T3 and T4; low TSH

myxedema-like
common in women

5

when you have an enlarged thryoid, what is one thing you should consider?

thyroid is attached to trachea

6

what do myxedema-like nodules indicate? where is it commonly located?

hyperthyroidism; anterior part of lower extremities (shins)

7

what is the morphology of graves disease

diffuse, symmetrical BEEFY red gland

8

what does "scalloping" indicate

edge of colloids have bubbles=pale with resorption vacuoles--mimics a scallop

characteristic of hyperthyroidism

9

do Down Syndrome people have hyperthyroidism or hypothyroidism typically? and what is the cause of it?

HYPOthyroidism; lymphocytic thyroiditis--damage to thyroid which decrease T3 and T4

10

what is myxedema

accumulation of hydrophilic ground substance throught CT of body

this is a symptom of hypothyroidism

11

features of myxedema

coarsening of facial features, enlargement of tongue, puffiness around eyes, *****Deepening and croakking of voice--LOW voice

12

what is the hypothyroidism 1st present in infancy or childhood

Cretinism

13

What is the window of duration that you have to treat Cretinism and successfully reverse the damage?

3 weeks within birth time!!

14

what are some features of cretinism

stunted growth, retarded mental developt

remain like small children mentally and physically throughout life

15

common chronic progressive thyroid disease is what?

Hashimoto Thyroiditis

16

Hashimoto thyroiditis cause? and which sex is predominant?

deficiency in Treg, increased cytotoxic T cells and activated B cells; female

17

Morphology of Hashimoto thyroiditis

diffusely enlarged thyroid, capsule is INTACT, and well demarcated

cutting surface is pale, yellow tan

18

what is the Histology of Hashimoto thyroiditis

mononuclear inflammatory infiltrates

Thyroid follicles are atrophic lined by HURTHLE CELLS

19

what are Hurthle cells

abundant eosinophilic, granular cytoplasm
-not evenly distributed
-sandy looking
-normal cuboidal cells get attacked and then it becomes eosinophilic and granular cytoplasm--hurthle cells

20

which hypothyroidism can cause pain? what causes it?

Subacute Granulomatous; thyroid virus infection

21

Goiter

thyroid gland impairment -->INCREASED TSH--> CAnnot produce T3 and T4--> enlarged thyroid

iodide deficiency

hypothyroidism

22

what are the two different stages to goiter

colloid goiter------->multinodular goiter

23

Pathology of Goiter?

colloid rich follicles of varying size with flattened epithelium due to colloid pressure

later stage: hemosiderin, calcification, nodules, hemorrhage (multinodule start to form)

24

what is a normal thyroid epithelium?

cuboidal

25

flattened epithelium, hemosiderin, calcification, hemorrhage nodule indicates what disease???

multinodular goiter

26

what can change the temp of a nodule to hot?

increased radioiodine, able to accumulate radioactivity

27

Solitary, encapsulated lesion, well defined, intact capsule, benign--no tendency to turn malignant

thyroid adenoma

28

which thyroid cancer has the best prognosis? worst?

papillary, Anaplastic--almost all will die

29

Papillary thyroid carcinoma characterisitcs

often multifocal cancer, common in adults, Irradiating thyroid gland gives increase risk for pappllary carcinoma

Radioactive iodine/therapy does not increase risk of cancer

30

"orphan annie eye", psammoma bodies, nuclear holes, "coffee bean" nuclei indicate what disease

papillary thyroid carcinoma

31

when does follicular thyroid carcinoma become malignant? and where does it usually metastasize to?

if tumor invades THROUGH its "capsule"

metastatazie to lungs and bones

32

What type of tumor is C-cell tumor? and what are the characteristics?

medullary thyroid cancer, it produces calcitonin-->decrease Ca levels

both alleles are lost on RET on chromosome 10=C cell tumor

33

Massive thyroid and low calcium indicate what disease

medullary thyroid carcinoma

34

what is the feature of Anaplastic Carcinoma of thyroid (undifferentiated carcinoma)

very very very both hoistologically and clinically

35

what does excess PTH cause?

hypercalcemia

36

Flank pain and hematuria

most common presentation of hyperparathyroidism. TOO much PTH-->excess Ca will be excreted in urine--> cause renal stone and then you can feel FLANK PAIN and hematuria

37

patient complains about pain in kidney, and urine analysis shows hematuria, what should you consider?

tumor, secondary hyperparathyroidism

38

what are the signs and symptoms of primary Hyperparathyroidism?

renal stones, painful bones, abdominal groans (high serum Ca), mental moans"

39

what are two main causes of Primary hyperparathyroidism?

hyperplasia and adenoma

40

what is the difference between Adenoma and hyperplasia histologically and physiologically?

Hyperplasia: no fat strurcutres, no RIM of normal parathyroid tissue , and all 4 glands are enlarged

Adenoma: has some normal parathyoid
and has a rim between normal parathyroid tissue and adenoma, only one gland enlarged

41

two main causes of 2ndary parathyroidism

NOT due to parathyroid itself, but due to other factors such as hypocalcemia, CRF

42

chronic renal failure is a very common cause in what?

secondary hyperparathyroidism

43

what are some main etiology of hypoparathyroidism

autoimmune

surgical misdaventure--accidental removal of parathyroid

Digeroge syndrome