Flashcards in thyroid and parathyroid pathology Deck (43):
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
-"lid lag" --delay in downward movement of the upper eyelid
-Thyroid storm: thyrotoxic crisis-critical can lead to death
what is an indication of hyperthryoidism that it is critical and deathly?
what is sometimes the only sign of hyperthyroidism symptom present?
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
common in women
when you have an enlarged thryoid, what is one thing you should consider?
thyroid is attached to trachea
what do myxedema-like nodules indicate? where is it commonly located?
hyperthyroidism; anterior part of lower extremities (shins)
what is the morphology of graves disease
diffuse, symmetrical BEEFY red gland
what does "scalloping" indicate
edge of colloids have bubbles=pale with resorption vacuoles--mimics a scallop
characteristic of hyperthyroidism
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
what is myxedema
accumulation of hydrophilic ground substance throught CT of body
this is a symptom of hypothyroidism
features of myxedema
coarsening of facial features, enlargement of tongue, puffiness around eyes, *****Deepening and croakking of voice--LOW voice
what is the hypothyroidism 1st present in infancy or childhood
What is the window of duration that you have to treat Cretinism and successfully reverse the damage?
3 weeks within birth time!!
what are some features of cretinism
stunted growth, retarded mental developt
remain like small children mentally and physically throughout life
common chronic progressive thyroid disease is what?
Hashimoto thyroiditis cause? and which sex is predominant?
deficiency in Treg, increased cytotoxic T cells and activated B cells; female
Morphology of Hashimoto thyroiditis
diffusely enlarged thyroid, capsule is INTACT, and well demarcated
cutting surface is pale, yellow tan
what is the Histology of Hashimoto thyroiditis
mononuclear inflammatory infiltrates
Thyroid follicles are atrophic lined by HURTHLE CELLS
what are Hurthle cells
abundant eosinophilic, granular cytoplasm
-not evenly distributed
-normal cuboidal cells get attacked and then it becomes eosinophilic and granular cytoplasm--hurthle cells
which hypothyroidism can cause pain? what causes it?
Subacute Granulomatous; thyroid virus infection
thyroid gland impairment -->INCREASED TSH--> CAnnot produce T3 and T4--> enlarged thyroid
what are the two different stages to goiter
colloid goiter------->multinodular goiter
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)
what is a normal thyroid epithelium?
flattened epithelium, hemosiderin, calcification, hemorrhage nodule indicates what disease???
what can change the temp of a nodule to hot?
increased radioiodine, able to accumulate radioactivity
Solitary, encapsulated lesion, well defined, intact capsule, benign--no tendency to turn malignant
which thyroid cancer has the best prognosis? worst?
papillary, Anaplastic--almost all will die
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
"orphan annie eye", psammoma bodies, nuclear holes, "coffee bean" nuclei indicate what disease
papillary thyroid carcinoma
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
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
Massive thyroid and low calcium indicate what disease
medullary thyroid carcinoma
what is the feature of Anaplastic Carcinoma of thyroid (undifferentiated carcinoma)
very very very both hoistologically and clinically
what does excess PTH cause?
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
patient complains about pain in kidney, and urine analysis shows hematuria, what should you consider?
tumor, secondary hyperparathyroidism
what are the signs and symptoms of primary Hyperparathyroidism?
renal stones, painful bones, abdominal groans (high serum Ca), mental moans"
what are two main causes of Primary hyperparathyroidism?
hyperplasia and adenoma
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
two main causes of 2ndary parathyroidism
NOT due to parathyroid itself, but due to other factors such as hypocalcemia, CRF
chronic renal failure is a very common cause in what?