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Flashcards in Thyroid - Denning Deck (71):
1

What do parafollicular cells secrete

calcitonin

2

Graves disease

hyperthyroidism

3

define hyperthyroidism and thyrotoxicosis

hyperthyroidism: hyperfunction
thyrotoxicosis: leakage of thyroid hormone

4

what is struma ovarii

thyroid tissue in ovary

5

what does hyperthyroidism do to basal metabolic rate

increases

6

GI signs and symptoms for hyperthyroidism

hypermotility
absorption
diarrhea

7

Nervous system signs and symptoms for hyperthyroidism

overactive sympathetic
- wide gazing stare
- lid lag
-- Stimulation of levator palebrae superioris

8

what is thyroid storm

abrupt onset of thyrotoxicosis
medial emergency

9

clinical features of thyroid storm

tachycardia
thermoregulatory dysfunction ( high temp)
nausea, vomiting

10

when can thyroid storm be seen

in Grave's disease
following surgery

11

what are blood values for hyperthyroidsim

high T4
low TSH
- then measure t3

12

treatment options for hyperthyroidism

- beta-blockers
- thionamides - block new hormone synthesis
- prevent conversion of T4 to T3
-Radioiodine to ablate thyroid function

13

what are most cases of hypothyroidism

primary

14

what is endemic cretinism

mother is iodine deficient
baby becomes mentally retarded

15

myxedema

- generalized apathy and mental sluggishness
- applied to older child or adult

16

what other condition does myxedema mimmic

depression

17

what are symptoms for myxedema

cold intolerant
mucopolysaccharide-rich edema

18

what are TSH levels for primary and secondary hypothyroidism

primary: increased
secondary: decreased

19

what is the most common cause of endogenous hyperthyroidism

grave's disease

20

exophthalmos

bulging eyes

21

signs and symptoms for grave's disease

thyrotoxicosisi
exopthalmus
pretibial myxedema

22

what happens in grave's disease

autoantibodies
TSI - TSH receptor
TGI - TSH receptor
TBII - prevents binding of TSH

23

histo for Grave's disease

- may have papillae without fibrovascular core
- colloid scalloping

24

What organs does Grave's impact? how

Heart: hypertophied and ischemia
ophthalmology: mucopolysaccharides and lymphocytes
Dermopathy: Pretibial myxedema

25

how can you treat Grave's

- beta-blockers
- thionamides
- radioiodine ablation
- surgery

26

what is the most common thyroid disease

goiters

27

what are problems that arise from goiters

- cosmetic problems
- airway obstruction

28

what syndrome is seen with goiters

plummer's syndrome

29

what is plummer's syndrome

- hyperfunctioning nodule forms in long standing goiter
- hyperthyroidism
- no ophthalmopahty or dermopathy

30

goiters can mask or mimic what

neoplasms

31

what usually causes goiters

iodine deficiency

32

what are thyroid and TSH levels in goiters? what do these levels cause

decreased thyroid
increased TSH
- thyroid enlargement (hypertrophy and hyperplasia)

33

In nonspecific lymphocytic thyroiditis, if you see germinal centers, what disease should you think

Hashimotos

34

what are signs and symptoms for Hashimoto's

painless enlargement

35

how does hashimotos work

anti-TSH receptor Ab blocks action of TSH
hypothyroidism

36

what would laboratory results show for hasimotos

hasitoxicosis
- increased T4 and T3
- decreased TSH
Radioiodine scan: decreased uptake

37

what is laboratory results for normal hypothyroid

decreased T4 and T3
increased TSH

38

Hashimotos has increased risk of developing what

B-cell lymphomas

39

what is a possible cause of De Quervains

viral infection

40

signs and symptoms for De Quervains

pain in neck, esp. swallowing
transient hyperthyroidism (6-8 weeks long)

41

De quervains has what type of reaction

Granulomatous rxn

42

histo for De Quervains

neutrophils
giant cells

43

laboratory values for De Quervains

increased: leukocyte count
sedimentation rate
T4 and T3

decreased: TSH

Radioactive iodine uptake decreased

44

what has "woody hard" fibrosis

Riedel's

45

what are thyroid adenomas derived from

follicular epithelium

46

signs and symptoms of thyroid adenomas

painless mass
minority hyperfunction
cold

47

what type of genetic mutation occurs in thyroid adenoma and what does it cause

somatic mutation
- chronic stimulation of cAMP pathway
- Gs-alpha mimic exaggerated TSH stimulation

48

gross thyroid adenoma

solitary, spherical, encapsulated

49

histo for thyroid adenoma

no papillary changes
- encapsulated papillary CA
- well-defined, intact capsule

50

does malignant transormation occur in thyroid adenoma

no except in exceptional circumstances

51

what gender is more likely to get carcinoma of thyroid

female

52

what is the most common type of carcioma of thyroid

papillary

53

signs and symptoms for papillary CA

mass in neck, thyroid or cervical lymph node

54

histo for papillary CA

- nuclear features: "ground glass" or "Orphan Annie" nuclei
- papillae: dense fibrovascular core
- Pasammmoma bodies

55

where does papillary CA mets to

lymphatics

56

what is the second most common carcinoma of thyroid

folliuclar Ca

57

signs and symptoms for follicular CA

solitary " cold" nodules

58

how is follicular and papillary CA differenciated

follicular: invasion of the capsule or vasculature

59

where does follicular CA mets to

vasculature

60

how is follicular CA treated

suppression by thyroid hormones which suppresses TSH

61

name a neuroendorcine tumor

medullary CA

62

what does medullary CA secrete

Calcitonin

63

what condition can allow someone to get Medullary CA

- MEN IIa and IIIb
-- RET protooncogene

64

signs and symptoms of medullary CA

- sporadic mass in neck
- may secrete VIP causing Diarrhea

65

medullary CA is associated with what condition

C-cell hyperplasia

66

medullary CA have what type of deposists

amyloid deposits of calcium

67

what is the most aggressive carcinoma

anaplastic

68

where is anaplastic CA usually seen

areas of endemic goiter

69

anaplastic CA grow with what

wild abadnon

70

where does anaplastic CA met

distant sites

71

prognosis of anaplastic CA

less than one year