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D&T 4 exam 1 > Thyroid - Denning > Flashcards

Thyroid - Denning Flashcards

1
Q

What do parafollicular cells secrete

A

calcitonin

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2
Q

Graves disease

A

hyperthyroidism

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3
Q

define hyperthyroidism and thyrotoxicosis

A

hyperthyroidism: hyperfunction
thyrotoxicosis: leakage of thyroid hormone

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4
Q

what is struma ovarii

A

thyroid tissue in ovary

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5
Q

what does hyperthyroidism do to basal metabolic rate

A

increases

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6
Q

GI signs and symptoms for hyperthyroidism

A

hypermotility
absorption
diarrhea

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7
Q

Nervous system signs and symptoms for hyperthyroidism

A

overactive sympathetic

  • wide gazing stare
  • lid lag
    • Stimulation of levator palebrae superioris
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8
Q

what is thyroid storm

A

abrupt onset of thyrotoxicosis

medial emergency

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9
Q

clinical features of thyroid storm

A

tachycardia
thermoregulatory dysfunction ( high temp)
nausea, vomiting

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10
Q

when can thyroid storm be seen

A

in Grave’s disease

following surgery

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11
Q

what are blood values for hyperthyroidsim

A

high T4
low TSH
- then measure t3

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12
Q

treatment options for hyperthyroidism

A
  • beta-blockers
  • thionamides - block new hormone synthesis
  • prevent conversion of T4 to T3
  • Radioiodine to ablate thyroid function
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13
Q

what are most cases of hypothyroidism

A

primary

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14
Q

what is endemic cretinism

A

mother is iodine deficient

baby becomes mentally retarded

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15
Q

myxedema

A
  • generalized apathy and mental sluggishness

- applied to older child or adult

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16
Q

what other condition does myxedema mimmic

A

depression

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17
Q

what are symptoms for myxedema

A

cold intolerant

mucopolysaccharide-rich edema

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18
Q

what are TSH levels for primary and secondary hypothyroidism

A

primary: increased
secondary: decreased

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19
Q

what is the most common cause of endogenous hyperthyroidism

A

grave’s disease

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20
Q

exophthalmos

A

bulging eyes

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21
Q

signs and symptoms for grave’s disease

A

thyrotoxicosisi
exopthalmus
pretibial myxedema

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22
Q

what happens in grave’s disease

A

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

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23
Q

histo for Grave’s disease

A
  • may have papillae without fibrovascular core

- colloid scalloping

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24
Q

What organs does Grave’s impact? how

A

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

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25
Q

how can you treat Grave’s

A
  • beta-blockers
  • thionamides
  • radioiodine ablation
  • surgery
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26
Q

what is the most common thyroid disease

A

goiters

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27
Q

what are problems that arise from goiters

A
  • cosmetic problems

- airway obstruction

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28
Q

what syndrome is seen with goiters

A

plummer’s syndrome

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29
Q

what is plummer’s syndrome

A
  • hyperfunctioning nodule forms in long standing goiter
  • hyperthyroidism
  • no ophthalmopahty or dermopathy
30
Q

goiters can mask or mimic what

A

neoplasms

31
Q

what usually causes goiters

A

iodine deficiency

32
Q

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

A

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

33
Q

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

A

Hashimotos

34
Q

what are signs and symptoms for Hashimoto’s

A

painless enlargement

35
Q

how does hashimotos work

A

anti-TSH receptor Ab blocks action of TSH

hypothyroidism

36
Q

what would laboratory results show for hasimotos

A

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

37
Q

what is laboratory results for normal hypothyroid

A

decreased T4 and T3

increased TSH

38
Q

Hashimotos has increased risk of developing what

A

B-cell lymphomas

39
Q

what is a possible cause of De Quervains

A

viral infection

40
Q

signs and symptoms for De Quervains

A 
pain in neck, esp. swallowing 
transient hyperthyroidism (6-8 weeks long)
41
Q

De quervains has what type of reaction

A

Granulomatous rxn

42
Q

histo for De Quervains

A

neutrophils

giant cells

43
Q

laboratory values for De Quervains

A

increased: leukocyte count
sedimentation rate
T4 and T3

decreased: TSH

Radioactive iodine uptake decreased

44
Q

what has “woody hard” fibrosis

A

Riedel’s

45
Q

what are thyroid adenomas derived from

A

follicular epithelium

46
Q

signs and symptoms of thyroid adenomas

A

painless mass
minority hyperfunction
cold

47
Q

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

A

somatic mutation

  • chronic stimulation of cAMP pathway
  • Gs-alpha mimic exaggerated TSH stimulation
48
Q

gross thyroid adenoma

A

solitary, spherical, encapsulated

49
Q

histo for thyroid adenoma

A

no papillary changes

  • encapsulated papillary CA
  • well-defined, intact capsule
50
Q

does malignant transormation occur in thyroid adenoma

A

no except in exceptional circumstances

51
Q

what gender is more likely to get carcinoma of thyroid

A

female

52
Q

what is the most common type of carcioma of thyroid

A

papillary

53
Q

signs and symptoms for papillary CA

A

mass in neck, thyroid or cervical lymph node

54
Q

histo for papillary CA

A
  • nuclear features: “ground glass” or “Orphan Annie” nuclei
  • papillae: dense fibrovascular core
  • Pasammmoma bodies
55
Q

where does papillary CA mets to

A

lymphatics

56
Q

what is the second most common carcinoma of thyroid

A

folliuclar Ca

57
Q

signs and symptoms for follicular CA

A

solitary “ cold” nodules

58
Q

how is follicular and papillary CA differenciated

A

follicular: invasion of the capsule or vasculature

59
Q

where does follicular CA mets to

A

vasculature

60
Q

how is follicular CA treated

A

suppression by thyroid hormones which suppresses TSH

61
Q

name a neuroendorcine tumor

A

medullary CA

62
Q

what does medullary CA secrete

A

Calcitonin

63
Q

what condition can allow someone to get Medullary CA

A
  • MEN IIa and IIIb

- - RET protooncogene

64
Q

signs and symptoms of medullary CA

A
  • sporadic mass in neck

- may secrete VIP causing Diarrhea

65
Q

medullary CA is associated with what condition

A

C-cell hyperplasia

66
Q

medullary CA have what type of deposists

A

amyloid deposits of calcium

67
Q

what is the most aggressive carcinoma

A

anaplastic

68
Q

where is anaplastic CA usually seen

A

areas of endemic goiter

69
Q

anaplastic CA grow with what

A

wild abadnon

70
Q

where does anaplastic CA met

A

distant sites

71
Q

prognosis of anaplastic CA

A

less than one year

D&T 4 exam 1 (17 decks)

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