Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Endo/Repro > Thyroid Disorders > Flashcards

Thyroid Disorders Flashcards

(56 cards)

Start Studying
1
Q

Thyroid embyrological origin

A

Developed from endoderm & 2nd pharyngeal pouch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How does TRH affect TSH?

A

Increases TSH by binding membrane receptor → thyroid stimulating immunoglobulin (TSI) → thyroglobulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Most sensitive measure of thyroid function

A

TSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How is iodine metabolized?

A

Dietary iodine → I- & Na+ symporter → travels to colloid via Pendrin pathway → oxidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

T3 composition

A

2 iodine + thyroglobulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe Wolff-Chaikoff effect

A

Excess iodine exposure → inhibition of thyroid hormone synthesis by blocking thyroglobulin iodination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is thyrotoxicosis

A

Hypermetabolic state d/t ↑ free T3 and T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Two causes of thyrotoxicosis

A

1° hyperthyroidism: ↑ TSH d/t thyroid dysfunction
2° hyperthyroidism: hypothalamic/pituitary cause ↑ TSH

Graves causes most cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

7 B’s of hyperthyroidism

A

-Brain maturation
-Bone growth (synergism with GH & IGF-1) → bone turnover
-β-adrenergic effects (↑ β1 in heart: ↑ CO, HR, SV, contractility)
-BMR ↑
-Blood sugar
-Break down lipids (lipolysis)
-Babies (surfactant synthesis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Labs in hyperthyroidism

A

↑ T4, ↓ TSH, ↑ 123 I, hyperglycemia, hyperlipidemia, hypercalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cause and labs of exogenous hyperthyroidism

A

Levothyroxine misuse (synthetic T4)

↑ free thyroxine, ↓ TSH, ↓↓ thyroglobulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Graves Disease presentation

A

Female 20-40 years
Enlarged thyroid/Smooth goiter
Exophthalmos
Dermopathy (pretibial myxedema)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Graves disease genetics

A

HLA-DR3 or polymorphism in inhibitory T cell receptor CTLA-4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pathogenesis of Graves

A

TSI IgG autoantibodies bind to TSH receptor → ↑ Adenylyl cyclase → ↑ thyroid hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What causes exophthalmos in Graves?

A

T cell lymphocytes recruit cytokines (TNF-α, IFN-γ) which ↑ fibroblast secretion of hydrophilic GAG’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Graves microscopy

A

Tall, crowded columnar follicular epithelial cells.
Pale colloid with scalloped margins.
Lymphoid infiltrates.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Precipitating factors of thyroid storm (thyrotoxic crisis)

A

Graves pts with ↑ catecholamine levels (surgery or acute infection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Thyroid storm symptoms and 1 important complication

A

Fever, flushing, sweating.

Cardiac dysrhythmias and sudden death.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Toxic multinodular goiter (Plummer syndrome) pathogenesis

A

Thyrotoxicosis d/t autonomous nodules that function independent of TSH stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Morphology of toxic multinodular goiter

A

Colloid-rich follicles lined by flattened, inactive epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Types of hypothyroidism

A

Cretinism (children) & Myxedema (adults)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Cretinism (Congenital Hypothyroidism) presentation

A

Severe mental retardation in infancy/early childhood (no manifestations at birth because maternal T4 crosses placenta)

Short stature, umbilical hernia, protruding tongue.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Causes of cretinism

Study These Flashcards
A

Iodine deficiency, maternal hypothyroidism (IgG crosses placenta)

24
Q

Causes of myxedema

Study These Flashcards
A

Hashimoto thyroiditis.
Iodine deficiency.
Idiopathic.

Or secondary hypothyroidism d/t pituitary failure

25
Clinical features of myxedema
Slow, dumb, cold intolerance, overweight, DIASTOLIC HTN (Na/H2O retention), ATHERSCLEROSIS, periorbital puffiness, delayed DTRs, menorrhagia
26
Lab findings of myxedema
↓ T4, ↑ TSH, hyperlipidemia (↓ LDL receptor synthesis)
27
Important complication of myxedema
Myxedema coma: SUDDEN FALL IN TEMP, ↓ HR/BP, confusion, coma Infection, MI, illness → ↓ T3/T4
28
Hashimoto thyroiditis presentation
Females 45-65 yo with diffuse goiter "enlarged rubbery" thyroid Initially hyperthyroidism → later hypothyroidism
29
Hashimoto thyroiditis pathogenesis
autoimmune destruction of thyroid via: -CD8 T cells (type IV HS) -anti TPO & anti thyroglobulin Ab (type II HS)
30
Hashimoto thyroiditis increases risk for ___.
B cell lymphoma (Marginal zone)
31
Hashimoto microscopy
-Lymphoplasmacytic infiltrate w/ germinal centers -Atrophic follicles -Hurthle cells: oncocytic metaplastic large cells with granular eosinophilic cypoplasm
32
Cause of postpartum thyroiditis
Decreased immunity during pregnancy → slow evolution of autoimmune response to thyroid autoantigens
33
Postpartum thyroiditis presentation
Painless diffuse thyromegaly within 1 year of pregnancy
34
Pathogenesis of postpartum thyroiditis
Self-limiting. Destruction → sudden release of stored thyroid hormone → transient hyperthyroidism (1-3 months) → hypothyroidism (4-8 months → recovery to euthyroid state
35
Subacute (De Quervain or Granulomatous) thyroiditis presentation
Female 30-50 yo w/ enlarged, firm, TENDER thyroid Fever, jaw pain, redness over skin Rare complication of septicemia
36
Pathogenesis of subacute thyroiditis
Follows a viral infection → transient hyperthyroidism → euthyroid → hypothyroid → euthyroid
37
Reidel's (invasive fibrous) thyroiditis presentation
Female 40-60 yo with rock-like painless goiter
38
Reidel's pathogenesis
Associated with inflammatory fibrosclerotic conditions (fibrosis, sclerosing cholangitis)
39
Reidel's gross pathology
Tan gray, WOODY, avascular
40
Reidel's microscopy
Fibrous tissue & inflammatory infiltrate (plasma cells (IgG4), lympocytes, macrophages, eosinophils)
41
Euthyroid sick syndrome presentation
abnormal thyroid function tests in normally functioning thyroid in hospitalized pts
42
Euthyroid sick syndrome pathogenesis
↓ thyroid hormones d/t cytokines (IL6) altered deiodinase enzyme activity
43
Lab findings in euthyroid sick syndrome
↓ T3, ↑ T4, ↑ REVERSE T3, ↓ TSH, ↓ thyroid binding globulin
44
Typical features of thyroid malignancy
young, male, cold nodule, pain, voice change
45
Radio iodine uptake
Hot nodule (↑ uptake): Graves/Nodular goiter Cold nodule (↓ uptake): adenoma/carcinoma
46
Follicular adenoma morphology
Solitary, well-circumscribed nodule
47
Most follicular adenomas are __.
Cold (non-functional) May become hot/toxic via autonomous TSH receptor pathway mutations
48
Four types of thyroid carcinomas
Papillary, Follicular, Medullary, Anaplastic (undifferentiated)
49
All thyroid carcinomas are derived from ___, except ___.
thyroid follicular epithelium medullary carcinoma (derived from parafollicular C cells)
50
List the genetics of each type of thyroid carcinoma
Papillary: activation of MAP kinase pathway by RET/PTC rearrangements or BRAF point mutations Follicular: RAS point mutations,, P13K/AKT/PTEN mutations, or PAX8-PPARγ translocations Medullary: MEN2A & 2B RET mutations Anaplastic: TP53 mutations
51
How to distinguish between follicular carcinoma or adenoma
Carcinoma: thyroid capsular/vascular invasion Adenoma: no invasion
52
How to distinguish between follicular or papillary carcinoma
Papillary carcinoma: Psammoma bodies (concentric calcified structures in cores of papilla) & Optically clear nuclei (Orphan Annie eyes)
53
Spread of follicular vs papillary carcinoma
Follicular: hematogenous Papillary: lymphatic
54
Which thyroid malignancies are multifocal, which aren't?
Papillary: multifocal Follicular adenoma & carcinoma: solitary
55
Medullary carcioma parafollicular C cells secrete ___.
Calcitonin (tumor marker) + CEA
56
Microscopic finding of medullary carcinoma
Amyloid polygonal deposits (Congo red stain/IHC)

Endo/Repro (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions