Thyroid Pathology Flashcards Preview

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Flashcards in Thyroid Pathology Deck (34):
1

What is the problem in primary thyroid disease? Secondary? Tertiary?

Primary: Thyroid itself
Secondary: Pituitary
Tertiary: Hypothalamus

2

What are the actions of T4?

Brain development
Bone growth
Beta-adrenergic effects
BMR increase

3

T4 high, TSH low.

1° hyperthyroidism

4

T4 high, TSH high.

2° or 3° hyperthyroidism

5

T4 low, TSH high

1° hypothyroidism

6

T4 low, TSH low

2° or 3° hypothyroidism

7

T4 normal, TSH high

Subclinical hyperthyroidism

8

T4 normal, TSH low

Subclinical hypothyroidism

9

Signs and symptoms of hyperthyroidism?

General: Weight loss, heat intolerance
Cardiac: Rapid pulse, arrhythmias
Neuromuscular: Tremor, emotional labiity
Skin: Warm, moist
GI: Diarrhea
Eye: lid lag

10

Most common causes of hyperthyroidism?

Graves disease
Multinodular goiter
Thyroid adenoma

11

Signs and symptoms of hypothyroidism?

General: Fatigue, weight gain, cold intolerance
Cardiac: Slow pulse, impaired contraction
Nervous: Delayed reflexes, lethargy
Skin: Rough, dry, hair loss (eyebrows)
GI: Reduced appetite, constipation
Myxedema: Deepened voice, "edema"

12

What are causes of congenital hypothyroidism?

Iodine deficiency, genetic problems

13

How do you treat congenital hypothyroidism?

T4 replacement

14

Most common causes of acquired hypothyroidism?

Hashimotos thyroiditis
Iatrogenic

15

Does thyroiditis result in increased or decreased radioactive iodine uptake?

Decreased

16

A painless, big thyroid with eventual hypothyroidism. Most common in women.

Hashimoto thyroiditis

17

What antibodies are most often present in Hashimoto thyroiditis?

Anti-peroxidase antibodies

18

What does thyroid look like on biopsy for Hashimoto thyroiditis?

HUGE whopping lymphoid follicles
Hurthle cells: Big, granular, pink cells

19

What cells are messed up in Hashimoto thyroiditis?

T cells, resulting in B cells

20

What antibodies to B cells make in Hashimoto?

Anti-TSH-receptor
Anti-thyroglobulin
Anti-peroxidase (MOST IMPORTANT)

21

A big, sore thyroid after a recent URI. Get hyperthyroidism initially but self-limiting.

DeQuervain (granulomatous) thyroiditis

22

What do slides look like with DeQuervain thyroiditis?

lymphoid infiltrate
Degenerating follicles
Multinucleated giant cells

23

What are the sequence of events in DeQuervain thyroiditis?

Viral infection
Antigen causes increase in CD8 cells
Damaged follicles leak colloid
Foreign-body giant cell reaction ensues

24

A painless, slightly enlarged thyroid with mild hyperthyroidism in a post-partum mother.

Silent thyroiditis

25

What does Silent thyroiditis look like on slide?

Lymphoid infiltrate with absence of Herkel Cells and germinal centers

26

Rock hard neck mass presenting with hypothyroidism and tracheal compression

Reidel Thyroiditis

27

A female with Hyperthyroidism, ophthalmopathy, dermopathy. What is it?

Graves Disease

28

What does the iodine scan show in Graves Disease?

Diffuse increased uptake

29

What does graves disease look like on slide?

Papillae and scalloped colloid

30

What antibodies are present in Graves Disease?

Anti-TSH receptor antibodies

31

Where are other receptors for anti-TSH-receptor antibodies than the thyroid?

Retroorbital tissues
Pre-tibial fibroblasts

32

What is symptomatic treatment for Graves Disease? Long term?

Symptomatic: Beta blocker, Surgery if necessary
Long term: Drugs, Radioactive iodine ablation, surgery

33

What three ways can you get a goiter from decreased T4?

No iodine
Goitrogenic foods (brussell sprouts/cauliflower)
Enzyme defects

34

How do you treat a goiter?

Levothyroxine or thyroidectomy