Flashcards in Thyroid Pathology Deck (34):
What is the problem in primary thyroid disease? Secondary? Tertiary?
Primary: Thyroid itself
What are the actions of T4?
T4 high, TSH low.
T4 high, TSH high.
2° or 3° hyperthyroidism
T4 low, TSH high
T4 low, TSH low
2° or 3° hypothyroidism
T4 normal, TSH high
T4 normal, TSH low
Signs and symptoms of hyperthyroidism?
General: Weight loss, heat intolerance
Cardiac: Rapid pulse, arrhythmias
Neuromuscular: Tremor, emotional labiity
Skin: Warm, moist
Eye: lid lag
Most common causes of hyperthyroidism?
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"
What are causes of congenital hypothyroidism?
Iodine deficiency, genetic problems
How do you treat congenital hypothyroidism?
Most common causes of acquired hypothyroidism?
Does thyroiditis result in increased or decreased radioactive iodine uptake?
A painless, big thyroid with eventual hypothyroidism. Most common in women.
What antibodies are most often present in Hashimoto thyroiditis?
What does thyroid look like on biopsy for Hashimoto thyroiditis?
HUGE whopping lymphoid follicles
Hurthle cells: Big, granular, pink cells
What cells are messed up in Hashimoto thyroiditis?
T cells, resulting in B cells
What antibodies to B cells make in Hashimoto?
Anti-peroxidase (MOST IMPORTANT)
A big, sore thyroid after a recent URI. Get hyperthyroidism initially but self-limiting.
DeQuervain (granulomatous) thyroiditis
What do slides look like with DeQuervain thyroiditis?
Multinucleated giant cells
What are the sequence of events in DeQuervain thyroiditis?
Antigen causes increase in CD8 cells
Damaged follicles leak colloid
Foreign-body giant cell reaction ensues
A painless, slightly enlarged thyroid with mild hyperthyroidism in a post-partum mother.
What does Silent thyroiditis look like on slide?
Lymphoid infiltrate with absence of Herkel Cells and germinal centers
Rock hard neck mass presenting with hypothyroidism and tracheal compression
A female with Hyperthyroidism, ophthalmopathy, dermopathy. What is it?
What does the iodine scan show in Graves Disease?
Diffuse increased uptake
What does graves disease look like on slide?
Papillae and scalloped colloid
What antibodies are present in Graves Disease?
Anti-TSH receptor antibodies
Where are other receptors for anti-TSH-receptor antibodies than the thyroid?
What is symptomatic treatment for Graves Disease? Long term?
Symptomatic: Beta blocker, Surgery if necessary
Long term: Drugs, Radioactive iodine ablation, surgery
What three ways can you get a goiter from decreased T4?
Goitrogenic foods (brussell sprouts/cauliflower)