Wk1 Thyroid Path Flashcards Preview

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Flashcards in Wk1 Thyroid Path Deck (49):
1

High T4

Low TSH

primary hypERthyroidism

2

High T4

High TSH

secondary or tertiary hypERthyroidism

3

Low T4

High TSH

primary hypOthyroidism

4

low T4

low TSH

secondary or tertiary hypOthyroidism

5

normal T4

low TSH

subclinical hypERthyroidism

**TSH changes before T4 -- think of the seesaw with fulcrum closer to T4

6

normal T4

high TSH

subclinical hypOthyroidism

**TSH changes before T4

7

anti-peroxidase Ab is likely:

Hashimoto's thyroiditis

8

anti-TSH Ab is likely:

Grave's disease

9

Most common cause of hyperthyroidism:

Graves disease

10

Myedema association:

hypOthyroidism

11

Painless

BIG thyroid

F>>M

hypOthyroid

Hashimoto

12

TFT findings in Hashimoto:

low T4

high TSH

13

lymphoid follicles

Hashimoto

14

Hurthle cells

Hashimoto

15

Cells that mediate Hashimoto

T-cells (CD8's)

16

Acute onset

BIG, SORE thyroid

recent URI

ealry hyperthyroid

self-limiting

DeQuervain

granulomatous

17

multinucleated giant cells

DeQuervain

18

Painless, slightly enlarged thyroid

post-partum

mild hyperthyroid

Silent thyroiditis

19

Rock hard neck mass "Woody"

hypOthyroid

tracheal compression

Reidel

fibrosing thyroiditis

20

hyperthyroid

ophthalmopathy

dermatopathy

Graves

21

TFT findings in Graves

high T4

low TSH

22

papillae and scalloped colloid

Graves

23

Pathogenesis of Graves:

anti-TSH receptor antibodies that are STIMULATORY

**follicular cell proliferation --> big thyroid

**TH release --> hyperthyroid sx

24

big thyroid gland

Goiter

25

two causes of goiters

1. inflammatory -- thyroiditis

2. non-inflammatory -- defective T4 synthesis

26

Cause of multinodular goiter:

trauma to simple goiter

27

Most common presentation of thyroid neoplasms:

benign Nodules

28

Uncommon cause of thyroid nodule:

carcinoma

29

Common thyroid nodule:

adenoma

30

RF for thyroid cancer:

male

solitary nodule

cold nodule

hx of radiation

31

Dx method for nodules:

fine needle aspiration

32

Harmless looking fine needle aspirate that needs to be resected:

follicles

33

Two possible genetic abnormalities of benign adenomas:

GPCR mutation

gain of function mutation

34

Treatment for thyroid adenoma:

Why?

take it out!

can look like CA

35

Most common thyroid carcinoma:

papillary

36

age for papillary thyroid carcinoma

30-50

F>M

37

Common site of metastasis for papillary CA

local LN

38

prognosis for papillary CA

excellent

39

Orphan Annie nuclei

Papillary CA

40

psammoma body

Papillary CA

41

pseudoinclusions

Papillary CA

42

nuclear grooves

"coffee bean"

Pappilary CA

43

Thyroid CA that mets to lung/bone

Follicular

44

age for Follicular CA

40-50

45

vascular invasion

**differentiates it from adenoma

Follicular CA

46

C cells cancer

poor prog if mets

Medullary

47

age for Medullary CA

50-60

48

Amyloid

Medullary

49

Bulky, fast growing, invasive

mets present at dx

very poor prog

Anaplastic CA