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33 Cards in this Set

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Embriological origin of thyroid
Pharyngeal epithelium, descends as thyroglossal duct
Histology of thyroid
Parafollicular calls (c-cells): make calcitonin, follicles lined by cuboidal epithelium filled with PAS+ thyroglobulin
congenital abnormalities of Thyroid gland
thyroglossal duct cyst, ectopic thyroid tissue: along course of thyroglossal duct
Causes of Hyperthyroidism (Thyrotoxicosis)
Grave's disease, multinodular goiter, Adenoma
clinical Manefestation of Hyperthyroidism
Weightloss, tremor, restless, heat intolerance, tachycardia, arrhythmia, palpitations, muscle waisting, increased appetite, fine hair, amenorrhea,
Thyroid Storm
sever onset of Hyperthyroidism, Arrhytmias, medical emergency, usually have graves
diagnosis of Hyperthyroidism
decreased TSH confirmed with increased T4
Causes of hypothyroidism
surgery, radiation, autoimmune(hashimotos), Drugs, congenital errors, thyroid hormone resistance syndrome, agenisis, secondary or tertiary
Clinical manifestation of cretinism
severe MR, dwarfism, large tongue, protuberant abdomen,
causes of cretinism
Iodine deficiency, enzyme defficiency, transplacental anti-thyroid Ab, drug: iodide, lithium alpha-interferon
Clinical manefistations of Myxedema
Insidious onset, cold intolerance, weight gain, lower pitch of voice, mental and physical slowness, constipation dry skin, hair loss, course hair
Pathogenesis of Hashimoto's thyroiditis
CD-8 cytotoxic t-cells, cytokine mediated, Anti-TSH Ab
Epidemiology of Hashimoto's thyroiditis
45-65 y/o, F>M(10:1), associated with chromosomal abnormalities
Morphology of Hashimoto's thyroiditis
Lymphocytic infiltrate w/ germinal centers, Hurthle cells (eosinophilic, granular, epithelial)
Clinical course of Hashimoto's thyroiditis
Symetric and diffuse goiter, hypothyroidism, possiple transient hyperthyroidism
Subacute(granulomatous) Thyroiditis
F>M, 30-50 y/o, viral infection, giant cells, hypo to hyper to recovery, thyroid pain w/ flu like symptoms
Subacute lymphocytic(painless) Thyroiditis
Lymphocytic infiltrate with germinal centers, hyperthyroidism
Reidel Thyroiditis
Extensive fibrosis, mimics carinoma
Triad of symptomes for Grave's Disease
Exopthalmos, hyperthyroidism, pretibial myxedema
Epidemiology of Grave's Disease
20-30 y/o, F>M, Familial link
Pathogenesis of Grave's Disease
TSI, TGI, TBII
Mophology of Grave's Disease
Diffuse hypertrophy, normal cells but too many, get papillae in colloid
Clinical course of Grave's Disease
Thyrotoxicosis, diffuse hyperplasia, audible bruit, exopthalmos, pretibial myxedema,
Most common cause of Diffuse multinodular Goiter
iodide deficience, impaired synthesis of TH
Benign of malignant:
Solitary
Younger Pts
Males
Hx of Radiation
Hot-nodules
Solitary: M
Younger Pts: M
Males: M
Hx of Radiation: M
Hot-nodules: B
Morphology of Thyroid Adenoma
Well defined, intact capsule, Hurthle cell adenoma: oxyphilia cells, follicular adenoma, unilateral painless mass, usually non-funcional
Most common Thyroid Carcinoma with best prognosis
Papillary Carcinoma
Morphology of Papillary Carcinoma
Papillary projections, Orphan annie eye nuclei, Psommoma bodies, will met to the lymphatics
causes of Papillary Carcinoma
ret-PTC translocation, or radiotherapy to the neck
Follicular Carcinoma of Thyroid
Uniform follicles, poorer prognosis, mets in vasculature
Morphology of Medullary Carcinoma
sheets of tumor cells in amyloid containing stroma
Cause of Medullary Carcinoma
From c-cells, associated with MEN-IIa and MEN-IIb (ret gene)
Undifferentiated (anaplastic) carcinoma of thyroid
Older Patients, poor prognosis