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55 Cards in this Set

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  • Back
Thyroid gland, C-cells (parafollicular cells),
stain for ______
calcitonin
Organification: iodine combines with ________ to form monoiodotyrosine and/or diiodotyrosine
tyrosine
Coupling: Two diodotyrosine combine forming (T4) or one monoiodotyrosine with diodotyrosine to form _____
triiodothyronine (T3)
Storage: Active hormones stored in ______
colloid
if after throid surgery, what nerve might be damaged if pt cannot talk well
Recurrent Laryngeal Nerve
Thyroid gland, radionuclide scan, What contrast mediums?
I-131, I-128, Tc ses
Thyroid gland, ultrasonogram, papillary carcinoma,
black area, aka?
(hypoechoic area)
Clean biopsy technique alternative to radionucleotide scan.
Fine Needle Aspiration
Stain to see follicular cells of thyroid
Wright stain
Goiter that extends inferior to clavicles
mediastinal goiter
What is FNA worthless for diagnosing?
follicular carcinomas
Cancers that are easily diagnosed by FNA?
papillary carcinoma

medullary carcinoma

anaplastic cancer
what is the abnormality if only half of the thyroid gland is imageable?
agenesis of the thyroid gland
What would you suspect the diagnosis to be with a central bump on the anterior neck?
thyroglossal duct cyst
What would you suspect the diagnosis to be with a lateral bump on the anterior neck?
brachial cleft cyst
a thyroglossal duct cyst arised from what lobe of the thyroid
pyramidal lobe
Where is a lingual thyroid gland?
tongue
What is the embryological journey of the thyroid gland?
Foramen Caecum, anterior of hyoid bone, anterior to thyroid cartilage, past cricoid cartilage
Basis for formation of nodular goiters is the variation in the response of follicular cells to ______
TSH
Basis for formation of nodular goiters is the variation in the response of follicular cells to TSH in the following categories:
Proliferation
Growth
TSH sensitivity
Function
Iodine metabolism
Autonomy
Clonality
Why do goiters occur in the setting of iodine sufficiency?
total or partial absence of enzymes required for the normal production of thyroid hormones
Abnormal thyroid hormones produced in the setting of iodine sufficiency have no braking effect on TSH which then causes uncontrolled proliferation of _____ & result in nodular goiters
follicular cells
What's the best way to learn edocrinology?
learn the definitions
Usual incidence of cancer in nodular goiters?
5%
Follicular carcinomas arise in background of ___________
nodular goiters
Follicular ca and goiter, higher incidence in _________areas
iodine deficient
Papillary ca, higher incidence in _______ areas, lower incidence in ________areas.
iodine sufficient


iodine deficient
Papillary carcinomas arise in background of ________ glands
normal glands
Pioneer in iodine prophylaxis
David Marine


accused of communism and trying to poison the public with Iodine
What did David Marine notice about Cleveland?
Dogs had goiters
Marine postulated that the development of nodular goiters followed a cycle, as follows:
Bout of iodine deficiency, results in hyperplasia
Exposure to iodine, changes regress
Cycles of the above changes results in nodular hyperplasia
Follicular cells vary in response to TSH as seen in previous slide

Nodules form because of the variations of the response of follicular cells to TSH.
Cycles of exposure to iodine deficiency and sufficiency leads to formation of nodules

Cycles continue and nodules proliferate and grow, with development of necrosis, hemorrhage & other degenerative changes
Nodules become autonomous, no longer controlled by body’s normal homeostatic mechanisms (TSH, etc.)
Why did Marine’s Experiment use only girls?
Thyroid disease is generally a women's disease.
What were the most common surgical procedures performed in Michigan before 1924?
thyroidectomies


with as many as 5000 per year
Well formed nodules with thin capsules, may resemble ______ _______, but not as cellular
follicular adenomas
Carcinomas, when present are of ________ type
follicular
Complications of Nodular Goiters
1) Growth into mediastinum (Mediastinal goiters, Substernal goiters)

2) Hyperthyroidism (Plummer disease)

3) Deviation of trachea and/or esophagus

4) Unsightly glands (Thyroidectomy for cosmesis)

5) Cancer
Why is cancer not a complication or indication for thyroidectomy?
because the incidence of cancer in nodular goiters is only about 5%
Surgical removal of nodular goiters is indicated when?
whenever any of the complications occur.

(except the RISK of cancer)
Are the gross appearance and microscopic changes distinctive in nodular goiters associated with clinical hyperthyroidism?
no
Graves Disease triad
goiter, exophthalmos, pretibial myxedema ( thyroidal dermatopathy)
Graves disease generally affects what age of pt?
Affects any age
Etiology of Graves disease
Etiology unknown
Is Graves An autoimmune disease?
yes
Who Is It?
Introduced taking of pulse, timed with watch.
Abandoned bleeding
and starving pts with fevers
Requested epitaph:
“He fed fevers”
Robert James Graves
Merseburg Triad of Graves disease

(Carl von Basedow)
Exophthalmos, goiter &
palpitation of heart
Term for bright red conjunctiva
chemosis
Periorbital edema
seen with Graves disease
What's this?
Thyroid gland, diffuse hyperplasia, Graves disease, note papillae
What do you notice here?
Thyroid gland, retrobulbar tissue Graves dis, note lymphocytes
What do you note here?
Thyroid gland, nodular goiter with hyperthyroidism
What's this?
Thyroid gland, nodular goiter
What's this?
Thyroid gland, nodular goiter
What's this?
Thyroid gland, nodular goiter
I can explain...
Thyroglossal duct cyst
What's this?
Thyroglossal duct cyst
What's this?