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39 Cards in this Set
- Front
- Back
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Myxedema?
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HYPOthyroidism.
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SXS of Myxedema?
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* Cold intolerance
* "Slowness" * Menorrhagia * Constipation * "Puffy" * Dry Skin * Coarse hair, or hair loss |
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Toxic Goiter?
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HYPERthyroidism
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Simple Goiter?
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Goiter w/out thyroid hormone dysfunction
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Thyrotoxicosis?
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Hyperthyroidism
* >> T4 * << TSH (Graves Disease) |
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What ectopic thyroid hormone tumor is only found in women?
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Struma Ovarii - an ovarian teratoma made up of thyroid tissue. May be hyperfunctional.
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What are the 4 types of thyroid carcinoma?
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1) Papillary
2) Follicular 3) Medullary 4) Anaplastic/Undifferentiated |
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What's the most common cause of Thyroiditis?
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Hashimoto's Thyroiditis (a.k.a. Chronic Lymphocytic Thyroiditis)
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What are the 4 listed types of Thyroiditis?
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1) Chronic Lymphocytic
2) Subacute Granulomatous 3) Subacute Lymphocytic 4) Acute Suppurative |
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Another name for Diffuse Toxic Goiter?
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Grave's Disease
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What are the 4 main disorders that produce NODULAR thyroid enlargement?
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1) Nodular Goiter (either nontoxic or toxic)
2) Thyroiditis (Hashimoto's, etc.) 3) Adenoma 4) Carcinoma |
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How is a thyroid nodule workup performed?
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* Fine-needle aspiration
* Check thyroid hormones |
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How do benign lesions appear on Thyroid FNAB?
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Mostly COLLOID, crowded groups of follicular cells
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How do malignant Thyroid lesions appear on FNAB?
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* Little/no colloid
* Crowded groups of follicular cells * Micro-follicles |
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What's the pathology behind Hashimoto's Thyroiditis?
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Auto-immune destruction of thyroid parenchyma.
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What's the pathology behind Grave's Disease?
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Autoantibodies to the TSH receptors (Thyroid Stimulating Immunoglobulin)
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How does Grave's appear histologically?
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* "Scalloping" of colloid tissue
* Diffuse thyroid follicle hyperplasia |
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Why do nodules form in Nodular Goiter?
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* Due to either iodine deficiency or unknown
* Nodularity from intermittent episodes of follicular hyperplasia and regression |
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In radiothyroid scans, are hot nodules associated with malignant lesions?
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No. Malignant lesions are more typically associated with "cold" nodules.
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What are the three legs of the Grave's Triad of clinical findings?
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1) Hyperthyroidism
2) Ophthalmopathy (Exophthalmos) 3) Dermopathy (Pretibial edema) |
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Use of what technique has reduced the need for thyroid surgery by 50%?
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Fine Needle Aspiration Biopsy
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What is a Follicular Adenoma?
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* A benign neoplasm arising from follicular epithelium.
* Well-circumscribed, no vascular or capsular invasion |
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Describe the histology of a Thyroid Papillary Carcinoma
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* Enlarged, overlapping nuclei with ground glass chromatin
* Inconspicuous nucleoli * Nuclear grooves * Psammoma bodies |
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Describe the histology of Follicular Carcinoma?
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* Predominance of microfollicles or trabeulae
* Low amount of associated colloid * Nuclear features similar to normal thyroid epithelium * Follicular patterned neoplasm with vascular invasion and/or capsular invasion |
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What's the difference between a Follicular Adenoma and a Follicular Carcinoma?
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Follicular Carcinoma will have
* Capsular invasion * Vascular invasion |
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How does a Thyroid Papillary Carcinoma invade? How does a Follicular Carcinoma invade?
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Papillary: via the lymphatics
Follicular: hematogenously |
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Thyroid Medullary Carcinoma secrete which hormone?
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Calcitonin. Medullary Carcinomas derive from the thyroid C-Cells.
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Describe the histology of Medullary Thyroid Carcinoma
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* Usually composed of polygonal to spindled cells growing as nests + traveculae
* Occasionally grow as follicles * May produce altered calcitonin that may form amyloid deposits within the neoplasm * Amyloid looks apple green with Congo red stain |
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What conditions/tumors may serve as precursor lesions for an Undifferentiated/Anaplastic Thyroid tumor?
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* Nodular Goiter
* Adenoma * Well differentiated Papillary/Follicular Carcinoma |
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How do Anaplastic Thyroid Cancers present?
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Rapidly growing thyroid mass. Infiltrates adjacent neck structures, causing airway obstruction.
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Describe the histology of Anaplastic Thyroid Cancer
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* Poorly differentiated malignant neoplasm with a variety of cellular appearances
* Sarcomatoid spindle cells * Pleomorphic + bizarre giant cells * Small cells |
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What are the 4 primary causes of Hyperparathyroidism?
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1) Parathyroid adenoma
2) Primary 4 Gland Hyperplasia (cause is usually renal failure) 3) Parathyroid carcinoma 4) Multiple Endocrine Neoplasia (MEN) Syndromes |
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In what part of the adrenal gland do pheochromocytomas originate?
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In the Medulla
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What are the two adrenal neoplasms arising in the cortex?
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1) Adrenal Cortical Adenoma
2) Adrenal Cortical Carcinoma |
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Cushing's Disease?
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Pituitary hypersecretion of ACTH.
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Cushing's Syndrome?
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Syndrome of excess cortisol.
* Exogenous * Cushing's Disease * Ectopic production of ACTH or CRH * Adrenal adenoma, carcinoma, nodular hyperplasia (Conn's) |
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Conn's Syndrome?
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Hypersecretion of Cortisol by an adrenal adenoma, carcinoma, or nodular hyperplasia.
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What is the most important clinical symptom of Pheochromocytoma?
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Hypertension
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What 4 familial syndromes are associated with Pheochromocytoma?
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1) MEN 2
2) von Hippel-Lindau 3) von Reclkinghausen 4) Sturge-Weber |
