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25 Cards in this Set

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This lesion demonstrates large and small colloid filled follicles, some markedly distended; foamy macrophages are found in scattered follicles.
Amiodarone treatment
This lesion is characterized by scattered small, disrupted follicles associated with a histiocytic infiltrate, but most histiocytes do not have a foamy cytoplasm.
palpation thyroiditis
How do these metastasize?
Papillary carcinoma
Follicular carcinoma
Medullary carcinoma
Papillary: lymphatics
Follicular: veins
Medullary: both
IHC for medullary carcinoma:
thyroglobulin
calcitonin
synaptophysin
chromogranin
CEA
TTF1
IHC for medullary carcinoma:
thyroglobulin -
calcitonin +
synaptophysin +
chromogranin +
CEA +
TTF1 + (80%)
What is the mechanism of periortibal edema and exophthalmos in Grave's disease?
Antigen-antibody complex deposition in periorbital tissues, especially muscles
Which thyroid neoplasm is positive for CK19?
Papillary
What is the most common site for ectopic thyroid?
Base of tongue

NOTE: 75% of people with ectopic thyroid do not have thyroid tissue anywhere else.
Location for thyroglossal duct cyst.
Midline above isthmus and below the hyoid bone.

NOTE: the duct remnant is always connected to the hyoid bone.
Does thyroglossal duct cyst move with swallowing?
Yes
Can medullary carcinoma develop in thyroglossal duct cyst?
No, only neoplasms of follicular cell origin develop here.
What percentage of the ovarian neoplasm needs to be thyroid in order to be called struma ovarii?
50%
What percentage of struma ovarii are bilateral?
5%
What causes black thyroid?
minocycline
How does the pigment in black thyroid stain?
PAS
Oil red O
Lipofuscin
Fontana Masson
Iron
How does the pigment in black thyroid stain?
PAS +
Oil red O +
Lipofuscin +
Fontana Masson +
Iron -
What HLA are associated with Hashimoto's thyroiditis?
HLA-DR3
HLA-DR4
HLA-DR5
What HLA is associated with follicular neoplasms and papillary thyroid carcinoma?
HLA-DR7
What are the 3 most common thyroid cancers and what are their prevalence?
1. Papillary (80%)
2. Follicular (10-20%)
3. Medullary (5-10%)
What molecular mutations are associated with follicular carcinoma? (4)
1. PPAR-gamma (25-50%)
2. N-RAS, H-RAS (25-50%)
3. p53
4. beta-catenin
What are the aggressive subtypes of papillary thyroid carcinoma? (3)
1. Diffuse sclerosing
2. Tall cell
3. Columnar cell
What molecular mutations are associated with papillary thyroid carcinoma?
1. BRAF (70%)
2. RET
3. Trk (20%)
In medullary carcinoma, what type of amyloid is present?
AA
In medullary carcinoma is associated with several familial syndromes including MEN2A, MEN2B, and familial non-MEN thyroid medullary carcinoma). List them, along with sporadic medullary carcinoma from best to worst prognosis.
Medullary thyroid carcinoma prognosis (best to worst):
1. Familial non-MEN thyroid medullary carcinoma
2. Sporadic = MEN2A
3. MEN 2B
What mutation is associated with medullary thyroid carcinoma?
RET
Is primary thyroid lymphoma usually indolent or acute?
Presents as acutely enlarging mass (even though most common type is MALT lymphoma)
DiGeorge syndrome is due to anomalies of what branchial pouches? What's the microdeletion?
3rd and 4th branchial pouches

Del 22q11.2

NOTE: Hypoparathyroidism --> hypocalcemia