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Pathology 2 misc.

Terms in this set (49)

Most common cause of thyrotoxicosis
hyperthyroidism
Most common cause of hyperthyroidism
Graves disease
Causes of hyperthyroidism
Graves disease
Toxic multinodular Goiter
Toxic adenoma
Thyroiditis types that can cause thyrotoxicosis
-Granulomatous thyroiditis/De Quervain/painful
-subacute lymphocytic thyroiditis / painless
-rare: hashitoxicosis
Ocular changes in thyrotoxicosis
Wide staring gaze and lid lag
Thyroid Ophthalmopathy (Grave's Disease)
Wide staring gaze and lid lag + exophthalmos
In apathetic hyperthyroidism, thyrotoxicosis features are present with?
Exaggerated <3 dz
Weight loss
If you want to choose one thyroid fx test, which is the best?
TSH
⬇️T4 ⬆️TSH
1° hypothyroidism
Normal T4 & ⬆️TSH
Sub clinical 1° hypothyroidism
⬇️T4 & ⬇️TSH
Central hypothyroidism
⬇️T4 & normal or mildly⬆️TSH
Central hypothyroidism
⬆️T4 & ⬇️TSH
Not central hyperthyroidism
Normal T4 & ⬇️TSH
Test for T3
1- if high: T3 toxicosis
2- if not high: subclinical hyperthyroidism
⬆️T4 & ⬆️TSH
Central hyperthyroidism
⬆️T4 & normal or mildly ⬇️TSH
Central hyperthyroidism
High RAIU, scan shows diffuse
Graves
High RAIU, scan shows one spot
Toxic adenoma
High RAIU, scan shows multiple spots
Toxic multinodular goitre
Low RAIU, High Tg
Thyroiditis
Low RAIU, low Tg
Exogenous
Eg Struma ovarii
Iodine induced hyperthyroidism
Central hyperthyroidism test:
Pituitary MRI
Most common cause of hypothyroidism in the developed world
Hashimoto's thryoiditis
Most common cause of congenital hypothyroidism in the US
thyroid dysgenesis
Dysmorphogenetic goitre
Goitrous HYPOthyroidism types
Dyshormogenetic goitre
Endemic deficiency of dietary iodine
Hashimoto
Side effect of drugs eg lithium iodides PAS
Cretinism prominent symptoms
Protruding tongue
Short limbs
Lack of hair and teeth
Pot belly
Hypotonia
Often umbilical hernia
Which thyroiditis is associated with CTLA4 mut?
Hashimoto
Which thyroiditis usually follows a URI?
painful subacute thyroiditis
Which thyroiditis is associated w/ extensive fibrosis?
Riedel
Which thyroiditis is an IgG4 related dz?
Riedel
Which thyroiditis is not autoimmune?
Painful subacute
Which thyroiditis as also called post partum thyroiditis?
Subacute lymphocytic painless
Which thyroiditis are self limited?
Subacute granulomatous & lymphocytic
Patients w/ hashimoto are at risk for developing?
Thyroid papillary ca
MALToma
Antibodies in hashimoto
ANTI- TPO
ANTI- TG
Antibodies in subacute painless thyroiditis
Antithyroid ab
Graves dz
Diffuse goitre + thyrotoxicosis + pretibial myxoedema + exophthalmos
Exophthalmus occurs in_____of graves
40%
Gene mutations in graves
HLA DR3
CTLA 4
PTPN22
Antibodies in graves
TSI --> IgG
TSH Binding inhibitor Ig
Thyroid Growth stim Ig
Specific and sensitive antibody in graves
TSI
Myxoedema Graves' disease is
Nonpitting
Hypersensitivity reactions involved in graves
Type II stimulatory
Hypersensitivity reactions involved in Hashimoto
Types II and IV
Goitre early vs late
Early-> diffuse
Late-> multinodular
Plummer syndrome
toxic multinodular goiter
Toxic Multinodular goitre occurrence
10% of All multinodular goitres
10 years to develop
Incidence of malignancy in long-standing multinodular goitre
Less than 5% but not 0
Concern for malignancy arises w/ goitres that______
Demonstrate sudden change in size or associated symptoms e.g. hoarsness
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