Notes in 06 Hypothyroidism, Thyroid Nodules, and Cancer

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Published	02/15/2024	Thyroid hormones are synthesized by the {{c1::follicular epithelial}} cells of the thyroid gland
Published	02/15/2024	Thyroid-stimulating hormone (TSH) secretion is decreased in response to {{c1::free T3/T4}}
Published	02/15/2024	How does free T3 cause decreased secretion of thyroid stimulating hormone? {{c1::Down-regulating the TRH receptors on the thyrotrophs of the anterior …
Published	02/15/2024	The most common cause of hypothyroidism in iodine replete countries is {{c1::autoimmune or Hashimoto thyroiditis}}
Published	02/15/2024	Hyperthyroidism vs Hypothyroidism Summary Table: no answer {{c1:::)}}
Published	02/15/2024	{{c2::Calcitonin}} is secreted by the {{c1::parafollicular cells (C cells)}} of the thyroid gland
Published	02/15/2024	Which thyroid imbalance presents with decreased heat production (cold intolerance) and decreased sweating?{{c1::Hypothyroidism}}
Published	02/15/2024	Which thyroid imbalance presents with weight gain and decreased appetite?{{c1::Hypothyroidism}}
Published	02/15/2024	Which thyroid imbalance presents with constipation?{{c1::Hypothyroidism}}
Published	02/15/2024	Which thyroid imbalance presents with decreased reflexes?{{c1::Hypothyroidism}}
Published	02/15/2024	Which thyroid imbalance presents with bradycardia and dyspnea on exertion?{{c1::Hypothyroidism}}
Published	02/15/2024	Which thyroid imbalance presents with proximal muscle weakness and increased creatine kinase?{{c1::Hypothyroidism}}
Published	02/15/2024	Does hypothyroidism present with hypo- or hyper-cholesterolemia? Why?{{c1::Hypercholesterolemia; due to decreased LDL receptor expression}}
Published	02/15/2024	{{c1::Multinodular goiter}} is an enlarged thyroid gland with multiple nodules
Published	02/15/2024	In hypothyroidism patients, myxedema commonly affects the {{c1::larynx}} (causing deep voice) and {{c1::tongue}} (causing enlargement)
Published	02/15/2024	Which thyroid imbalance is associated with dry, cool skin and coarse, brittle hair?{{c1::Hypothyroidism}}
Published	02/15/2024	What is the most common cause of hypothyroidism in regions where iodine levels are adequate?{{c1::Hashimoto thyroiditis}}
Published	02/15/2024	Thyroid nodules are more likely to be {{c1::benign::benign or malignant}} than {{c1::malignant::benign or malignant}}
Published	02/15/2024	Thyroid nodules may be studied using {{c1::131I}} radioactive uptake studies
Published	02/15/2024	If a thyroid nodule has increased uptake of 131I, it is considered a(n) {{c1::hot}} nodule; seen in Graves disease or nodular goiter
Published	02/15/2024	If a thyroid nodule has decreased uptake of 131I, it is considered a(n) {{c1::'cold'}} nodule
Published	02/15/2024	How is a biopsy performed for a thyroid nodule? {{c1::Fine needle aspiration (FNA)}}
Published	02/15/2024	What is the most common type of thyroid carcinoma? {{c1::Papillary Carcinoma (80%)}}
Published	02/15/2024	Exposure to {{c1::ionizing radiation}} in childhood is a major risk factor for thyroid {{c2::papillary}} carcinoma
Published	02/15/2024	What two gene mutations are associated with increased risk of thyroid papillary carcinoma?{{c1::RET and BRAF}}
Published	02/15/2024	Thyroid {{c1::papillary}} carcinoma may be lined by cells with clear, '{{c2::Orphan Annie eye}}' nuclei
Published	02/15/2024	In addition to 'Orphan Annie eye' nuclei, thyroid papillary carcinoma may have cells with intranuclear {{c1::grooves}} and inclusions
Published	02/15/2024	Thyroid {{c2::papillary}} carcinoma may have {{c1::psammoma}} bodies on biopsy, which are characterized by concentric layers of calcification
Published	02/15/2024	Thyroid papillary carcinoma often spreads to the {{c1::cervical}} nodes (lymphatic invasion)
Published	02/15/2024	What is the prognosis of thyroid papillary carcinoma? {{c1::Excellent}}
Published	02/15/2024	Thyroid follicular carcinoma is characterized by a malignant proliferation of follicles surrounded by a(n) {{c1::fibrous capsule}} with {{c1::inv…
Published	02/15/2024	What mutation is thyroid follicular carcinoma associated with?{{c1::RAS}}
Published	02/15/2024	What is the most common route of metastasis for a thyroid follicular carcinoma?{{c1::Hematogenous}}
Published	02/15/2024	Thyroid {{c1::medullary}} carcinoma is a malignant proliferation of {{c2::parafollicular "C"}} cells
Published	02/15/2024	Thyroid medullary carcinomas secrete {{c1::calcitonin}}
Published	02/15/2024	In thyroid medullary carcinoma, calcitonin often deposits within the tumor as {{c1::amyloid}}, which may be visualized with a(n) {{c2::congo red}…
Published	02/15/2024	Detection of a RET oncogene mutation warrants prophylactic {{c1::thyroidectomy}}
Published	02/15/2024	What type of thyroid carcinoma is illustrated in this histology slide? {{c1::Medullary carcinoma}}
Published	02/15/2024	What two multiple endocrine neoplasias are associated with thyroid medullary carcinoma?{{c1::MEN 2A and 2B}}
Published	02/15/2024	Thyroid {{c1::anaplastic}} carcinoma is an undifferentiated malignant tumor of thyroid
Published	02/15/2024	What demographic is most commonly associated with anaplastic carcinoma?{{c1::Elderly women}}
Published	02/15/2024	Thyroid {{c1::anaplastic}} carcinoma often invades local structures leading to dysphagia or respiratory compromise
Published	02/15/2024	What is the prognosis of thyroid anaplastic carcinoma?{{c1::Poor}}
Published	02/15/2024	What type of thyroid carcinoma is illustrated in this histology slide? {{c1::Anaplastic carcinoma}}
Published	02/15/2024	{{c1::Levothyroxine}} is a T4 hormone analog used to treat hypothyroidism and myxedema
Published	02/15/2024	Medullary carcinoma of the thyroid is characterized by deposition of {{c1::calcitonin}} within the tumor
Published	02/15/2024	{{c1::Hashimoto's Thyroiditis}} is an autoimmune disorder that initially causes a hyperthyroidism that then becomes a hypothyroidism
Published	02/15/2024	Levothyroxine and Triiodothyronine are {{c1::thyroid replacement}} medications that are used to treat hypothyroidism and myxedema
Published	02/15/2024	The {{c2::Wolff-Chaikoff}} effect is the inhibition of thyroperoxidase by excess {{c1::iodine}}
Published	02/15/2024	Patients who undergo radioactive iodine (I131) treatment can develop {{c1::hypothyroidism}}
Published	02/15/2024	{{c1::Lithium}} is a mood stabilizer associated with development of hypothyroidism
Published	02/15/2024	What is the initial step in evaluation of a newly discovered thyroid nodule? {{c1::TSH level and U/S}}
Published	02/15/2024	Most notably, the serum tumor marker Calcitonin is seen elevated in {{c1::Medullary Thyroid Carcinoma}}
Published	02/15/2024	Which thyroid imbalance presents with Abnormal Uterine Bleeding and Infertility?{{c1::Hypothyroidism AND Hyperthyroidism}}
Published	02/15/2024	Which thyroid imbalance presents with hypoactivity, lethargy, and fatigue?{{c1::Hypothyroidism}}
Published	02/15/2024	Which thyroid imbalance presents with increased TSH (if 1*) and decreased free T3 / T4?{{c1::Hypothyroidism}}
Published	02/15/2024	{{c1::Postpartum thyroiditis}} is a self-limited thyroiditis arising up to 1 year after delivery
Published	02/15/2024	A thyroid nodule is diagnosed as malignant with ultrasound-guided {{c1::fine needle aspiration}}, which is reliable for all cancers except {{c1::folli…
Published	02/15/2024	Thyroid papillary carcinoma = {{c1::lymphatic::lymphatic/hematogenous}}Thyroid follicular carcinoma = {{c1::hematogenous::lymphatic/hematogenous}}
Published	02/15/2024	What is the likely diagnosis in an older patient with memory changes, weight gain, fatigue, and constipation?{{c1::Hypothyroidism}}
Published	02/15/2024	What is the likely diagnosis in a patient that presents with constipation, cold intolerance, low libido, and hypoglycemia with eosinophilia on laborat…
Published	02/15/2024	What is the primary treatment for papillary thyroid carcinoma?{{c1::Surgical resection}}
Published	02/15/2024	Post-operative adjuvant therapies for papillary thyroid carcinoma may include radioiodine ablation and/or suppressive doses of {{c1::thyroid hormone}}
Published	02/15/2024	Thyroid nodules >1 cm with high risk sonographic features (ultrasound) should undergo {{c1::fine-needle aspiration (FNA)::test}}
Published	02/15/2024	What type of thyroid nodule, hyperfunctioning ("hot") or hypofunctioning ("cold"), is more likely to be cancerous?{{c1::Hypofunctioning ("cold")}}
Published	02/15/2024	= {{c1::Hypothyroidism::Diagnosis}}
Published	02/15/2024	Exophthalmos (proptosis) is most likely {{c1::Graves disease::condition}}
Published	02/15/2024	Diffuse goiter and diffuse radioactive iodine uptake = {{c1::Graves disease}}
Published	02/15/2024	Before doing TSH level / ultrasound to evaluate thyroid nodule, what do you do?{{c1::H&P}}
Published	02/15/2024	What is the next best step in diagnosing/treating a thyroid nodule that has low TSH?{{c1::RAIU scan}}
Published	02/15/2024	Which subtype of thyroid cancer typically invades blood vessels and metastasizes hematogenously? {{c1::Follicular thyroid carcinoma}}
Published	02/15/2024	Post-resection of medullary thyroid carcinoma, {{c1::calcitonin}} levels should be measured
Published	02/15/2024	Thyroid GlandThe arrows are pointing to {{c1::follicular}} cells.
Published	02/15/2024	Thyroid GlandThe arrows are pointing to {{c1::parafollicular (C) cells::cell type}}.
Published	02/20/2024	Thyroid GlandParafollicular cells are {{c1::larger::smaller/larger}} than follicular cells and stain {{c1::paler::paler/darker}}
Published	02/15/2024	{{c1::Papillary}} thyroid carcinoma is due to PTC mutations
Published	02/15/2024	{{c1::Follicular}} thyroid carcinoma is due to PAX8-PPARγ mutations
Published	02/15/2024	Hashimoto's thyroiditis can cause {{c1::fibrosis}} in the interstitium of the thyroid gland
Published	02/15/2024	Which thyroid malignancy may arise sporadically or from progression of papillary or follicular carcinoma?{{c1::Anaplasti…
Published	02/15/2024	Anaplastic thyroid carcinoma is associated with loss of the {{c1::p53::gene}} cell division checkpoint regulation
Published	02/15/2024	Follicular thyroid carcinoma is most common in {{c1::older women::demographic}} and is the second most common thyroid malignancy
Published	02/15/2024	Which thyroid malignancy is usually solid with prominent areas of necrosis and hemorrhage?{{c1::Medullary thyroid carcinoma}}
Published	02/15/2024	Most cases of papillary thyroid carcinoma are due to activating mutations of the {{c1::MAPK}} signaling pathway
Published	02/15/2024	Most solitary thyroid nodules are {{c1::benign::benign or malignant}}, fluid-filled cysts
Published	02/15/2024	What is the second most common thyroid malignancy?{{c1::Follicular thyroid carcinoma}}
Published	02/15/2024	What is the most common cause of hypothyroidism (endemic goiter) worldwide?{{c1::Iodine deficiency}}
Published	02/15/2024	Many cases of Riedel's thyroiditis progress to subclinical and overt {{c1::hypothyroidism}}
Published	02/15/2024	What is the most sensitive screening test for primary hypothyroidism?{{c1::High TSH}}
Published	02/15/2024	The arrows are pointing to {{c1::follicular cells::cell type}} in the {{c1::thyroid gland::organ}}
Published	03/12/2024	In the thyroid axis, T{{c1::R}}H induces release of T{{c1::S}}H
Published	02/15/2024	The colloid in the thyroid follicles is rich in {{c1::thyroglobulin::protein}}, which is rich in {{c1::tyrosine::amino acid}}
Published	02/15/2024	This image is taken from the {{c1::thyroid gland::organ}}
Published	02/15/2024	fc4a32dc126f45478c001b1067abcf62-ao-1
Published	02/15/2024	fc4a32dc126f45478c001b1067abcf62-ao-2
Published	02/15/2024	fc4a32dc126f45478c001b1067abcf62-ao-3
Published	02/15/2024	Levothyroxine must be taken {{c1::without::with/without}} food
Published	02/20/2024	Triiodothyronine (synthetic T3) is only recommended for patients with {{c1::5'- deiodinase}} deficiency
Published	02/15/2024	Thyroid cancer in woman < 60 y/o: {{c1::papillary}} or {{c1::follicular}}Thyroid cancer in woman > 60 y/o: {{c1::anaplastic}}
Published	02/15/2024	Papillary and follicular thyroid carcinoma are both more common in {{c1::females::gender}}
Published	02/15/2024	This thyroid biopsy shows {{c1::oncocytic*}} follicles on the left and {{c1::lymphocytic}} infiltrate on the right, a combination which is s…
Published	02/15/2024	Compared to the normal cross section of a thyroid on the left, the thyroid on the right is pale, which is suggestive of {{c1::Hashimoto's thyroid…
Published	02/15/2024	This thyroid biopsy shows {{c1::papillary hyperplasia (scalloped colloid)::histologic finding}}, which is suggestive of {{c1::Graves disease…
Published	02/15/2024	This thyroid biopsy shows {{c1::optically clear (Orphan Annie) nuclei::histologic finding}}, which is suggestive of {{c1::papillary carcinom…
Published	02/15/2024	Compared to the normal cross section of a thyroid on the left, the thyroid on the right is suggestive of {{c1::papillary…
Published	02/15/2024	This thyroid biopsy shows {{c1::amyloid::histologic finding}}, which is suggestive of {{c1::medullary carcinoma::dx}}
Published	02/15/2024	Compared to the normal cross section of a thyroid on the left, the thyroid on the right is waxy, which is suggestive of …
Published	02/15/2024	The {{c1::thyroid}} gland in the neck produces {{c2::T3}}, {{c2::T4}}, and {{c2::calcitonin}}, which impact metabolism and calcium regulation.
Published	02/15/2024	The 2 cell types in the thyroid gland are:{{c1::follicular cells}} that make {{c2::T3/T4}}{{c1::parafollicular/C cells}} that make {{c2::calcitonin}}
Published	02/20/2024	Histologically, Hashimoto thyroiditis may have {{c1::Hurthle}} cells, which are eosinophilic metaplastic cells that line the follicles
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