Endocrine System: Thyroid Gland Quiz
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Questions and Answers

What is the primary cause of endemic goiter in populations?

  • Excessive iodine intake from local diets
  • Increased levels of TSH due to autoimmune disorders
  • Genetic mutations in thyroid hormone synthesis
  • Iodine deficiency in soil, water, and food (correct)

    • Which of the following features characterizes pretibial myxedema?

  • Painful inflammation of the eyes
  • Enlargement of the thyroid gland
  • Protrusion of the eyeball (correct)
  • Decreased production of TSH

    • What is a characteristic feature of a colloid goiter?

  • Presence of multiple nodules with hyperplastic lining
  • Irregular enlargement of the thyroid gland
  • Absence of colloid in the thyroid follicles
  • Follicular epithelium involutes and contains abundant colloid (correct)

    • How does TSH contribute to the development of goiter?

    <p>By causing hyperplasia of thyroid follicular cells (C)</p> Signup and view all the answers

    Which phase of goiter presents symmetrical enlargement with crowded columnar cells?

    <p>Diffuse simple goiter (C)</p> Signup and view all the answers

    Which of the following describes multinodular goiter?

    <p>Asymmetric enlargement with nodules of variable sizes containing colloid (D)</p> Signup and view all the answers

    What condition can complicate the ophthalmopathy associated with thyrotoxicosis?

    <p>Corneal injury (A)</p> Signup and view all the answers

    What is the main characteristic of sporadic goiter?

    <p>It affects females more than males (B)</p> Signup and view all the answers

    What is the main cause of subacute thyroiditis?

    <p>Viral infection (D)</p> Signup and view all the answers

    Which of the following structures is commonly affected by Riedel thyroiditis?

    <p>Contiguous neck structures (D)</p> Signup and view all the answers

    What type of autoantibodies are primarily involved in Grave's disease?

    <p>Thyroid-stimulating immunoglobulin (TSI) (B)</p> Signup and view all the answers

    What is a common clinical feature of Grave's disease?

    <p>Pretibial myxedema (A)</p> Signup and view all the answers

    Which microscopic feature is characteristic of subacute thyroiditis?

    <p>Presence of multinucleate giant cells (D)</p> Signup and view all the answers

    Which of the following describes the morphology of the thyroid gland in Grave's disease?

    <p>Mildly enlarged, smooth surface, and fleshy red color (C)</p> Signup and view all the answers

    What percentage of patients with Grave's disease may experience infiltrative ophthalmopathy?

    <p>40% (D)</p> Signup and view all the answers

    Which immunological process is responsible for the thyroid damage in subacute thyroiditis?

    <p>Cytotoxic T-cell-mediated damage (D)</p> Signup and view all the answers

    What characterizes Hashimoto thyroiditis?

    <p>Autoimmune destruction of thyroid antigens (B)</p> Signup and view all the answers

    Which of the following features is NOT associated with Hashimoto thyroiditis?

    <p>Acute clinical presentation (D)</p> Signup and view all the answers

    What type of thyroiditis is characterized by painful enlargement of the thyroid?

    <p>Subacute granulomatous (de Quervain) thyroiditis (A)</p> Signup and view all the answers

    What type of cells are abundant in the thyroid tissue of patients with Hashimoto thyroiditis?

    <p>Hürthle cells (C)</p> Signup and view all the answers

    What is a possible complication of Hashimoto thyroiditis?

    <p>Increased risk of B-cell non-Hodgkin lymphomas (B)</p> Signup and view all the answers

    In the context of Hashimoto thyroiditis, what does the term 'intense lymphocytic infiltration' refer to?

    <p>Destruction of thyroid follicles (D)</p> Signup and view all the answers

    Which lesion is typically associated with autoimmune thyroiditis?

    <p>Papillary thyroid carcinoma (B)</p> Signup and view all the answers

    What type of thyroiditis is known for its gradual thyroid failure?

    <p>Hashimoto thyroiditis (C)</p> Signup and view all the answers

    Flashcards

    Hashimoto Thyroiditis

    An autoimmune disease causing gradual thyroid failure due to immune destruction of the thyroid gland.

    Hashimoto Thyroiditis Pathology

    Characterized by lymphocytic infiltration, follicular cell loss, and fibrosis of the thyroid.

    De Quervain Thyroiditis

    Subacute granulomatous thyroiditis; an inflammatory condition with granulomas.

    Thyroiditis

    Inflammation of the thyroid gland. Several types exist, including autoimmune and infectious forms.

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    Infectious Thyroiditis

    Rare inflammation of the thyroid gland possibly due to infection.

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    Hürthle cells

    Epithelial cells with abundant eosinophilic, granular cytoplasm. Found in Hashimoto's Thyroiditis.

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    Autoimmune Thyroiditis

    Inflammation of the thyroid gland due to the body's immune system attacking its own thyroid cells.

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    Goiter

    Enlarged thyroid gland, often a symptom of thyroid problems

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    Exophthalmos

    Protrusion of the eyeball forwards, often associated with thyroid eye disease.

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    Pretibial Myxedema

    Localized swelling, most commonly on the shins, that can occur in patients with thyroid eye disease. It has a similar appearance and is caused by the same underlying mechanism.

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    Goiter Pathogenesis

    The underlying cause of a goiter is often impaired thyroid hormone synthesis, mainly due to iodine deficiency. This triggers increased TSH production, causing the thyroid to grow.

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    Endemic Goiter

    Goiter that affects a large population in a specific geographical area, usually due to widespread iodine deficiency in the environment.

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    Sporadic Goiter

    Goiter that occurs in individuals, not linked to a specific geographical area. It's often related to factors like hormonal changes or increased thyroid hormone demand.

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    Diffuse Simple Goiter

    The initial stage of goiter development, characterized by thyroid cell hyperplasia in response to increased TSH. The thyroid gland is enlarged but the individual remains euthyroid (normal thyroid function).

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    Colloid Goiter

    A stage of goiter where the thyroid follicles become filled with colloid (a thick fluid). This can occur if the need for thyroid hormone decreases or iodine deficiency is resolved.

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    Subacute Thyroiditis

    Inflammation of the thyroid triggered by a viral infection, causing follicular epithelial damage due to cytotoxic T-cells. It's self-limiting as the immune response is virus-initiated.

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    Subacute Thyroiditis Morphology

    Early stages show neutrophils forming microabscesses, followed by lymphocyte aggregates, activated macrophages, plasma cells, multinucleate giant cells, and eventually fibrosis.

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    Riedel Thyroiditis

    A rare form of thyroiditis with unknown cause, characterized by extensive fibrosis involving the thyroid and surrounding neck structures.

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    Grave's Disease

    An autoimmune disorder resulting in thyrotoxicosis (overactive thyroid). It often presents with infiltrative ophthalmopathy (eye problems) and sometimes pretibial myxedema (swelling on the shins). More common in women aged 20-40.

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    Grave's Disease Pathogenesis

    Autoantibodies target the TSH receptor, mimicking TSH action (TSI) or stimulating thyroid growth (TGI). The infiltrative ophthalmopathy is T cell-mediated, but the exact antigen is unclear.

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    Grave's Disease Microscopy

    Shows diffuse hyperplasia of follicular epithelium with irregular papillary folds, decreased colloid, and lymphocyte accumulation with lymphoid follicle formation.

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    Grave's Ophthalmopathy

    Characterized by T lymphocyte infiltration, swelling, and accumulation of hyaluronic acid and chondroitin sulphate in extra-orbital muscles and retro-orbital tissue.

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    Grave's Disease Gross Morphology

    The thyroid gland is moderately enlarged, symmetrical, smooth, fleshy, and red due to increased blood vessels.

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    Study Notes

    The Endocrine System - Thyroid Gland

    • Thyroiditis: Inflammation of the thyroid gland.
      • Types:
        • Infectious: Rare
        • Autoimmune: Hashimoto, the most common.
          • characterized by gradual thyroid failure due to autoimmune destruction
          • Intense lymphocytic infiltration of the thyroid gland.
          • Etiology/Pathogenesis: Autoimmune disease directed against thyroid antigens.
        • Others: Granulomatous (De Quervain), and Reidel's thyroiditis.

    Hashimoto Thyroiditis (Chronic Lymphocytic Thyroiditis)

    • Definition: Autoimmune disease characterized by persistent enlargement of the thyroid gland, with intense lymphocytic infiltration.
    • Etiology/Pathogenesis: Autoimmune disease directed against thyroid antigens.

    Grave's Disease

    • Definition: Autoimmune disorder causing thyrotoxicosis (overactive thyroid). Often characterized by infiltrative ophthalmology (in 40% of patients), and pretibial myxedema in some patients.
      • More common in women ages 20-40
      • Genetic susceptibility
    • Pathogenesis: Production of autoantibodies (TSI & TGI) that bind to TSH receptors and mimic TSH function, leading to increased T3 & T4 production.

    Subacute Granulomatous (De Quervain) Thyroiditis

    • Definition: Viral infection or post-viral inflammatory process impacting the thyroid, resulting in cytotoxic T-cell-mediated follicular damage.
    • Morphology: Characterized by early neutrophil infiltration (microabscesses), followed by lymphocytes, activated macrophages, and multinucleate giant cells, and later fibrosis.

    Riedel Thyroiditis

    • Definition: A rare, unknown-cause thyroid inflammation.
    • Characteristics: Extensive fibrosis involving the thyroid gland and surrounding neck tissues.
    • Clinical presentation: Hard and fixed thyroid mass (clinically mimicking thyroid carcinoma).

    Goiter

    • Definition: Non-inflammatory, non-neoplastic enlargement of the thyroid gland.
    • Pathogenesis: Often related to iodine deficiency, leading to compensatory TSH increase and subsequent thyroid follicular cell hyperplasia.
    • Types:
      • Endemic: Deficiency of iodine in environment (e.g., mountain areas).
      • Sporadic: Other causes (e.g., genetic).

    Thyroid Neoplasms

    • Benign: Follicular adenoma (well-circumscribed, encapsulated tumor composed of follicles), can be solitary or multiple. Sometimes hyperfunctional causing thyrotoxicosis.
    • Malignant:
      • Papillary Carcinoma: Most common thyroid cancer.
      • Follicular Carcinoma: Less common than papillary.
      • Anaplastic Carcinoma: Undifferentiated type.
      • Medullary Carcinoma: Originates from parafollicular cells (C cells)

    Thyroid Gland Pathology Summary

    • Inflammation (thyroiditis), and Enlargement (goiter) are key aspects of thyroid pathology.
    • Autoimmune conditions are common causes of thyroid dysfunction.
    • Some benign and malignant tumors can also affect the thyroid gland.

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    Related Documents

    The Endocrine System - Chapter 13 PDF

    Description

    Test your knowledge on the endocrine system, specifically the thyroid gland. Explore key concepts around thyroiditis, Hashimoto's disease, and Grave's disease, including their definitions, types, and pathogenesis. Challenge yourself with this informative quiz about thyroid disorders!

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