Hyper And Hypo Thyroid Jeopardy Template

Clinical presentation	Pathophysiology	Histopathological/gross appearance	Treatment/ Lab Tests	Miscellaneous
100 What is Graves Disease weight loss, hot flashes, bilaterally enlarged thyroid, warm dry skin, heart palpitations, nervousness, prone to thyroid storm	100 What is toxic adenoma Activating mutations in TSH receptor or its associated G protein i.e. Gs alpha subunit mutation	100 What is papillary carcinoma psammoma bodies, ground glass "orphan annie eye" nucleus, fibrovascular stalk	100 What is iodine replacement via diet or supplement Iodine Deficiency Treatment	100 What is HT:: High TSH, low T4/T3, increases TRH, stimulates prolactin --> amennorhea via feedback inhibition. Cushing's --> neg feedback disrupt GnRH Compare and contrast reason for amenorrhea in hypothyroidism vs. Cushing's disease
200 What is Iodine Deficiency bilaterally enlarged thyroid, gradual decline in mental function, gradual onset of fatigue, cold intolerant, overweight, constipation, dyspnea	200 What is thyroid stimulating immunoglobulin, binds to TSH receptor and mimics TSH action Graves disease	200 What is graves' disease diffuse hypertrophy and hyperplasia, tall and crowded follicular cells, pale colloid with scalloped margins	200 What is radioactive iodine therapy, methimazole, propylthiouracil, beta blockers, thyroidectomy Graves Disease Treatment	200 What is FAS binds FAS-L, --> DISC (death inducing signalling complex) - includes FADD, --> caspase 8, -->caspase 3 and BID. (extrinsic) Death pathway experienced by thyroid cells in hashimoto thyroiditis
300 What is functional thyroid adenoma unilateral swelling of the thyroid - solitary nodule, hot on RAIU, weight loss, hot flashes, heart palpitations, nervousness	300 What is hashimoto thyroiditis loss of self-tolerance to thyroid auto-antigens, increased T-cell activity and inflammatory response	300 What is hemorrhagic adrenals, presenting with hypotension and DIC secondary to N. meningitis Waterhouse-Friderichsen	300 What is hashimoto thyroiditis decreased T3/T4, increased TSH, elevated WBC and inflammatory markers	300 What is labs: hypocalcemia, increased calcitonin Mutation: RET activation Familial Medullary Thyroid Carcinoma: lab levels? mutation?
400 What is Hashimoto Thyroiditis An older female, diffusely enlarged thyroid, cold on RAIU, decline in mental function, weight gain, fatigue, constipation	400 What is issue with: iodine transport into cell, moves basal to apical movement, oxidized by peroxidase, combined with thyroglobulin - forms MIT/DIT Iodine Deficiency	400 What is Hashimoto Thyroiditis (Hurthle cells = metaplastic response to inflammation) lymphocytic invasion, extensive mononuclear infiltrate, Hurthle cells	400 What is toxic adenoma high T3/T4, low TSH	400 What is hyperaldosteronemia - Conn's syndrome - via adrenal hyperplasia (17-OH deficiency), adenoma hypertension, hypernatremia, hypokalemia, alkalosis, low renin
500 What is Cushing's Disease weight gain, buffalo hump, abdominal striae, high blood pressure, hyperglycemia, fatigue, oligomenorrhea	500 What is MEN 1 --> parathyroid, pituitary, and pancreatic endocrine tumors mutation in menin, increased calcitonin, hyperparathyroidism, Zollinger-Ellison syndrome	500 What is toxic adenoma well-circumscribed mass with capsule demarcated from adjacent parenchyma, uniform follicles, homogeneous follicular cells	500 What is when in acute need - i.e. surgery - T4 takes 6 weeks to show improvement, T3 takes only 2. When would you give T3 as opposed to T4	500 What is pituitary adenoma dexamethasone test - fail single, fail low, pass high

Hyper and Hypo Thyroid

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