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Jaspie - Pathology > 23 - Endocrine system > Flashcards

23 - Endocrine system Flashcards

1
Q

Most common cause of hyperpituitarism:

A

functional anterior pituitary adenoma

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2
Q

Most common type of functional anterior pituitary adenoma:

A

prolactin cell adenoma

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3
Q

Second most common type of functional anterior pituitary adenoma:

A

somatotroph adenoma

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4
Q

Most common arrhythmia in hyperthyroidism:

A

atrial fibrillation

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5
Q

Most common cause of congenital hypothyroidism worldwide:

A

Iodine deficiency hypothyroidism

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6
Q

Most common cause of hypothyroidism in iodine-sufficient areas:

A

Hasthimoto’s thyroiditis

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7
Q

Most common cause of goiters:

A

iodine deficiency

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8
Q

Most common type of thyroid carcinoma:

A

papillary thyroid carcinoma

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9
Q

Second most common type of thyroid carcinoma:

A

follicular thyroid carcinoma

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10
Q

Most common cause of primary hyperthyroidism:

A

Graves disease

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11
Q

Most common cause of primary hyperparathyroidism:

A

parathyroid adenoma

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12
Q

Most common cause of secondary hyperparathyroidism:

A

renal failure

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13
Q

Enumerate signs (3): von Recklinghausen disease of bone:

A
  • increased osteoclast activity
  • peritrabecular fibrosis
  • cystic brown tumors
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14
Q

Most common cause of hypoparathyroidism:

A

iatrogenic (surgically induced)

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15
Q

Identify: location (chromosome) of the most important susceptibility gene for type I DM

A

chromosome 6

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16
Q

Most common type of pancreatic neuroendocrine tumor:

A

insulinoma

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17
Q

Enumerate: Whipple’s triad

A
  • Hypoglycemia
  • neuroglycopenic symptoms
  • relief upon parenteral glucose administration
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18
Q

Enumerate: triad of Zollinger-Ellison syndrome:

A
  • pancreatic islet cell tumor
  • hypersecretion of gastric acid
  • severe peptic ulceration
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19
Q

Most common cause of Cushing syndrome:

A

Exogenous steroids

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20
Q

Most common endogenous cause of Cushing syndrome:

A

ACTH-secreting pituitary adenoma (Cushing disease)

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21
Q

Most common cause of primary hyperaldosteronism

A

bilateral idiopathic hyperplasia

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22
Q

Most common clinical manifestation of hyperaldosteronism:

A

hypertension

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23
Q

Most important clinical manifestation of hyperaldosteronism:

A

hypertension

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24
Q

Most common cause of Addison disease:

A

autoimmune adrenalitis

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25
Q

-Enumerate (4): rule of 10s -What disease does this refer to?

A
  • 10% are extrarenal
  • 10% are bilateral
  • 10% are biologically malignant
  • 10% are not associated with hypertension - pheochromocytoma
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26
Q

Triad of syndrome in MEN1:

A
  • prolactinoma - Pituitary
  • primary hyperparathyroidism - Parathyroid
  • insulinoma or gastrinoma (Zollinger-Ellison syndrome) - Pancreas

PPP! Pituitary, Parathyroid, Pancreas

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27
Q

Tumors common to MEN2A and MEN2B

A

Pheochromocytoma and Medullary Thyroid Carcinoma

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28
Q

Sign(s) of MEN2A not found in MEN2B

A

parathyroid hyperplasia

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29
Q

Sign(s) of MEN2B not found in MEN2A

A
  • -neuroma
  • -ganglioneuroma
  • -marfanoid habitus
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30
Q

Main histologic feature of pituitary adenomas.

A

Monomorphic cells without a significant reticulin network

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31
Q

Most common pituitary adenomas.

A

Prolactin cell adenoma; followed by Somatotroph (GH) cell adenoma

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32
Q

The main pathology of Cushing disease (not syndrome).

A

Corticotroph cell adenoma

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33
Q

Associated with mass effects and hypopituitarism (secondary to destruction of the normal pituitary parenchyma).

A

Nonfunctioning pituitary adenomas

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34
Q

The only definitive criterion for diagnosis of pituitary carcinoma.

A

Metastases

35
Q

Atypical adenomas with metastases; usually functional, with ACTH as the most common hormone produced, followed by prolactin.

A

Pituitary carcinoma

36
Q

Posterior pituitary syndromes.

A

Diabetes insipidus and SIADH

37
Q

The origin of this tumor is from vestigial remnants of Rathke pouch; with bimodal age incidence (5-15 years; 65 years); has adamantinomatous, and papillary types.

A

Craniopharyngioma

38
Q

Most common cause of primary hyperthyroidism.

A

Diffuse toxic hyperplasia (Graves disease) (85%)

39
Q

Most common cause of congenital hypothyroidism worldwide.

A

Iodine deficiency

40
Q

Most common cause of hypothyroidism in iodine-sufficient areas.

A

Hashimoto thyroiditis

41
Q

Hypothyroidism in infancy and childhood, impaired development of CNS (Mental retardation) and skeletal system (short stature), coarse facial features, protruding tongue, and umbilical hernia.

A

Cretinism

42
Q

Hypothyroidism in late childhood and adults; and slowing of physical and mental activity; overweight, hypercholesterolemia, nonpitting edema, coarse facial features, macroglossia and deepening of voice; accumulation of matrix substances, such as glycosaminoglycans and hyaluronic acid, in skin, subcutaneous tissue, and a number of visceral sites.

A

Myexedema

43
Q

Histologically characterized by dense lymphocytic infiltrate with germinal centers; follicles are atrophic with Hurthle cell change (cells with eosinophilic granular cytoplasm); associated with antibodies against thyroglobulin and thyroid peroxidase; Type IV hypersensitivity with Type II component.

A

Hashimoto thyroiditis

44
Q

Granulomatous inflammation of the thyroid and viral infections; clinically presents as painful thyroiditis.

A

Subacute Granulomatous (De Quervain) thyroiditis

45
Q

Lymphocytic inflammation of the thyroid (morphologically similar to Hashimoto but without Hurthle cell change, fibrosis); commonly seen in postpartum patients; clinically presents as painless thyroiditis.

A

Subacute Lymphocytic thyroiditis

46
Q

Characterized by extensive fibrosis of the thyroid gland; associated with primary retroperitoneal fibrosis (Ormond disease) and autommune IgG4-related disease; pathology is unknown, but postulated to be of autoimmune type.

A

Reidel thyroiditis

47
Q

Triad of Graves disease.

A

Thyrotoxicosis, ophthalmopathy and dermopathy

48
Q

Main pathology of Graves disease.

A

Presence of thyroid stimulating immunoglobulin (TSIs); binding to TSH receptors causes activation of follicular cell function

49
Q

Histologic features of Graves disease.

A

Diffuse hypertrophy and hyperplasia of the follicles with scalloped colloid (moth-eaten) (because of active reabsorption of follicular cells)

50
Q

Usually hypothyroid (and compensatory TSH increase leads to proliferation of the gland)

A

Diffuse and multinodular goiter

51
Q

Goiter that has 2 phases: 1. Hyperplastic phase (due to TSH influence), and 2. Colloid phase (involution of gland due to sufficient iodine intake or increased thyroid hormone demand)

A

Colloid goiter

52
Q

Repeated hyperplastic and colloid phases results in irregular involvement of the thyroid gland, leading to a condition known as:

A

Multinodular goiter

53
Q

Multinodular toxic goiter characterized by development of autonomously functioning nodules; presents with hyperthyroidism not associated with ophthalmopathy and dermopathy.

A

Plummer syndrome

54
Q

Clinical characteristics favoring malignancy in thyroid nodules.

A

Solitary, young, male, history of radiation therapy, “cold” nodules

55
Q

Normal looking follicular cells surrounded by an intact capsule; can also be composed of follicular cells that underwent Hurthle cell change (Hurthle cell adenoma); solitary; Note: adenomatous nodule, which is a part of multinodular goiter, is the more appropriate diagnosis for multiple nodules showing adenomatous change.

A

Follicular adenoma

56
Q

Main distinguishing feature of follicular carcinoma from follicular adenoma.

A

Capsular and vascular invasion

57
Q

Most common form of thyroid cancer; histologically characterized by papillary architecture with dense fibrovascular cores; nucleus has finely dispersed chromatin (ground-glass or Orphan Annie nuclei); with Psammoma bodies; spreads by lymphatic route (vs. follicular carcinoma (hematogenous)).

A

Papillary carcinoma

58
Q

Carcinoma arising from parafollicular C cells (secretes calcitonin); histologically characterized by amyloid deposits; known for its multicentricity and association with MEN2 syndromes.

A

Medullary Thyroid Cancer (MTC)

59
Q

Highly lethal thyroid cancer (mortality rate of 100% in 6 months) with a highly pleomorphic morphology; clinically presents with rapidly enlarging thyroid mass; immunostaining for thyroglobulin is negative.

A

Undifferentiated carcinoma (Anaplastic carcinoma)

60
Q

Most common cause of primary hyperparathyroidism; almost always confined to one gland (compared to hyperplasia that involves multiple glands); may sometimes show atypia.

A

Parathyroid Adenoma (85-95%)

61
Q

Definitive criteria for diagnosis of parathyroid carcinoma.

A

Metastases and local invasion

62
Q

Most common cause of secondary hyperparathyroidism.

A

Renal failure

63
Q

Most common cause of hypoparathyroidism.

A

Iatrogenic

64
Q

Absolute deficiency of insulin secondary of beta cell destruction by an autoimmune process; accounts for only 10% of cases of DM; Type IV hypersensitivity with Type II component; histologically characterized by mononuclear infiltration of the islets with reduction of islet size and number (insulitis).

A

Type I DM

65
Q

Peripheral resistance to insulin and relative insulin deficiency is the main pathology; most common form of DM; histologically characterized by amyloid replacement of islets.

A

Type 2 DM

66
Q

The hallmark of diabetic macrovascular disease, which explains its association with coronary artery disease and cerebrovascular disease.

A

Accelerated atherosclerosis

67
Q

Histologic characteristics of diabetic microangiopathy.

A

Diffuse thickening of the basement membrane, with more leaky capillaries

68
Q

Nodular glomerulosclerosis (Kimmelsteil-Wilson lesion); Hyaline arteriolosclerosis; and necrotizing papillitis from pyelonephritis are lesions encountered in:

A

Diabetic nephropathy

69
Q

Retinal hemorrhages, microaneurysms, venous dilations, edema, exudates and thickening of retinal capillaries are lesions encountered in what form of diabetic retinopathy?

A

Nonproliferative (background)

70
Q

Neovascularization and fibrosis are lesions encountered in what form of diabetic retinopathy?

A

Proliferative

71
Q

Most common PanNET; associated with Whipple’s triad: 1. Hypoglycemia <50 mg/dL; 2. Neuroglycopenic symptoms; and 3. Relief with feeding or parenteral administration of glucose; Biologically favorable behavior; characterized by deposition of amyloid.

A

Insulinoma

72
Q

Associated with Zollinger-Ellison syndrome: 1. Pancreatic islet cell tumor; 2. Hypersecretion of gastric acid; and 3. Peptic ulceration; also associated with MEN-1; biologically aggressive behavior.

A

Gastrinoma

73
Q

Most common cause of Cushing syndrome (hypercortisolism).

A

Exogenous administration of steroids

74
Q

Most common cause of endogenous hypercortisolism.

A

ACTH-secreting pituitary adenoma (Cushing disease)

75
Q

Morphologic change in adrenal cortex of patients with ACTH-dependent Cushing syndrome.

A

Diffuse hyperplasia

76
Q

Morphologic change in adrenal cortex of patients with ACTH-independent Cushing syndrome. (Cortisol-secreting adrenal adenoma).

A

Cortical atrophy

77
Q

Most common cause of primary hyperaldosteronism.

A

Bilateral idiopathic hyperplasia (60%)

78
Q

The most common enzymatic defect in congenital adrenal hyperplasia.

A

21-hydroxylase deficiency

79
Q

Most common cause of primary adrenal insufficiency (Addison disease).

A

Autoimmune adrenalitis (60-70%)

80
Q

The only criterion to distinguish adrenocortical carcinoma from an adrenocortical adenoma.

A

Metastases (adenomas tend to have atypia as well)

81
Q

Tumor of chromaffin cells; histologically composed of polygonal to spindle-shaped cells with finely granular cytoplasm, arranged in nests called zellballen; only criteria for malignancy is metastases; 10% extraadrenal; 10% bilateral; 10% biologically malignant; 10% are not associated with hypertension.

A

Pheochromocytoma

82
Q

MEN with 3Ps: Parathyroid (Primary hyperparathyroidism either secondary to hyperplasia or adenoma), Pancreas (either Gastrinoma or Insulinoma), and Pituitary (most common is Prolactinoma, followed by Somatotroph adenoma); Autosomal dominant; associated with mutations in MEN1 gene on 11q13.

A

MEN 1 (Wermer syndrome)

83
Q

MEN with MTC, Pheochromocytoma and primary hyperparathyroidism; Autosomal dominant; associated with gain of function mutations on RET proto-oncogene in 10q11.2

A

MEN 2A (Sipple syndrome)

84
Q

MEN with MTC, Pheochromocytoma, ganglioneuromas and Marfanoid habitus; associated with different mutations on RET proto-oncogene.

A

MEN 2B

Jaspie - Pathology (29 decks)

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