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Lecom pathology year 2 > chapter 24- endocrine pathology > Flashcards

chapter 24- endocrine pathology Flashcards

1
Q

what is the most common pituitary adenoma

A

prolactinoma

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2
Q

what is the proper treatment for prolactinoma

A

dopamine agonists or surgery

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3
Q

what hormonal effect does prolactinoma have on Males and females

A

males= decreased libido and headache; females= galactorrhea and amenorrhea

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4
Q

how do you diagnose (lab results) GH adenoma

A

increased GH and IFG-1; lack of GH suppression by oral glucose

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5
Q

what is the common tumor causing hypopituitarism in adults

A

pituitary adenoma

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6
Q

what is the common tumor causing hypopituitarism in kids

A

craniopharyngioma

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7
Q

how do people with sheehan syndrome present

A

poor lactation and loss of pubic hair

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8
Q

how do you diagnose central diabetes insipidus

A

H2O deprivation fails to increase urine osmolality

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9
Q

what is the treatment for central diabetes insipidus

A

desmopressin (ADH analogue)

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10
Q

what is the term for cystic dilation of thyroglossal duct remnant

A

thyroglossal duct cyst

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11
Q

if you see the term “scalloping of calloid” what disease should you think of

A

graves disease

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12
Q

describe TSH and T4 levels in graves disease

A

total and free T4 increased; decreased TSH

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13
Q

what is a major complication of graves disease

A

thyroid storm

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14
Q

what is multi nodular goiter due to

A

relative iodine deficiency

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15
Q

what is the term for hypothyroid in neonates and infants

A

cretinism

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16
Q

what are the clinical presentations of cretinism

A

mental retardation, short stature with skeletal abnormalities, coarse facial features, enlarged tongue

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17
Q

what HLA is hashimoto thyroiditis associated with

A

HLA-DR5

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18
Q

what antibodies are often present with hashimoto thyroiditis

A

antithyroglobin and antimicrosomal

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19
Q

what lymphoma are people with hashimoto more common to get

A

B-cell lymphoma

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20
Q

when you hear increased number of pink cells or herthel cells what disorder should you think

A

hashimoto thyroiditis

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21
Q

what typically precedes subacute/de quiervain granulomatous thyroiditis

A

viral infection

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22
Q

describe the thyroid gland in redial fibrosing thyroiditis

A

hard as wood, nontender

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23
Q

who does redial fibrosing thyroiditis classically occur in

A

young females

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24
Q

what conditions cause increased uptake of radioactive iodine

A

graves or nodular goiter

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25
Q

what conditions cause decrease uptake of radioactive iodine

A

adenoma and carcinoma

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26
Q

describe follicular adenoma

A

benign; usually non-functional; follicles surrounded by fibrous capsule

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27
Q

what is the major risk factor for papillary carcinoma

A

exposure to ionizing radiation in childhood

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28
Q

if you see orphan-anide nuclei and simmoma body what should you think

A

papillary carcinoma

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29
Q

what cells are malignantly proliferating in medullar carcinoma

A

parafollicular cells

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30
Q

what carcinoma presents similarly to rediel, except that rediel is in young and this carcinoma is in old

A

anapestic carcinoma

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31
Q

what is the most common cause of secondary hyperparathyroidism

A

chronic renal failure

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32
Q

what is likely occurring if there is numbness and tingling, especially around lips; tetany; decreased PTH and decreased serum calcium

A

hypoparathyroidism

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33
Q

what is the issue in pseudohypoparathyroidism

A

end organ resistance to PTH due to issue with Gs protein

34
Q

describe the presentation of someone with pseudohypoparathyroidism

A

autosomal dominant; associated with short stature and short 4th and 5th digits

35
Q

what is the likely genetic basis of pancreatic endocrine tumors (of islet cells)

A

component of MEN1

36
Q

how do you diagnose CUshings syndrome

A

increased 24 hour urine cortisol levels

37
Q

how do you distinguish between ACTH secreting pituitary adenoma and paraneoplastic ACTH secretion

A

high-dose dexamethasone

38
Q

what is the most common deficit in congenital adrenal hyperplasia

A

21 hydroxylase deficiency

39
Q

if you have a young child that previously had neisseria infection that is not presenting with adrenal insufficiency, what is the likely diagnosis

A

waterhouse-friderichsen syndrome

40
Q

what is the term for a tumor of chromatin cells in the adrenal medulla

A

pheochromocytoma

41
Q

how do you diagnose pheochromocytoma

A

increased serum metanephrines and increase 24 hour urine metanephrines and UMA

42
Q

What do the stem cells that somatotrophs, mammosomatotrophs, and lactotrophs derive from express

A

PIT-1

43
Q

What factors are expressed for gonadotroph differentiation

A

SF-1 and GATA-2

44
Q

What is the mechanism of alteration of GNAS

A

Activating mutation

45
Q

What gene is involved as an activating mutation in pituitary carcinomas

A

HRAS

46
Q

What gain of function gene is associated with GH adenomas

A

GNAS

47
Q

What type of adenomas are associated with MEN1

A

GH, prolactin, and ACTH adenomas

48
Q

What is the most common alteration in hyperpituitarism

A

G protein mutations

49
Q

What distinguishes pituitary adenomas from non-neoplasticism anterior pituitary parenchyma

A

Cellular monomorphism and absence of significant reticulum network

50
Q

What is the most common hyperfunctioning adenomas of the pituitary gland

A

Prolactinoma

51
Q

What adenoma is commonly associated with Psammoma bodies and/or pituitary stone

A

Prolactinoma

52
Q

Describe the morphology findings of somatotropin adenoma

A

Sparsely granulated subtypes are composed of chromophobe cells with considerable nuclear and cytologic pleomorphism and focal, weak staining for GH

53
Q

What syndrome can occur after removal of adrenal glands for treatment of Cushing syndrome

A

Nelson syndrome

54
Q

What are the clinical presentations with SIADH

A

Hyponatremia, cerebral edema, resultant neurologic dysfunction

55
Q

What is the diagnostic feature of adamantinomatous type of craniopharygiomas (occuring in kids

A

Wet keratin (lamellar keratin formation); dystrophic calcification (machine oil like)

56
Q

When you see the term hurthle cell what disease should you think of

A

Hash improvement

57
Q

What polymorphisms increase susceptibility to hashimoto

A

CTLA4 and PTPN22

58
Q

Describe the cut section of Graves’ disease

A

Parenchyma has soft, meaty apperance resembling muscle

59
Q

What are the 2 phases of diffuse nontoxic (simple) goiter

A

Hyperplastic and colloid involution

60
Q

What is the usual presentation of thyroid gland adenomas

A

Unilateral painless mass

61
Q

What is the hallmark finding with thyroid gland adenomas

A

Presence of intact, well formed capsule encircling tumor

62
Q

What are most cases of papillary thyroid gland carcinomas assoaciated with

A

Prior radiation, orphan Annie eyes nuclei, papillae, psammomma bodies

63
Q

What is the common phrase used to describe hyperparathyroidism

A

Painful bones, renal stones, abdominal groans, psychic moans

64
Q

What does symptomatic untreated hyperparathyroidism lead to (interrelated skeletal abnormalities)

A

Osteoporosis, brown tumors and osteitis fibrosa cystica

65
Q

What is the most common cause of secondary hyperparathyroidism

A

Renal failure

66
Q

What are the autoimmune causes of hypoparathyroidism

A

APS1 and mutations in AIRE

67
Q

How does hypoparatyroidism present in childhood

A

Candidiasis

68
Q

What are the classic findings on physical exam with hypoparathyroidism

A

Chvostek sign and trousseau sign

69
Q

What is the classic triad with DM

A

Polyuria, polydipisia, polyphagia

70
Q

Is ketoacidosis more common with DM1 or 2

A

DM1

71
Q

What do alpha cell tumors increase and then cause due to this

A

Increases glucagon; characteristic skin rash

72
Q

What does the pituitary show with Cushing syndrome in its hyaline

A

Crooks hyaline change

73
Q

What is the most common clinical consequence of hyperadrenalism

A

HTN

74
Q

What side are aldosterone producing adenomas more common on

A

Left

75
Q

What adrenal cortex issue is associated with spironlactone bodies

A

Aldosterone-producing adenomas

76
Q

Who should congenital adrenal hyperplasia always be suspected in

A

Neonate with ambiguous genitalia

77
Q

What disease should you think of when the nuclei are usually round to oval with salt and pepper chromatin

A

Pheochromocytoma

78
Q

What is sipple syndrome associated with (alteration)

A

MEN-2A

79
Q

What is associated with MEN-2B

A

Neuro as, marfanoid habitus

80
Q

What mutations are common in familial medullary thyroid cancer

A

RET mutations

Lecom pathology year 2 (18 decks)

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