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CP53 - Endocrine Pathology Flashcards

1
Q

How does endocrine gland work?

A

secrete hormones directly into the blood stream and act systematically

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2
Q

How does paracrine system work?

A

secrete hormones which act locally

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3
Q

how does autocrine system work?

A

affect the cell which secrete the protein

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4
Q

what id the pituitary gland located?

A

situated in the sella turcica beneath the hypothalamus

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5
Q

what are the 2 parts of the pituitary glands?

A

anterior (75%) & posterior (25%)

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6
Q

what are some of the causes of adenohypophysis hypofunction?

A

most common tumours - non-secretory adenoma (more common), metastatic carcinoma, but also trauma, infraction, inflammation etc (anything which causes compression on the sella turcica

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7
Q

what is the name of the anterior part of the pituitary gland?

A

adenohypophysis

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8
Q

what is the name of the posterior part of the pituitary gland?

A

neurohypophysis

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9
Q

are primary pituitary tumors mostly benign or malignant?

A

most are adenomas and hence benign

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10
Q

where within the pituitary glands can primary cancer arise?

A

from any hormone producing cells within the pituitary gland

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11
Q

what are the clinical effect of the tumors if they are functional?

A

secondary to hormones being produced eg acromegaly

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12
Q

what is the local effect of pituitary tumors

A

pressure on optic chiasma/ adjacent pituitary cells

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13
Q

what are the different types of adenohypophysial adenoma?

A
  • prolactinoma - commonest, galactorrhea (milky nipple dischange unrelated to normal breast milk) & menstrual disturbance
  • growth hormone secreting - gigantism (unusually largeness) in children and acromegaly in adults
  • ACTH secreting - Cushing’s syndrome
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14
Q

thyroid anatomy?

A

bilobed organ joined by isthmus encased in thin fibrous capsule located at the level of 5th, 6th and 7th verterbra in the anterior neck in close proximity to the trachea

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15
Q

what is ectopia?

A

tissue present in a place where it does not belong

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16
Q

what is heterotopia

A

tissue present in a place where it does not belong due to displacement

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17
Q

what is the function of thyroid glands

A

produce iodinated amino acid thyroxine (T4) & iodothyronine (T3)

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18
Q

where is the most common ectopia of thyroid?

A

lingual thyroid - usually at the base of tongue

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19
Q

what is thyroglossal duct cyst

A

it is persistent track representing the embryological migratory path of thyroid anlage in the anterior neck

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20
Q

what is acute thyroiditis?

A

acute inflammatory of the thyroid parenchyma associated with local/systemic viral, bacterial or fungal infection, most cases due to generalised sepsis

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21
Q

what is palpation thyroiditis

A

microscopic granulomatous foci centered on thyroid follicles - secondary to rupture of thyroid follicles due to palation or suregery

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22
Q

what is reidel thyroiditis

A

rare fibrosing form of chronic thyroiditis, present with firm goitre

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23
Q

what is Hashimoto’s thyroiditis?

A

it is chronic lymphocytic thyroiditis - an autoimmune chronic inflammatory disorder associated with diffuse enlargement and thyroid autoantibodies.

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24
Q

what is the presentation of Hashimoto’s thyroiditis

A

diffusely enlarged non-tendered gland, serum thyroid antibodies elevated

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25
what is the charactersitic of Hashimoto's thyroiditis histologically?
infiltration of lymphocytes and plasma cells.
26
what happen to the functioning level of the thyroid of the patients with Hasimoto's thyroiditis
hypothyroidism
27
what conditions are patients with Hashimoto's thyroiditis more at risk of?
thyroid lymphoma, papillary carcinoma of thyroid
28
what is Graves' thyroiditis
it is diffuse hyperplasia - an autoimmune process results in clinical hypothyroidism and diffuse hyperplasia of the follicular epithelium.
29
what are some of the physical findings for Graves' thyroiditis
diffuse goitre, pretibial myxoedema, hair loss, wide-eyed stare/proptosis/exophthalmos (protruding of eyeball) , tachycardia, hyperactive reflexes
30
what are some of the clinical findings of Graves' thyroiditis?
T3 & T4 elevated, TSh markedly suppressed, present of thyroid autoantibodies, especially thyroid stimulating immunoglobulin.
31
what are the histopathological findings for Graves' thyroiditis?
thyroid gland show hyperplasia of the acinar epithelium, reduction of stored colloid and local accumulations of lymphocytes.
32
why does Hashimoto's thyroiditis cause hypothyroidism?
lymphocytic infiltration and thyroid cells undergoes atrophy
33
what precentage of patients with hypothyroidism have Graves' Disease?
80%
34
what is multinodular goitre?
enlargement of thyroid with varying degrees of nodule involved
35
what does the level of thyroid function of patients with multinodular goitre have ?
normal - euthyroid
36
what are some of the complication for multinodular goitre?
tracheal compression or dysphagia
37
what is follicular adenoma of thyroid
benign encapsulated tumor with evidence of follicular differentiation
38
what is the usual presentation for follicular adenoma of thyroid
painless neck mass - often present for years, solitary nodule involving only one lobe
39
what are the different subtype of carcinoma in the htyroid?
papillary, follicular, anaplastic, medullary
40
what is the commonest thyroid carcinoma?
papillary carcinoma
41
what are the macroscopic appearance of pappillary carcinoma ?
ill defined, infiltrative, some encapsulated, maybe cystic, granular
42
what are the subtype of follicular carcinoma?
follicular adenoma, minially invasice follicular carcinoma, widely invasive follicular carcinoma, hurthle ell neoplasms
43
what are some of the presentation of follicular carcinoma?
90% - present with solitary nodule in thyroid
44
what are the 2 types of follicular carcinoma?
minimally invasive & widely invasive ( they have different prognosis 7 different degree of metastasis )
45
what classify minially invasive & widely invasive follicular carcinoma
- Minimally invasive – Completely encapsulated. Invasion only detectable histologically - Widely invasive – Macroscopic evidence of invasion. Widespread invasion histologically.
46
what is the characteristic of Hurthle Cell Carcinoma
large acidophilic cells in canine thyroid
47
what are the clinical presentation of hurthle cell carcinoma?
high incidence of cervical lymph node metastases
48
what are the 3 differentiated thyroid carcinoma?
papillary, follicular & Hurthle cell carcinoma
49
what are poorly differentiated thyroid carcinoma?
insular carcinoma, anaplastic carcinoma, medullary carcinoma, lymphoma
50
what are characteristic of anaplastic carcinoma?
rapdily enlarging thyroid mass, long history of goitre,
51
what is the characteristic of medullary carcinoma?
malignant tumor showing differentiation to parafollicular C cells - 80% sporadic, 20% - autosomal dominant inherited (MEN2a&2b)
52
what is primary thyroid lymphoma
primary lymphoma arisisng within the thyroid glnad often associated with lymphocytic thyroiditis,
53
what is lymphoma ?
malignancy within the lymphocytes and can generally be sub-catogrise into 2 types eg Hodgkin & non-Hodgkin lymphoma
54
what is the characteristic of primary thyroid lymphoma
mass in thyroid, often associate with rapid enlargement, pain, dysphagia, may have assoicated cervical lymphadenopathy
55
can MEN 2A cause hyperthyroidism?
yes
56
what is primary chief cell hyperplasia
non-neoplastic increase in parathyroid tissue without a known stimulus - can cause hyperparathyroidism
57
what is parathyroid adenoma?
an encapsulated benign neoplasm of parathyroid cells, has symptoms of hypercalaemia, associated with MEN 1 & MEN 2, hyperparathyroidism
58
what is parathyroid carcinoma
malignant tumour derived from parathyroid parenchymal cells, symptoms referable to excess Ca2+
59
what is Addison's Disease
primary adrenal cortical insufficiency caused by adrenal dysgenesis, adrenal destruction
60
Which form of Addison's Disease is more common
autoimmune form most common & tuberculosis more common in developing world
61
what are the 3 most common characteristic of Addison's Disease?
Triad of hyperpigmentationm postural hypotension & hyponatraemia
62
what is the treatment of Addison's Disease?
long term steroid replacement therapy
63
what is adrenal cortical adenoma?
benign neoplastic proliferation of adrenal cortical tissue
64
what are the symptoms of adrenal cortical adenoma?
related to endocrine hyperfunction - hypertension, Cushing's snydrome and virilisation (secondary sexual characteristic development).
65
what can aldosterone-producing tumour cause?
Conn's Syndrome
66
what is adrenal cortical carcinoma?
malignant counterpart of adrenal adenoma
67
what are some of the common symptoms of adrenal cortical carcinoma?
related to hormone excess, abdominal mass,
68
what is phaeochromocytoma
catecholamine secreting tumour arising from adrenal medulla
69
what is catecholamine
norepinephrine & dopamine
70
what are some of the causes of phaeochromocytoma?
sporadic & familial syndromes MEN 2A & 2B
71
what are some clinical observation of phaeochromocytoma
elevated urine catecholamines, adrenaline, noradrenaline

Endocrine Pathology (5 decks)

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