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Clinical Pathology > CP9-1 diseases of the endocrine system > Flashcards

CP9-1 diseases of the endocrine system Flashcards

1
Q

What is meant by the term neurocrine?

A

Secretion of hormones into the bloodstream by neurones

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2
Q

What is meant by the term endocrine?

A

secretion of hormones into the bloodstream by endocrine glands

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3
Q

What is meant by the term paracrine?

A

Hormones molecules that are secreted by one cell affects an adjacent cell

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4
Q

What is meant by the term autocrine?

A

Hormone molecules secreted by a cell affect the secreting cell i.e. affect itself

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5
Q

What are some main glands in the body?

A

Pineal gland
Pituitary gland
Parathyroid gland
Thyroid gland
Adrenal gland
Pancreas
Ovary/testis

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6
Q

What are the most common tumours affecting the pineal gland?

A

Germline tumours -seminomas or teritomas

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7
Q

What is the role of the pituitary gland?

A

Control other endocrine glands

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8
Q

In which bone is the pituitary gland sat?

A

Sphenoid bone

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9
Q

What are the two lobes of the pituitary gland?

A

Neurohypophysis
Adenohypophysis

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10
Q

What hormones are secreted by posterior pituitary gland?

A

Oxytocin
ADH

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11
Q

What hormones are secreted by the anterior pituitary gland?

A

TSH
ACTH
FSH and LH
GH
Prolactin
Endorphin

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12
Q

What is the most common pituitary gland tumour?

A

Adenine (benign)

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13
Q

What determines how a pituitary tumour presents?

A

Depends on which hormone producing cell the tumour has developed from and clinical effects reflect the effects of excess hormone production

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14
Q

What are some local effects of pituitary tumours?

A

Bitemporal hemianopia or hypofunction of other pituitary gland cells

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15
Q

What is the most common adenoma of the pituitary gland?

A

Prolactinoma

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16
Q

When is a prolactinoma classes as a microprolactinoma?

A

<10 mm diabeter

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17
Q

When is a prolactinoma classed as a macroprolactinoma?

A

> 10 mm diameter

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18
Q

What symptom is common with a prolactinoma?

A

Bitemporal hemianopia

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19
Q

What are symptoms of prolactinoma?

A

Symptoms associated with increased prolactin production including:
Galactorrhea
Gynecomastia
Amenorrhea
Infertility

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20
Q

How is the pituitary gland related to acromegaly and gigantism?

A
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21
Q

What is the epidemiology of thyroid problems?

A

12%

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22
Q

at hormones are secreted by the thyroid gland?

A

Calcitonin
TRH
TSH
T3+T4

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23
Q

What thyroid hormone is involved in the negative feedback loop?

A

T4

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24
Q

What element (halogen) is important in thyroid function?

A

Iodine

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25
What is hypothyroidism?
Insufficiency of circulating T3 and T4 hormones
26
What can cause hypothyroidism?
Congenitally = cretinism Hashimoto’s thyroiditis (autoimmune disease) Iodine deficiency Drugs Post-radioiodine therapy Occurs secondary to pituitary gland pathology Tertiary to hypothalamus pathology affecting pituitary gland and subsequently thyroid gland
27
What is the epidemiology of hypothyroidism?
2% Women > men
28
How do patients with hypothyroidism present?
Painless, diffuse enlargement of gland Elevated serum thyroid antibodies (especially in hashimoto’s)
29
What does hashimoto’s increases the risk of?
Thyroid lymphoma or papillary carcinoma
30
What are signs of hashimoto’s?
Hypothermia Bradycardia Periorbital oedema Hair loss Diastolic hypertension Enlargement of tongue Low basal metabolic rate Pleural and pericardial effusion
31
What are symptoms of hashimoto’s?
32
What is hyperthyroidism?
Increased basal metabolic rate due to excess production of T3 and T4 hormones (very rarely due to excess TSH)
33
What is the most common cause of hyperthyroidism?
Grave’s disease (autoimmune condition)
34
What can cause hyperthyroidism?
Grave’s disease Diffuse goitre Functional adenoma Toxic modular goitre
35
What is Grave’s disease?
An autoimmune disease where IgG auto-antibody binds to the thyroid epithelial cells causing a similar reaction to TSH and causes thyroid gland to enlarge
36
What percentage of hyperthyroidism is caused by grave’s disease?
80%
37
What is the epidemiology of grave’s disease?
1% worldwide Women > men
38
What are signs and symptoms of Graves’ disease?
pretibial myoxoedema weight loss tachycardia heat intolerance + sweating hair loss wide eyed stare aka proptosis hyperactive reflexes
39
What is multinodular goitre (MNG)?
Enlargement of thyroid with varying degree nodularity that doesn’t cause hyper or hypothyroidism
40
What can MNG be mistaken for?
Dominant nodule can be mistaken for thyroid carcinoma
41
What are some complications of MNG?
Tracheal compression causes dysphagia
42
When may multinodular goiter (MNG) present as hyperthyroidism?
If toxic MNG aka Plummer’s disease
43
What is the epidemiology of MNG?
44
What is a thyroid follicular adenoma?
A tumour with a defined fibrous tissue capsule developed from a solitary thyroid node.
45
How does a thyroid follicular adenomas appear on radio-isotope scanning?
46
What is thyroid follicular carcinoma?
A well differentiated malignant tumour in the thyroid, within a solitary module in 90% of cases, which invades the capsule and blood vessels
47
What % of thyroid cancers are thyroid follicular carcinomas?
10-20%
48
What % of patients with a thyroid follicular carcinoma have distant metastases?
49
What is a papillary thyroid carcinoma?
A well differentiated carcinoma that invades lymphatics and spreads to local lymph nodes
50
What is the most common thyroid malignant tumour?
Papillary thyroid carcinoma
51
What % of thyroid carcinomas are papillary thyroid carcinomas?
60-70%
52
Who is usually affected by papillary thyroid carcinomas?
<45 year olds Women > men
53
What is seen in histology in papillary thyroid carcinomas?
Annie eye nuclei Round Calcification
54
How many parathyroid glands does each person have?
4 in 90% 10% 3 or 5
55
What is a role of the parathyroid gland?
Vitamin D, calcium and phosphate regulation
56
What are causes or hyperparathyroidism?
Primary: Parathyroid adenoma, hyperplasia or carcinoma Familial hypocalciuric hypercalemia Secondary to hyperthyroidsm: Due to renal failure Decreased calcium Tertiary: Autonomous hypersecretion of parathyroid hormone
57
What is the epidemiology of primary hyperparathyroidism?
0.1% of population Post menopausal women q
58
What are symptoms of primary hyperparathyroidism?
Renal stones Muscle weakness Fatigue Thirst and poluria Anorexia Constipation
59
What are causes of hypercalcaemia?
Bone metastasise Vit D intoxication Sarcoidosis Multiple myeloma PTH producing tumours (rare)
60
What are the 3 parts of the adrenal cortex?
Zona glomerulosa Zona fasciculata zona reticularis (Outer —> inner )
61
What cells are in the adrenal medulla?
Chromaffin cells
62
What are the functions of the adrenal glands?
Salt regulation and BP Blood sugar levels Production of sex hormones Production of stress hormones
63
What is released by each layer of the adrenal cortex?
64
What is secreted by chromaffin cells in adrenal medulla?
65
What is Cushing’s syndrome?
A rare endocrine disorder due to excessive cortisol production
66
What is the epidemiology of Cushing’s syndrome?
Men = women 25-40 year olds
67
What are signs and symptoms of Cushing syndrome?
Central obesity with thinner arms and legs Purple striae Weight gain High blood sugars High BP Fatigue Sleep disorders Emotional instability
68
What is Conn’s syndrome?
Hyperaldosteronism causing renal retention of water and Na+ via the RAA system
69
What causes Conn’s disease ?
Usually secondary to adrenal cortical hyperplasia, adenoma, carcinoma and familial hyperaldosteronism
70
What is the epidemiology of Conn’s disease?
Women > men 30-50 year olds
71
What are signs and symptoms of Conn’s disease?
mood disturbances, headaches and fatigue polyuria and nocturia muscle weakness, spasms and paresthesia hypertension cardiac arrythmias
72
What is Waterhouse-Friderichsen syndrome?
Blood vessels in adrenal glands rupture due to severe bacterial infection. This causes acute adrenal insufficiency stopping the adrenal glands from producing hormones leading to adrenal crisis
73
What is Addison’s disease?
Primary adrenocortical insufficiency secondary to failure of ACTH secretion - usually autoimmune cause.
74
What is the epidemiology of Addison’s disease?
75
What causes Addison’s disease?
autoimmunity
76
What are signs and symptoms of Addison’s disease?
77
What is pheochromocytoma?
Tumours of the adrenal medulla or autonomous nervous system which produce catecholamines like adrenaline and noradrenaline
78
What are symptoms and signs of pheochromocytoma?
Racing heart beat e.g. palpitations Headache Pallor Sweating High BP
79
What statistics surrounding pheochromocytoma are 10%?
10% are extraadrenal 10% affect children 10% are bilateral 10% are familial 10% are malignant 10% are incidental 10% are recurrent
80
Most pituitary tumours are… malignant/bengin?
Benign

Clinical Pathology (65 decks)

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