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Year 2 - Clinical Pathology > Diseases of endocrine > Flashcards

Diseases of endocrine Flashcards

1
Q

define these terms
autocrine
endocrine
paracrine

A

cell secretes messenger which targets the same cells

glandular - secrete products into blood and act systemically

hormones or messenger which act locally

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2
Q

where do you find the pituitary gland

A

sella turcica just below hypothalamus

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3
Q

what are the differences in the two lobes of the pituitary gland

A

anterior - 75% - rathkes pouch
responsable for adenohyphosis hormones such as GH, prolactin, FSH, LH, TSH, adrenocorticotropic (ACTH)

posterior - 25%, responsable for neurohypophosis, oxytocin and vasopressin (ADH)

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4
Q

what are some causes of anterior primary hypofucntion

A

tumours (benign adenomas), trauma, infarction, inflammation

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5
Q

what can causes visual defects from compression on optic chiasma

A

tumour of the anterior pituitary

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6
Q

what are three examples of anterior pituitary adenoma (hyperfucntion)

A

prolactinoma - most common, galactorrhea, menstrual

GH secreting - gigantism in children, acromegaly in adults

ACTH secreting - cushings

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7
Q

describe the structure and eco;ation of the thyroid gland

A

butterfly, bilobed in neck joined by an isthmus

located at C5,6,7 in front of trachea

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8
Q

where does the thyroid gland come from

A

migrates from the foregut to the anterior neck

ultimobranchial body from branchial arches and fuses with the main part laterally

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9
Q

what is a thyroglassoal duct cyst

A

if thyroglossal tract remains in thyroid gland after it reaches its terminal location

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10
Q

what is hashimotos thyroiditis, who does it affect more commonly and what are some tell signs

A

chronic, lymphocytic thyroiditis - autoimmune chronic inflammatory = hypothyroidism
more common in females which peak at 59 y/o
serum thyroid antibodies raised

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11
Q

what is graves disease, who does it affect more commonly and what are some tell signs

A

diffuse hyperplasia - autoimmune - hyperthyroidism
most common fore hyperthyroidism cases
females more than men in 30’s/40’s
increased T3 and T4 with deceased TSH
increased thyroid antibodies
orange peel skin, hair loss, wide eyed stare, tachycardia

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12
Q

describe the physical manifestations of mulitnodular goitre of the thyroid

A

enlargement with nodularity
can be normal functioning
may develop tracheal compression or dysphasia

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13
Q

describe a follicular adenoma of the the thyroid gland

A

benign encapsulated tumour affecting follicular epithelium
more common in females in 50/60’s
painless neck mass
seen as cold nodule on radioactive iodine imaging

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14
Q

what is papillary carcinoma, casques and presentation

A

malignant
most common differentiated thyroid carcinoma, familial inheritance, more common in females

associated with cowdens syndrome or FAP
caused by exposure to radiation therapy, cystic mass or nodule
macroscopic fingerlike projections and calcification

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15
Q

what is a follicular neoplasm of the thyroid

A

adenoma - benign
carcinoma - malignant
2nd most common cancer of thyroid
RAS mutation

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16
Q

what is hurtle cell carcinoma

A

poorer prognosis - type of follicular neoplasm of the thyroid
has a greater incidence of cervical lymph node metastasis

17
Q

what is the structure and location of parathyroid glands

A

superio/inferior lateral to thyroid - 4 parathyroid glands

18
Q

what is primary hyperparathyroidism and what are some clinal manifestations

A

excessive secretion of parathyroid hormone from one or more glands - pathology lies within gland

arterial HT, hypercalcaemia, decreased renal function, psychiatric problems

19
Q

what is secondary / tertiary hyperparathyroidism

which types of patients does it commonly affect

A

2nd - hyperplasia of glands with elevated PTH in response to hypocalcaemia

3rd - long standing secondary hyperparathyroidism

patients with renal failure

20
Q

what is parathyroid adenoma and what are the associated risks

A

primary hyperparathyroidism, benign neoplasm - secrete PTH
hypercalcaemia
MEN1 and MEN2 syndrome associations
usually a single enlarged parathyroid gland

21
Q

describe the physiology of parathyroid carcinoma

A

rare primary hyperparathyroid
PTH and Ca high than normal adenoma
symptoms of excess Ca

22
Q

what is the structure and location of the adrenal glands

A

superior to kidneys
with adrenal cortex and medulla

cortex - (outer) zona glomerulosa, zona fasiculata (thickest), zona reticularis, medulla

23
Q

what hormones are made in the different layers of the adrenal cortex and medulla

A

glomerulosa - aldosterone
fasiculata - cortisone
reticularis - androgens
medulla - catecholamines

24
Q

what is virilisation

A

increased secretion of androgens from the zona reticularis = women develop male like features

25
Q

what is cushings syndrome, causes and symptoms

A

prolonged exposure to cortisol ie from zona fasiculata or adrenal cortex

exogenous - excessive glucocorticoid medication

endogenous, adrenal cortical tumours/hyperplasia, ACTH secreting tumour of pituitary

hypertension, central obesity, muscle wakens, fatigue, headaches

26
Q

what is conns syndrome, cases and manifestations

A

hyperaldosternism - from zona glomerulosa
low renin levels
hypertension, weakness, spasms, high urine, cardiac arrhythmia

27
Q

what is Addisons diseases causes, manifestations and treatment

A

primary adrenal cortex insufficiency, autoimmune or adrenal destruction
secondary from lack of ACTH
autoimmune most common
hyperpigmentation, postural hypotension and hyponatreamia (triad)

treat with long term steroids

28
Q

what is an adrenal cortical nodule and treatment

A

benign may be functional or not
commonly seen in elderly and diabetics
no treatment if no symptoms

29
Q

what is adrenal cortical adenoma with associated symptoms

A

benign proliferation of adrenal cortical tissue
depending on where in the cortex is the tumour is it can cause conns (aldosterone - glomerlusoa), cushing (cortisol - fasciulata), virulisation (andorgens - reticularis)

30
Q

what is phaechromocytoma, symptoms and prognosis

A

catecholamine secreting tumour arising from adrenal medulla
rule of 10&, bilateral, extradrenal, malignant, familial, children
hypertension, headaches, anxiety, elevated urine catecholamines, adrenaline and NA
aggressive necrosis

Year 2 - Clinical Pathology (67 decks)

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