Diseases of the endocrine system Flashcards
1
Q
Primary pituitary tumours
A
- most are adenomas, benign
- if the tumour is functional, the clinical effect is secondary to the hormone being produced
- Local effect is due to pressure on optic chiasma
2
Q
Types of anterior Pituitary adenoma
A
1) Prolactinoma – commonest - galactorrhoea, menstrual disturbance
2) Growth hormone secreting – gigantism in children, acromegaly in adults
3) ACTH secreting – Cushing’s syndrome
3
Q
Thyroid gland
A
- Located at the 5,6,7 level of cervical vertebrae
- recurrent laryngeal nerve directly behind
- In front of trachea
4
Q
Hashimoto’s thyroiditis
A
- Autoimmune chronic inflammatory disorder = diffuse enlargement and thyroid autoantibodies and many patients become hypothyroid
- F>M, peak age = 59
- Lymphoid follicles form
- Increased risk of papillary carcinoma of thyroid
5
Q
Grave’s disease
A
- Diffuse hyperplasia
- Autoimmune process resulting in clinical hyperthyroidism and diffuse enlargement and hyperplasia of the follicular epithelium
- Peak in late 30, F>M
- Thyroid autoantibodies elevated
- Orange peel skin, hair loss, tachycardia
6
Q
Multinodular goitre
A
- Enlargement of thyroid with varying degrees of nodularity; with multiple hyperplastic nodules involving the gland.
- Most patients are euthryoid
- Tracheal compression/ dysphagia may develop
7
Q
Follicular adenoma
A
- Benign encapsulated tumour affecting follicular epithelium with evidence of follicular cell differentiation
- F>M, late 50’s peak
- Painless neck mass
- Usually cold nodule on radioactive iodine imaging
8
Q
Malignant tumours of Thyroid %
A
5-9% are medullary carcinoma
1-2% are anaplastic carcinoma
1-3% are malignant lymphoma
85% of thyroid malignant tumours are well differentiated thyroid carcinoma.
9
Q
Papillary carcinoma
A
- > 70% of thyroid cancers
- mean age 43, 2.5 x F>M
- Appears as an irregular solid or cystic mass or nodule in a normal thyroid parenchyma
10
Q
Papillary carcinoma aetiology
A
- Familial inheritance - autosomal dominant non-medullary thyroid carcinoma
- Associated with Cowden/s syndrome and FAP
- Can be result of exposure to radiation
- RET or NTRK1 genes are activated or RAS mutation
11
Q
Papillary carcinoma macroscopic appearance
A
- ill defined, infiltrative, some encapsulated, may be cystic, granular. Finger like projections, nuclei crowded, clear.
12
Q
Follicular neoplasms
A
- Follicular adenoma
- RAS mutation
- Hurthle cell carcinoma = potential lymph node carcinoma
13
Q
Primary hyperparathyroidism
A
- excessive secretion of parathyroid hormone from one or more glands, pathology lies within gland.
- Signs = arterial HT, hypercalcaemia, decreased renal function
14
Q
Primary hyperparathyroidism aetiology
A
- Single adenoma (90%)
- aging
- ionizing radiation
- Men 2a syndrome
15
Q
Secondary hyperparathyroidism
A
- hyperplasia of glands with elevated PTH in response to hypocalcaemia
- increase in parathyroid parenchymal cell mass
- Common in patients with renal failure and on dialysis
