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Endo - Meg Deck > Endo Neoplasms II > Flashcards

Endo Neoplasms II Flashcards

1
Q

pituitary adenomas are categorised by

A

**size **(micro <10mm macro >10mm)
functional (secrete hormone) / non-functional (non-secreting)
Cell origin affected - somatotrph, thyrotroph, lactotroph, gonadotroph, corticotroph

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2
Q

pituitary adenomas are benign or malignant?

A

benign

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3
Q

mutation of lactinotroph adenoma

A

derived - PIT-1 lineage
sporadic - MEN-1

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4
Q

hypogonadism
lack of libido
amennorhoea
galactorrhoea
gyecomastica

A

lactotrophic adenoma (prolacin)

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5
Q

treatment of lactotrophic adenoma

A

bromocriptine
cabergoline

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6
Q

mutation of somatotroph adenoma

A

GNAS 1

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7
Q

Growth hormone has a negative feedback on

A

glucose
IGF-1

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8
Q

what is growth hormone effect on sodium

A

antinaturetic
sodium retention

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9
Q

hyperglycaemia, hypertension
headache, visual defects
organomegaly, myopathy

A

somatotroph adenoma

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10
Q

somatotroph adenoma increases the risk of

A

GIT cancers
Heart failure

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11
Q

mutation of corticotroph adenoma

A

transcription factor TPIT

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12
Q

30-40yo female
high cortisol
cushing disease
microadenoma <10mm

A

corticotroph adenoma

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13
Q

headache, visual disturbances
high ACTH, low cortisol
increased MSH - pigmentation

A

nelson syndrome

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14
Q

craniopharyngiomas develop from

A

Rathke’s pouch
ectoderm buds

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15
Q

supratentorial
children
cystic
dystrophic calcification
mass effects

A

craniopharyngioma

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16
Q

gene mutation of craniopharyngioma

A

CTNNB1
B catenin gene mutation

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17
Q

cystic tumour with haemorrhage
dystrophic calcification
motor oil - cholesterol rich

A

craniopharyngioma

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18
Q

islands of epithelium
peripheral nuclar palasaiding
loose areas stellate reticulum

A

adamantinomatous craniopharyngioma

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19
Q

fibrovascular core
peripheral palasaiding squamous cells
spongy reticulum

A

papillary craniopharyngioma

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20
Q

thyroid nodules - malignant features on RIU

A

solitary
younger pt
male
cold nodule

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21
Q

female
non-functional
hot nodule
can be a toxic adenoma

A

follicular thyroid adenoma

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22
Q

solitary spherical
encapsulated
uniform follicles
contain colloid

A

follicular thyroid adenoma (benign)

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23
Q

mutations of thyroid carcinomas:
papillary, follcular, medullary, anaplastic

A

Papillary = RET/PTC + radiation, BRAF
Follicular = RAS, PAX8-PPAR-y rearrangement, PIK3CA & PTEN
Medullary = MEN2, RET
Anaplastic = P53

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24
Q

20-30yo female
radiation / hashimotos
RET translocation
lymphatic invasion
orphan annie eye nuclei

A

papillary thyroid carcinoma

25
Q

40-50yo female
iodine deficiency
N-RAS mutation
painless, cold nodules
capsular / vascular invasion

A

follicular thyroid carcinoma

26
Q

medullary carcinomas derived from which cells

A

parafollicular C cells

27
Q

MEN2
mass in neck
secretes calcitonin
c cells
amyloid accumulation
congo red stain

A

medullary thyroid carcinoma

28
Q

65yo
inactivation P53
rapidly enlarging neck mass
inavdes neighbouring tissues
often fatal

A

anaplastic thyroid carcinoma

29
Q

diarrhoea
flushing
itching
are a result of which thyroid tumour & secretion of what…

A

medullary carcinoma
calcitonin secretion
MEN2A MEN2B

30
Q

physical findings of thyroid tumours

A

fixed nodules
hoarseness
cervical lymphadenopathy

31
Q

tests for thyroid cancer diagnosis

A

radioactive iodine uptake
fine needle aspiration
core tissue biopsy

32
Q

solitary nodule
women 50-70yo
overexpression cyclin D1 gene
MEN syndrome

A

parathyroid adenoma

33
Q

4 glands enlarged
HRPT2 parafibromin gene
retinoblastoma locus
vascular invasion
bands dense fibrous tissue

A

parathyroid hyperplasia

34
Q

4 glands enlarged
nodular / diffuse
clear cell hyperplasia
MEN syndrome

A

parathyroid carcinoma

35
Q

unilateral, tumour of chromafin cells
produce catecholamines
headache, sweating, tachycardia

A

pheochromocytoma of adrenal medulla

36
Q

increased metanephrine
increased VMA
lack suppression of NOR with clonidine
hyperglycaemia
neutrophilic leucocytosis

A

pheochromocytoma of adrenal medulla

37
Q

LOF mutation in succinate dehydrogenase subunit
micro: zellballen, nuclear salt & pepper

A

pheochromocytoma of adrenal medulla

38
Q

adrenal medulla & organ or Zuckerkandl contain N-Methyltransferse, so produce

A

norepinephrine AND epinephrine
(N-M enzyme converts nor –> epi)

39
Q

Bladder wall, posterior mediasinum don’t produce N-Methyltransferase, so produce

A

norepinephrine NOT epinephrine
(N-M enzyme converts nor –> epi)

40
Q

what mutations have predisposition to pheochromoctyoma

A

von Hippel-Lindau syndrome
MEN -1
NF-1

41
Q

what are the metabolic products of EPI and NOR

A

metanephrine
vanillylmandelic acid (VMA)

42
Q

list some hyperadrenergic (adrenal) symptoms

A

pain - headache
pressure - raised BP
perspiration
palpitation
pallor

43
Q

name the 4 cell types in islet of langerhans

A

Alpha cell = glucagon
Beta cell = insulin
Delta cell = somatostatn
PP cell = pancreatic polypeptide

44
Q

what is the pathway of insulin metabolism

A

Beta cells –> preproinsulin –> proinsulin –> insulin –> c-peptide

45
Q

what pancreatic tumour is non-malignant

A

insulinoma

46
Q

that 3 major genes contribute to pancreatic tumours

A

MEN-1
PTEN
ATRX, DAXX

47
Q

3 clinical syndromes associated with functional pancreatic endocrine neoplasms

A

hyperinsulinism
hypergastrinaemia - Zollinger-Ellison syndrome
MEN syndrome

48
Q

benign
hyperinsulinaemia precipitated by exercise/fasting
decreased insulin
increased c peptide

A

insulinoma

49
Q

low fasting blood glucose
hypoglycaemia
neurological symptoms
relief of symptoms with glucose admin

A

insulinoma
Whipples triad

50
Q

giant islets
preserved cords of monotonous cells
abundant amyloid deposition

A

insulinoma

51
Q

malignant
post-menopausal
high plasma glucose
nerolytic migratory erythema

A

glucagonoma

52
Q

cutaneous paraneoplastic syndrome
painful f=pruritic crusty erythematous papules
brone coloured induration
palues & necrosis

A

necrolytic migratory erythema
feature of glucagonoma

53
Q

malignant
secretes gastrin
MEN1
abdominal pain, diarrhoea

A

gastrinoma

54
Q

zollinger ellison syndrome is associated with what tumour

A

gastrinoma

55
Q

abdominal pain
heartburn
Diarrhea
Nausea and vomiting
weight loss
tarry stool

A

Zollinger Ellison Syndrome - assoc. with gastrinoma

56
Q

secretion injection test - what is seen in ZES

A

dramatic rise in gastrin levels (G cells normally inhibited)

57
Q

watery diarrhoea, hypokalaemia, anchlorydria
tea coloured odourless urine

A

VIPoma
vasoactive intestinal peptide

58
Q

diabetes mellitus
cholelithiasis
steatorrhoea
hypochlorhydria

A

somatostatinoma

Endo - Meg Deck (11 decks)

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