Endocrine Flashcards
MCC of hyperpirtuitarism
functioning anterior pitiutary adenoma
1cm – can determine micro/macroadenoma
MC pituitary adenoma
Prolactin cell adenoma
2nd MC: Somatroph adenoma
Origin of Craniopharygioma
Vestigial remnants of Rathke pouch
Hypothalamic suprasellar tumor
mass effect and hypopituitarism
bimodal age: 5-15, 65
hypermetabolic state caused by increase thyroid hormone level in the blood
Thyrotoxicosis
hyperthyroidism - thyrotoxicosis 2nd to thyroid gland hyperfunction
MCC of primary hyperthyroidism
Graves disease
Type II HS
Posterior Pituitary Syndrome can be cause by this neoplasm
Small cell lung Ca
MCC of congenital hypothyroidism
Iodine deficiency
MCC of congenital hypothyroidism in Iodine sufficient areas
Autoimmune (Hashimoto)
extensive fibrosis of the thyroid and contiguous neck structures
Riedel Thyroiditis
Painless thyroid enlargement
Autoantibodies against thyroglobulin and thyroid peroxidase
Hurtle cell changes
Lymphoplasmacytic infiltrates with germinal centers
+ fibrosis
Hashimoto thyroiditides
Painless thyroid enlargement
Autoantibodies against thyroid peroxidase
family hx of autoimmunity
- fibrosis and hurtle changes
Subacute Lymphocytic
PainFUL thyroid enlargement
Antigen mediated immune damage to follicular cells
history of URTI prior to thyroiditis
Granulomatous thyroiditis
Most thyroid carcinoma arise from thyroid follicular epithelium, except
Medullary – Parafollicular C cells
assoc. with MEN2A, MEN2B
present with PAraneoplastic syndrome (VIP, ACTH) and high level of Calcitonin
MC thyroid Ca
Papillary > Follicular
Favorable prognosis
+ Orphan annie nuclei
+ Psammoma Bodies
Thyroid ca:
Pleomorphic giant cells
Spindle-shaped cells
IHC: Cytokeratin, PAX8
Anaplastic Thyroid Ca
Most helpful thyroid differentiation marker in anaplastic Ca
PAX8
Thyroid Ca with Amyloid deposits
Medullary thyroid Ca
familial origin: C-cell hyperplasia
sheet of polygonal to spindle shaped cells in nests, trabeculae or follicules
IHC: Calcitonin
most important susceptibility genes in T1DM
Ch 6
TRIAD of DMT2
Genetic
Environmental - most important factor: Central/visceral obesity
Proinflammatory
MCC of death in DM
Coronary heart disease
HM: accelerated atherosclerosis
Insulin deficiency sufficient to develop KETOACIDOSIS
DKA
<7.25pH
+ ketones
visceral sx
Insulin deficiency INSUFFICIENT to develop ketoacidosis
HHS
>7.30 pH
neurologic symptoms
MC Pancreatic NET
Insulinomas
Hyperinsulinism
Whipple TRIAD
Amyloid deposition
loc: pancreas
benign
Whipple TRIAD
Hypogylcemia <50mg/dl
Neuroglycopenic symptoms
Relief upon parenteral glucose administration
pancreatic islet cell tumor
hypersecretion of gastric acid
severe PUD
Zollinger-Ellison syndrome
Seen in Gastrinoma – malignant, located at Gastrinoma Triangle
Presentation of VIPoma
WDHA
watery diarrhea
Hypokalemia
Achlorhydia
MCC overall of Cushing syndrome
Exogenous steroids/ Iatrogenic
MC endogenous cause of Cushing
ACTH secreting pituitary adenoma (Cushing Disease)
MCC of Primary hyperaldosteronism(Conn syndrome)
Bilateral idiopathic hyperaldosteronism
neoplasm: Adenoma > Adrenocortical Carcinoma
Secondary Hyperaldos - decreased renal perfusion
TRIAD of Pheochromcytoma
Diaphoresis
Headaches
Palpitations
RULE OF 10s
Cytogenic origin of Pheochromocytoma
Chromaffin cells of medulla
releases catecholamines
Zellballen
Clusters of polygonal or spindle-shaped chromaffin or chief cells surrounded by sustentacular cells
Zell ballen
Rule of 10s
Extra -adrenal
bilateral
biological malignant
not associated with hypertension
25% germline genetic mutations
Syndrome of MEN1
Wermer syndrome:
Pituitary
Parathyroid
Pancreas
Syndrome of MEN2A
mutation
Sipple sydrome
mutation: RET
Phechromocytoma, Medullary TCa,
2A: PArathyroid Neoplasm
2B: neuromas, ganglioneuromas, Marfanoid habitus
Syndrome of MEN2B
Wagemen-Froboese syndrome, Mucosal neuroma syndrome
