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Year 5 Histopath > Endocrine > Flashcards

Endocrine Flashcards

1
Q

anterior pituitary

A

epithelial cells
blood from pituitary portal systems > hypothalamus to pituiatry

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2
Q

pituitary is ?
blood supply

A

nervous in origin
nerves supraoptic nucleus

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3
Q

hypothalamic factor

A

TRH -
dopamine
corticotrohphin
growth hormone
gonadotrophin

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4
Q

symptoms of pituitary disease
categorise?

A

hyperpituitarism - functional (benign adenoma)

hypopituitarism
deficiency of trophic hormones

local mass- expanding lesions

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5
Q

hyperpituitarism - functional (benign adenoma)

detected by?

A

immunohistochemistry

classified by basis of what hormones they contain

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6
Q

most common pituitary adenomas?

make how much of clinical attention?

A

prolactin cell

10%
4th-6th decade

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7
Q

prolactinomas clinical effects

A

amenorrhea
galactorrhea
loss of libido
infertility

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8
Q

growth hormones adenomas

A

prepuberty - gigantism

acromegaly
predisopose to DM
muscle weakness
htn
congestivce heart failure

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9
Q

corticotroph adenomas

A

cushing syndrome

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10
Q

HYPOpituitarism

caused by?

A

nonsecretory adenomas- compress and lessen function

ischaemic necrosis - sheehans syndrome (pituitary enlarges during pregnancy)

DIC, sickle cell, elevated ICP

ablation of pituitary due to surgergy or irradiation (tumout treatment)

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11
Q

hypopituitary signs

A

growth failure -
GnRH - deficient amenorrhea / infertility in women
> decreased libido

later on this can occur

TSH and ACTH
hypothyroidism
hypoadrenalism

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12
Q

posterior pituatry releases 2?

A

adh
oxytocin

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13
Q

ADH failure to secrete

A

Diabetes insipidus
siadh

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14
Q

local mass effect

A

compressed optic chiasm
bitemporal hemianopia

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15
Q

obstructive hydrocephalus

A

compression of brainstem

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16
Q

thyroid cells

A

follicle cells contain colloid
parafollucilar cells

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17
Q

thyroglobulin > T4/T3

A

TSH from anterior pituiatry actions

follicular epithelial cells use colloid in converting thyroglobulin > t4/t3

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18
Q

effect of t4/t3

A

increase basal metabolic rate

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19
Q

role of parafollicular cells?

A

synthesise calcitonin (promotes absorption of calcium by skeletal system)

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20
Q

t4
t3 distribution

A

90% inactive thyroxine T4
10% active triiodinthyronine T3

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21
Q

goitre

classification

A

enlarged thyroid

toxic

non-toxic

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22
Q

non-toxic goitre

A

little iodine
endemic in areas

derbyshire neck

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23
Q

non toxic goitre causes

A

hereditary enzymes

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24
Q

multinodular goitre

why do they develop dysphagia

A

compress structures because they get so big

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25
Q

thyrotoxicosis

A

hypermetabolic state

T4/T3

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26
Q

thyrotoxicosis classify

A

primary : Graves

secondary - TSH secreting pituitary adenoma

struma ovarii - ovarian teratoma w ectopic thyroid

exogenous thyroid intake

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27
Q

Graves

A

infiltration of tissues behind eye - exophthalmos

pretibial myxoedema

young females

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28
Q

graves pathogenesis

A

antibodies to TSH receptor and thryoglobulin

associated with other types of autoimmune diseases
sle
pernicious
addisons

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29
Q

hypothyroid causes

A

postablative
autoimmune - hashimoto’s thyroidtis
iodine deficiency

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30
Q

hashimotos thyroidtis histology

A

infiltrate of lymphoid cells

germinal centres within thyroid - autoimmune

epithelial cells become enlarged - hertle cells

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31
Q

neoplasms of thryoid
benign

A

benign
adenoma

32
Q

neoplasms of thryoid

A

carcinoma

33
Q

neoplastic clues

A

solitary nodules
solid > cystic

nodules in younger patients
nodules in males
cold nodules - no uptake of radioactive iodine

34
Q

assessing morphology

A

fine needle aspiration
core biopsy / remove histology

35
Q

adenoma

A

well formed capsule
fibrous
compression of surrounding parenchyma

36
Q

predispose to carcinoma of thryoid

A

multiple endocrine neoplasia

ionizing radiation - atomic bomb/ chernobyl

37
Q

papillary carcinoma
nuclear features

A

most common neoplasm of thyroid

optical clear nuclei
intranuclear inclusions
psammoma bodies- foci of calcification

38
Q

presentation of papillary tumour

A

metastasise to lymph nodes

may present w cervical lymph node
10 year survival 90%

39
Q

follicular carcinoma

A

follicular morphology
well demarcted with minimal invasion

usually metastasise via blood stream
> lungs
> bone
>liver

40
Q

medullary carcinoma
distinctive why?

A

arises from parafollicular cells which secrete calcitonin

41
Q

medullary origin

A

80% spontaneous
20% familial - MEN

42
Q

calcitonin is broken down into amyloid

which cancer ?

which dye detects this?

A

medullary

congo red > polarised light gives rise to green colour

43
Q

anaplastic

A

v aggressive
metastases early widely
most die within 1 year

44
Q

parathyroid glands
how many?

A

usually 4
10% only have 3/ 5

45
Q

activiyt of parathyorid

A

free calcium

46
Q

decreased calcium = increased PTh
which causes

A

activated osteoclast
increased renal absorption of calcium
increased Vit d> active
increased EXCRETION of urinary phosphate
increased intestinal calcium absorption

47
Q

solitary adenoma hyperparathyroidism

A

benign
80%

48
Q

normal parathyroid is about 50%

A

fat
but not adenoma

49
Q

osteitis fibrosa cystica

A

primary hyperparathyroidism causes
bone resorption w thinning of cortex and cyst formation
= may lead to fractures

= fracture

50
Q

primary hyperparathyroidism

renal effects

A

stones
obstructive uropathy

51
Q

primary hyperparathyroidism

GI

A

constipation
pancreatitis
gallstones

52
Q

primary hyperparathyroidism

CNS effects

A

alterations
depression
lethargy
and fits

53
Q

primary hyperparathyroidism

neuromuscular effects

A

weakness

54
Q

primary hyperparathyroidism

Uro effects

A

polyuria and polydipsia

55
Q

primary hyperparathyroidism

useful mnemonic for symptoms

A

painful bones
renal stones
abdominal groans
psychic moans

56
Q

secondary hyperPTH

A

chronic depression of serum calcium
causes persistent stimulation
> enlarged glands
widespread bone disease

renal failure is a big cause

57
Q

hypoPTH

A

surgical ablation
congenital absence
autoimmune

58
Q

signs of HypoPTH

A

neuromuscular irritibility : tingling tetany
cardiac arrhythmia
fits
cataracts

59
Q

adrenal gland

A

cortex surrounded by medulla

60
Q

zona glomerulosa -

A

aldosteone

61
Q

zona fasciculata

A

glucocorticoids

62
Q

zona reticularis

A

androgens
glucocorticoids

63
Q

medulla

A

noradrenaline

64
Q

cushing syndrome

A

most cases caused by exogenous steroids

65
Q

cushing disease

A

primary hypothalamic pituitary disease with increased ACTH - cushing disease

66
Q

cushing syndrome
secretion of ectopic ACTH by what tumour?

A

most commonly
small cell carcinoma of lung

non-endocrine

bilateral hyperplasia

67
Q

iatrogenic cushing syndrome

adrenals

A

atrophy

68
Q

hyperaldosteronism

A

primary - Conn’s syndrome
bilateral hyperplasia
htn and HYPOkalaemia

69
Q

waterhouse-friderichson syndrome

A

a group of symptoms caused when the adrenal glands fail to function normally. This occurs as a result of bleeding into the glands

70
Q

adrenal insufficiency
split by

A

acute: sudden withdrawal of steroids
haemorrhage (neonates)
sepsis w DIC

chronic
> autoimmune: addison’s
TB
HIV

haemchromatosis
sarcoid

71
Q

adrenal medulla

A

secretes catecholamines in response to signals from the sympathetic nervous system

> phaeochromocytoma
Neuroblastoma

72
Q

phaeo
rule of 10

A

secrete catecholamines

10% genetic syndrome
MEN, von Hippel
10% bilateral
10% malignant

73
Q

Multiple endocrine neoplasia

A

inherited
proliferative lesions
multiple endocrine organs

74
Q

tumours in MEN

A

occur at a younger age than sporadic tumours

arise in multiple endocrine organs

multifocal in one organ
preceded by hyperplasia
usually more aggresive than sporadic tumours

75
Q

parafolliculary c cells which carcinoma

A

medullary

76
Q
A

Year 5 Histopath (11 decks)

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