Endocrine Flashcards
Most common cause hyperpituitarism
adenoma ant lobe
GNAS1 most common mutation
Morphology pituitary adenoma
cellular monomorphism
absence reticulin network
Percentage loss for symptomatic hypopituitarism
75% parenchyma
main cause ectopic ADH secretion
small cell carcinoma lung
Most common cause hyperthyroid
85% graves - diffuse hyperplasia
multinodular goitre
thyroid adenoma
Hashimotos
10x more women
autoimmune destruction thyroid gland
assoc other autoimmine and marginal zone b cell lymphoma thyroid
granulomatous (de quervians) thyroiditis
painful
triggered by viral infection
multinucleate giant cells
transient hyperthyroid
no radioiodine uptake
Graves
most common cause hyperthyroid
90% have thyroid stimulating immunoglobuln
Anti tsh ab
diffuse non toxic goitre
enlarged follicles filled with colloid
main cause iodine deficiency
euthyroid
Signs of thyroid neoplasm
solitary nodule
young male
previous radiation head / neck
takes up radioiodine
capsular and vascular invasion
Most common thyroid cancer
papillary > follicular > medullary > anaplastic
hypercalcaemia in malignancy
more likely to be symptomatic
from rankl activating osteoclasts
PTHrP from squamous cell carcinoma
main cause hypercalcaemia
primary hyperthyroid - adenoma
Cause of death DM
MI then renal
T1DM immunological and genetic
destruction of beta cells by T lymphocytes
Class II MHC on chormosome 6
95% have HLA DR3 or DR4
viruses - cocksackie B, MMR, CMV, mono
MEN1 syndrome
Pancreas Pituitary Parathyroid
assoc insulinoma and zollinger ellison (ulcers inc jejenum)
Main causes hypercorisolism
main exogenous - steroids
non exogenous 70% pituitary microadenoma (cushings disease)
10 ectopic ACTH e.g. small cell carcinoma lung
10 adrenal adenoma
10 adrenal carcinoma
Dexamethasone suppression test
in cushings disease small dose makes no difference, large dose suppresses ACTH and thus urinary steroids decreased
Causes primary hyperaldosteonism
60% bilateral idiopathic
35% adenoma (conns)
or carcinoma
CAH
autosomal recessive
main cause 21 hydroxylase deficiency
ciculatory collapse and virulisation
waterhouse friedrichson syndrome
bilateral adrenal haemarrhage
caused by sepsis normally n meningitides
DIC and widespread purpura
circulatory collapse and death witout steroids
Main causes addisons
autoimmune adrenalitis with ABs against IL17, 21 and 17 hydroxylase
TB
Aids
Metastatic Ca
secondary adrenocortical insufficiency
pituitary
decreased sex hormones an cortisol but aldosterone maintained
no change in skin pigmentation
Syndromes assoc adrenocortical neoplasms
li fraumeni 9TP53), beckwit wiedermann
Phaeochromocytoma rule of 10s
10% extra adrenal
10% of sporadic bilateral
10% malignant
10% not assoc increased BP
Acidophil cells
progenitors for both GH-producing somatotrophs and prolactin-producinglactotrophs
Twin concordance T2DM
Up to 80%
