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Patho 3 Shea > Endocrine 4 > Flashcards

Endocrine 4 Flashcards

1
Q

Are benign or malignant thyroid neoplasms more common?

A

benign tumors are more common

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2
Q

Only 3-4 cases of ___________ are diagnosed yearly per 100,000 people, and less than 1000 people die each year in U.S

A

Thyroid cancer

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3
Q

What condition?

Presents as a nodule, which may vary in size, most being small, well encapsulated with fibrous tissue, and composed of thyroid follicles

A

follicular adenomas (a type of thyroid adenoma)

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4
Q

how is the final diagnosis of a thyroid adenoma made?

A

only by microscopic examination of biopsy material

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5
Q

Are thyroid adenomas premalignant? Do they require tx?

A

No

so small nodules dont require any tx

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6
Q

Thyroid carcinomas occur in several histologic forms, including what 4 types?

A

In order of most common:

  1. Papillary (by far MC)
  2. Follicular
  3. Medullary
  4. Anaplastic

“Pappi Forgot Meds Again”

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7
Q

All thyroid carcinomas originate from ______ cells, except for which one?

A

Follicular cells

Except Medullary Carcinoma

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8
Q

T/F: no definite risk factors for developing thyroid cancers are known

A

true

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9
Q

Are thyroid cancers more common in males or females?

A

Females

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10
Q

Which cancer accounts for 80% of all thyroid cancers?

A

Papillary Carcinoma

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11
Q

Which thyroid cancer?

It is a low-grade malignant lesion that is hormonally inactive

A

Papillary Carcinoma

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12
Q

When do papillary carcinomas occur and when is the peak incidence?

A

Occurs early in life

peak incidence: 3rd to 5th decades

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13
Q

Where does the papillary carcinoma tend to metastasize to?

A

local lymph nodes

distant mets are not found until late in the disease

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14
Q

What is the prognosis of papillary carcinomas?

A

very favorable prognosis with 80% of patients still alive 10 yrs. after diagnosis.

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15
Q

Which thyroid cancer differs from the other types of thyroid carcinomas in that it is derived from Parafollicular C-Cells

A

Medullary carcinomas

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16
Q

Medullary Carcinoma-

What do the parafollicular C-cells (what medullary carcinomas are derived from) produce?

A

Like normal C-Cells, it produces Calcitonin, the hormone involved in regulating the homeostasis of Calcium

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17
Q

Which thyroid cancer?

Histologically, it is composed of round neuroendocrine cells arranged in groups or nests.

The stroma contains Amyloid which is derived from the Calcitonin.

A

Medullary Carcinoma

18
Q

Which thyroid tumor?

A rare tumor with an extremely poor prognosis with most patients dying within one year of diagnosis.

A

Anaplastic Carcinoma

19
Q

Histologically, which tumors are composed of undifferentiated, large or small tumor cells that bear no resemblance to normal thyroid cells.

A

Anaplastic Carcinoma

20
Q

Adrenal hyperfunctioning results in which 3 partially overlapping syndromes?

A
  1. Cushings Syndrome or hypercortisolism
  2. Conn’s syndrome or hyperaldosteronism
  3. Adrenogenital syndrome
21
Q

What is Cushing’s Syndrome caused by?

A

hypersecretion of glucocorticoids

22
Q

What is Conn’s Syndrome caused by?

A

hypersecretion of mineralcorticoids

23
Q

What is Adrenogenital Ayndrome caused by?

A

hypersecretion of the adrenal sex hormones

24
Q

Of these, which is addisons and which is cushings?

A

top is Addisons, bottom is Cushings

25
Q

Which layer of the adrenal cortex relates to Cushing’s Syndrome?

A

Zona fasciculata (produces glucocorticoids)

26
Q

Which of the 3 diseases of the adrenal cortex (Cushing’s syndrome, Conn’s syndrome or Adrenogenital syndrome) is most common?

A

Cushing’s syndrome

27
Q

Cushing’s Syndrome is caused by adrenal ______ or ______

A

Hyperplasia or neoplasia

28
Q

Cushing’s syndrome or Disease

In 70% of cases, hypercortisolism occurs as a result of hypersecretion of ACTH from pituitary adenomas

A

Cushing’s DISEASE

29
Q

T/F: The same symptoms can also occur as a result of hypersecretion of corticosteroids from adrenocortical tumors (Cushing’s Syndrome).

A

True

30
Q

Cushings Disease or Cushings syndrome?

_____= hypercortisolism occurs as a result of hypersecretion of ACTH from pituitary adenomas

________= same sxs as above but as a result of hypersecretion of corticosteroids from adrenocortical tumors

A

Cushing’s Disease= hypercortisolism occurs as a result of hypersecretion of ACTH from pituitary adenomas

Cushing’s Syndrome= same sxs as above but as a result of hypersecretion of corticosteroids from adrenocortical tumors

31
Q

70% of cases of hypercortisolism are from Cushing’s Disease

What accounts for ~20% of the cases of hypercortisolism?

What about the remaining 10% of cases?

A

20%= Cushing’s Syndrome

10%= extrapituitary tumors (ex: small cell carcinoma of the lungs)

32
Q

What is the most common source of ectopically secreted ACTH.

A

Extrapituitary tumors, like small cell carcinoma of the lungs

33
Q

Pathology of which condition?

  1. Hyperplasia of the adrenals leads to bilateral thickening of the cortex.
  2. The tumor appears as discrete nodules or marked irregular enlargement of the entire gland.
  3. The tumors may be benign adenomas or malignant carcinomas.
A

Cushing’s Syndrome

34
Q

Why are adrenocortical tumors yellow?

A

b/c of their high lipid content

35
Q

_______ are usually well circumscribed whereas ________ tend to extend into the adjacent tissues

A

Adenomas, carcinomas

36
Q

Symptoms of which condition?

  1. truncal or central obesity- most prominent on the face and trunk (moon face and buffalo hump)
  2. red in the face b/c of engorgement of blood
  3. HTN
  4. Thinning of the skin
  5. Fatigue
  6. Weakness
  7. Mental instability
  8. Glucose intolerance/DM
A

Cushing’s Syndrome

37
Q

What are the most common biochemical disturbances in Cushing’s Syndrome

A

Glucose intolerance and Diabetes

38
Q

The following are common features of which condition?

A

Cushing’s Syndrome

39
Q

In clinical practice, what is the most common cause of Cushing’s Syndrome?

A

Exogenous Steroid hormones

(commonly used for tx of various immune disorders, renal disease, and many skin disorders)

40
Q

Exogenously induced Cushing’s Syndrome responds well to what?

A

gradual tapering off and cessation of steroid treatment

***NO ABRUPT CESSATION B/C PT NOT PRODUCING ACTH–> COULD KILL THEM****

Patho 3 Shea (19 decks)

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