Endocrine Flashcards
Alpha amanitin is what?
found in mushrooms, inhibits RNA polymerase II
What is Lyonization?
female carriers variably affected depending on the pattern of inactivation of the X chromosome carrying the mutant vs normal gene
Hashimoto Thyroiditis patients are at an increased risk of getting what?
non-Hodgkin lymphoma
What is the path issue with Hurthle cells? How does the thyroid feel?
Hashimoto Thyroiditis Non tender
A kid with a big tongue and an umbilical hernia, not to mention mental impairment is what?
Cretinism, hypothyroidism
What is Subacute granulomatous thyroiditis (de Quervain), usually caused by?
Is the thyroid painful?
Viral Infection
very tender thyroid
Riedel Thyroiditis mimics what due to its rock hard fibrosis?
Is the thyroid painful?
anaplastic carcinoma, has an IgG4 related systemic disease
painless goiter
Papillary carcinoma, has what path buzz phrase?
What are the main causes?
empty appearing nuclei with central clearing (orphan annie eyes)
psammoma bodies (Tall cell variant, follicular hyperplasia lined by tall epithelial cells)
childhood irradiation
Follicular Carcinoma is DDX from an adenoma based on what?
What is the genetic mutation?
invades thyroid capsule and vasculature
Pax-8, PPAR-gamma issues, RAS mutation
What is in the medullary carcinoma path buzz phrase?
What does it produce?
amyloid –> congo red RET mutations in the MEN 2A and 2B remember amyloid is polygonal or spindle cell activation
produces calcitonin
What is undifferentiated/anaplastic carcinoma path findings? What is the DDX?
What is the go to gene mutation?
spindle cell and Giant cell differentiation Reidel’s Thyroiditis
p53
What part of the kidney is particularly worrisome with Diabetes Melitus?
Renal efferent arteriosclerosis
When we are undergoing DKA, what is one lab value to look at?
phosphate
Thyroid and parafollicular cells, C cells make calcitonin, where are they derived from?
endoderm
Basophils are what hormones?
Acidophils are what hormones?
Basophils: FSH, LH, ACTH, TSH
Acidophils: GH, and PRL
What is hypothyroidism has granulomatous inflammation, mixed cellular infiltration with occasional multinucleated giant cells?
Painful or Non-painful?
Subactue Granulomatous thyroiditis (de Quervain)
Painful
Thyroid, histo of tall, crowded follicular epithelial cells; scalloped colloid?
Graves Disease
What is focal patches of hyperfunctioning follicular cells distended with colloid working independently of TSH?
Toxic Multinodular Goiter
If I have cold nodules what do I have?
Carcinoma, adenoma
Endocrine
AD
Bad G(s) Subunit
Mother imprinting
Shortened 5th digit
High PTH, low Calcium
Pseudohypoparathyroidism
Defective G-coupled Ca2+ sensing receptors in multiple tissues, higher than normal Ca, required to suppress PTH, mild hypercalcemia and hypocalciuria, elevated PTH
Familial hypocalciuric hypercalcemia
Adrenal Cortex is from what embryological structure? Adrenal Medulla is from what embryological structure?
Adrenal Cortex: mesoderm
Medulla: neural crest
Where is the anterior pituitary gland derived from? Where is the posterior pituitary gland derived from?
Rathke Pouch: oral ectoderm –> anterior pituitary
Derived from the neuroectoderm –> posterior pituitary
What hormone does squamous cell carcinoma, renal cell carcinoma?
PTH-related peptide
What is the path issue with Hurthle cells? How does the thyroid feel?
Hashimoto Thyroiditis Non tender
Amiodarone can cause what?
hyperthyroidism
Papillary carcinoma, has what path buzz phrase? What are the main causes?
empty appearing nuclei with central clearing (orphan annie eyes)
psammoma bodies childhood irradiation (Tall cell variant, follicular hyperplasia lined by tall epithelial cells
Follicular Carcinoma is DDX from an adenoma based on what?
What is the gene mutation?
invades thyroid capsule and vasculature, RAS mutation
Pax-8, PPAR-gamma issues
What is in the medullary carcinoma path buzz phrase?What does it produce?
amyloid –> congo red RET mutations in the MEN 2A and 2B remember amyloid is polygonal or spindle cell activation something calcitonin
When we are undergoing DKA, what is one lab value to look at?
phosphate
What thing is bad with Acanthosis Nigricans?
Insulin Resistance
What amino acid is responsible for HbA1c glycation?
valine
What test, though appealing, cannot tell the difference between an adenoma or cancer?
Fine Needle Aspiration
Neuroblastoma stains positive for what two things?
NSE and Bombesin
Wilms tumor vs Neuroblastoma both affect kids, which is which?
Wilms doesnt cross the midline
Neuroblastoma crosses the midline, has Homer Wright Rossetes
Nelson syndrome is what?
Removal of the adrenal glands, and a pituitary adenoma forms due to a lack of negative feedback
Small Cell Lung Cancer can secrete what hormone that can cause problems with urination or blood pressure?
ADH exogenous
What is the whipple triad?
low blood glucose symptoms of hypoglycemia resolution of symptoms seen in insulinoma
Basophils are what hormones?
Acidophils are what hormones?
Basophils: FSH, LH, ACTH, TSH
Acidophils: GH, and PRL
What drug is a synthetic analog of aldosterone that is used in primary adrenal insufficiency?
Fludrocortisone
After a woman has a child, what is the histology of her thyroid?
lymphocytic infiltrate with occasional germinal center formation
Postpartum thyroiditis
What is hypothyroidism has granulomatous inflammation, mixed cellular infiltration with occasional multinucleated giant cells?
Painful or Non-painful?
Subactue Granulomatous thyroiditis (de Quervain)
Painful
What disease is the thyroid replaced by fibrous tissue with inflammaotry infiltrate, mimics anaplastic carcinoma?
Riedel Thyroiditis
What is focal patches of hyperfunctioning follicular cells distended with colloid working independently of TSH?
Toxic Multinodular Goiter
If I have cold nodules what do I have?
Carcinoma, adenoma
Endocrine
AD
Bad G(s) Subunit
Mother imprinting
Shortened 5th digit
High PTH, low Calcium
What are both names?
Pseudohypoparathyroidism or Albright Hereditary Osteodystrophy
End Organ PTH resistance
Endocrine
AD
Bad G(s) alpha unit
Dad imprinting
no shortened digit
Normal PTH/Normal Calcium
Pseudopseudohypoparathyroidism, no PTH end organ resistance
What is the ADH anatagonist that treats SIADH?
Demeclocycline
What disease am I?
Pituitary Tumors (Prolactin and GH)
Pancreastic Endocriine Tumors (Z-E Syndrome, VIPomas)
Parathyroid Adeonomas
MEN1
What disease am I? What is the gene mutation?
Parathyroid Hyperplasia
Medullary Thryoid Carcinoma (Increased Calcitonin)
Pheochromocytoma (secretes catecholamines)
MEN 2A
RET gene mutation, bad tyrosine kinase
What is the the disease? What is the gene mutaiton?
Pheochromocytoma (secretes catecholamines)
Mucosal Neuromas (oral/intestinal ganglioneuromatosis)
Marfanoid Habitus
MEN 2B
RET gene, bad tyrosine kinase
What is the GHRH analog?
Tesamorelin
Autoimmune pancreatitis
Retroperitoneal fibrosis
Non-infectious Aortitis
This triad is married to what endocrine (hypothyroid) issue?
Riedel Thyroiditis
What is Follicle with lymphocytic infiltrate and germinal center formation?
Hashimoto Thyroiditis
Mixed cellular infiltration with occasional multi-nucleated giant cells? (non-caseating granulomas, to some ppl)
Subacute granulomatous thyroiditis
What is lymphocytic infiltration of retroorbital space, activates T cells?
Graves Disease
What is undifferentiated/anaplastic carcinoma histology?
Spindle cells and focal necrosis
What is another name for ergocalciferol?
Vitamin D2
