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GERR > Endocrine Pathology > Flashcards

Endocrine Pathology Flashcards

1
Q

complications of diabetes?

A
  • Atherosclerosis
  • Susceptibility to infections
  • microangiopathy
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2
Q

Pathogenesis of type 1?

A
  • All have genetic susceptibility
  • viral infection in children can disturb immune regulation
  • auto reactive T-cells infiltrate islets and destroy beta cells
  • Autoantibodies produced against B cell antigens can be detected
  • beta cell loss becomes critical and resultant hyperglycaemia
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3
Q

Pathogenesis of Type II?

A
  • Genetic and lifestyle (obesity)
  • insulin resistance: peripheral tissue doesn’t respond to insulin
  • beta cell dysfunction: inadequate insulin secretion when hyperglycaemia occurs and insulin resistance
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4
Q

What are the CV complications of diabetes?

A
  • accelerated atherosclerosis
  • increased incidence of MI and peripheral vascular arteriole disease
  • autonomic neuropathy affects bodies response to MI (can often see silent MIs)
  • peripheral vascular disease and peripheral neuropathy is what causes problems in feet
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5
Q

What are the renal complications of Diabetes?

A
  • Vascular lesions: atherosclerosis of large and small vessels and efferent arteriole
  • Glomerular lesions and glomerulosclerosis
  • increased risk of pyelonephritis as susceptible to infections which can lead to papillary necrosis
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6
Q

Complication of diabetes in the eyes?

A
  • Retinopathy
  • Cataracts
  • Glaucome
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7
Q

What is the main cause of Hyperpituitarism?

A

Anterior pituitary gland adenoma

can have functional (release hormones) and non functional tumours

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8
Q

What symptom could a macroadenome of pituitary gland cause?

A
  • Peripheral vision loss due to compression of optic chiasma
  • bitemporal i.e. on both sides
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9
Q

What is the optic chiasm?

A

Crossing over of the visual pathways

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10
Q

What will be the effects of Hyperprolactinaemia?

A
  • Amenorrhea
  • Galactorrhea
  • loss of lipids
  • Infertility
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11
Q

What are the types of adenohypophysial adenoma?

A
  • Prolactinoma
  • GH-secreting
  • ACTH-secreting
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12
Q

What will the effects of excess Growth hormone release?

A

Acromegaly (adults)
- characterised by enlarged feet and hands, increased heel-pad thickness, coarse facial feature and large stature
- get hypertension and cardiomegaly also
Gigantism (children i.e. pre-epiphyseal plate fusion)
- similar to acromegaly

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13
Q

What are the causes of pituitary hypo function?

A
  • macro non-functioning adenoma, metastatic carcinoma

- post-partum ischaemic necrosis of pituitary (Sheehans syndrome)

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14
Q

What are the effects of anterior pituitary syndrome?

A
  • amenorrhea
  • infertility (women)
  • hypothyroidism
  • hypoadrenalism
  • Diabetes insipidus due to lack of ADH release
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15
Q

Causes of hypothyroidism?

A
  • Hashimoto’s disease (autoimmune)
  • iodine deficiency
  • congenital defect where no thyroglobulin synthesised
  • post-surgery removal of thyroid gland
  • Drugs e.g. lithium
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16
Q

Causes of Hyperthyroidism?

A
  • Grave’s disease
  • hyper-functioning toxic goitre or adenoma (produce thyroxine)
  • thyroiditis (inflammation of thyroid) can be lymphatic or granulomatous
  • exogenous excess thyroid hormone e.g. when prescribed to treat hypothyroidism
17
Q

Features of hyperthyroidism?

A
  • Weight loss
  • Tachycardia
  • sweating
18
Q

Features of hyperthyroidism?

A
  • Weight loss
  • Tachycardia
  • atrial fibrillations
  • sweating
  • tremor
  • oncholysis (nail bed)
  • protruding eyes
19
Q

What is Hashimoto’s thyroiditis?

A
  • Lymphatic infiltration of thyroid follicles
  • formation of reactive lymphoid follicles with germinal centres
  • destroys thyroid follicular epithelium (become very pink staining)
20
Q

Pathogenesis of Hashimoto’s thyroiditis?

A
  • Anti-thyroid antibodies secreted by plasma cells cause cell-mediated cytotoxicity
  • CD4+ cells activate macrophages to cause thyrocyte injury
  • CD8+ T cells cause T-cell-mediated cytotoxicity
21
Q

What is Graves disease?

A
  • breakdown in the tolerance of thyroid auto antigens which produce autoantibodies
  • autoantibodies increase thyroid stimulating immunoglobulins which bind to TSH receptor
  • mimics impacts of TSH
22
Q

What is Goiter?

A
  • enlargement of thyroid gland
  • can get some enlarged and some smaller hyperplastic follicles
  • get haemorrhage
  • can occur due to ingestion of foods which interfere with thyroxine biosynthesis
  • can also occur due to congenital enzyme defect so thyroxine not synthesised
23
Q

What symptoms can Goiter cause?

A
  • difficulty breathing
  • difficulty swallowing
  • hoarseness (recurrent laryngeal nerve impacted)
24
Q

Tumours of the thyroid Gland?

A

1) papillary carcinoma - distinctive nuclear features, metastases to regional lymph nodes
2) follicular carcinoma - similar to follicular adenoma but will have capsular and vascular invasion, metastases to lungs or bones
3) medullary carcinoma - neuroendocrine tumour, secretes calcitonin and other hormones, spreads locally to blood or lymph

25
Q

What is Cushing syndrome?

A
  • Cause: ACTH producing adenoma (Cushing disease)
  • Cause: Adrenal cortical neoplasms
  • get excess production of glucocorticoids
26
Q

Symptoms of Cushing syndrome?

A
  • hyperglycaemia
  • acne
  • red cheeks
  • rounded face
  • thinning hair
27
Q

What is Conns syndrome?

A
  • Primary hyperaldosteronism
  • associated with bilateral nodular hyperplasia of adrenal glands
  • excessive secretion of mineralocorticoids
  • get hypertension and hyperkalaemia
28
Q

What tumour of adrenal medulla can cause hypertensive crises during surgery?

A

Phaeochromocytoma

screened for by checking for urinary catecholamines

29
Q

What is Waterhouse Friedrickson syndrome?

A
  • caused by Meningitis
  • disseminated intravascular coagulation
  • haemorrhage into adrenal gland
  • associated with acute adrenal dysfunction
30
Q

What is Addisons disease?

A
  • cause of chronic adrenocortical insufficiency
  • autoimmune
  • caused by: AIDS, tuberculosis or carcinoma
  • associated with high ACTH levels and hyperpigmentation
31
Q

Symptoms of Addisons?

A
  • fatigue
  • weakness
  • GI disturbance
32
Q

Causes of hyperparathyroidism?

A

Primary - hyperplasia of adrenal gland or PTH secreting adenoma
Secondary - inc in PTH in response to hypocalcaemia
Tertiary - development of autonomous hyper secreting adenoma in secondary hyperparathyroidism

GERR (49 decks)

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