Endocrine Pathology

Question 1

3 main types of hyperpituitarism

Answer 1

= functioning adenoma
Prolactinoma
GH adenoma
ACTH adenoma

Question 2

how will prolactinoma present

Answer 2

amenorrhoea, galactorrhoea, dec libido, infertility

Question 3

how will GH adenoma present

Answer 3

gigantism/acromegally, DM, muscle weakness, HTN

Question 4

what will ACTH adenoma cause

Answer 4

cushings disease

Question 5

causes of hypopit

Answer 5

non sec pit adenoma -> compression
ischaemic necrosis (sheehan syndro, DIC, shock)
surgery/radiation

Question 6

what presents similar to prolactinoma

Answer 6

GnRH deficiency

Question 7

what are some common complication of pituitary tumours

Answer 7

lrg tumour -> compression of optic chiasm -> bitemporal hemianopia
raised ICP - headaches in morning/ when coughing/leaning forward, N&V

Question 8

what hormones are produced by the posterior pituitary

Answer 8

oxytocin and ADH

Question 9

changes in ADH levels and results

Answer 9

ADH excess = SIADH (eurovol hyponat)

ADH def = DI - absolute def (cranial) or resistance (nephrogenic)

Question 10

causes of hyperthyroidism

Answer 10

primary = graves, multinodular goitre, thyroiditis

secondary = TSH prod adenoma

Question 11

how will graves disease presnt

Answer 11

thyrotoxicosis, exophalmos, pretibial myxoedema

F>M

Question 12

what is the antibody in graves disease

Answer 12

anti-TSH R ab

Question 13

what AI disorders are associated with graves

Answer 13

SLE
pernicious anemia
T1DM
addisons

Question 14

most common cause of hypothyroidism

Answer 14

uk = hashimotos - 45-65, painless enlargement
world = iodine def

Question 15

4 types of thyroid carcinoma

Answer 15

papillary (75-85%)
Follicular (10-20)
medullary - mainly 50-60y
anaplastic - elderly, v rare but v aggressive

Question 16

what are the features of a papillary thyroid carcinoma

Answer 16

painless mass in neck

psammomas

Question 17

what would you suspect if you saw a medullary thyroid carcinoma in a young pt

Answer 17

suspect MEN

Question 18

blood changes in primary and secondary hyperpara

Answer 18

pri = inc PTH, inc Ca
sec = inc PTH, low Ca

Question 19

causes of pri hyperpara

Answer 19

adenoma, gland hyperplasia, carcinoma

Question 20

causes of secondary hyperpara

Answer 20

renal F

Question 21

symptoms of hypoparathy

Answer 21

CATS go numb
chvostek - tap facial nerve -> twitch
trousseau - inflate Bp cuff -> carpopedal spasm

Question 22

hormone production in the adrenals

Answer 22

ZG -> mineralo (aldos)
ZF -> glucoc (cortisol)
ZR -> androgens
Medulla -> stress hormones

Question 23

how will cushings syndro present

Answer 23

HTN, trunchal obesity, moon face, buffalo hump, cutaneous striae

Question 24

causes of cushings syndro

Answer 24

exogenous steroids = most common
ectopic ACTH = sml cell carcinoma of lung
cushings d = ACTH prod adenoma

Question 25

how will hyperaldosteronism present

Answer 25

HTN and hypokalaemia

Question 26

causes of hyperaldosteronism

Answer 26

Conn’s syndro (aldos sec adenoma), bilat adrenal hyperplasia

Question 27

causes of adrenal insuff

Answer 27

acute = sudden withdrawal of long term steroids, sepsis with DIC, haemorrhage
chronic = AI/TB