endocrine pathology

Question 1

differentiate anterior and posterior pituitary

Answer 1

Anterior pit:
Epithelium cells
Supplied by blood from pit portal system from hypothalamous

posterior pit:
* nervous cells
* supplied by nerves from supraoptic and paraventricular nucleus

Question 2

histopath of anterior pit

`

Answer 2

epithelial cells from oral cavity embryonologically

Question 3

what are the hypothalamic hormones and their effects on ant pit hormones

Answer 3

Question 4

what is the main cause of hyperpituitarism

Answer 4

functional adenoma of pit cells

Question 5

how is hyper pit classified

Answer 5

previously:
* based on morphological character of predominant cells
* acidophil
* basophil
* chromophobe

now:
* based on hormones produced - using immunohistochem

Question 6

what are the commonest pit ademonmas

Answer 6

Prolactinoma

1/5 grow w/o producing any hormones at all

Some have mixed effects

Question 7

epi of pit adenoma

Answer 7

Question 8

clinical features of prolactinaemia

Answer 8

Question 9

clinical features of GH adenomas

Answer 9

Question 10

causes of hypopituitarism

Answer 10

Question 11

clinical features of hypopit

Answer 11

Question 12

what are the posterior pit hormones

Answer 12

ADH
oxytocin

Question 13

local mass effect of pit tumours

Answer 13

Question 14

histology of thyroid gland

Answer 14

Question 15

physiology of thyroid gland

Answer 15

Question 16

what is, and causes of, non-toxci goitre

Answer 16

• Enlargement of thyroid
  
  • Common if impairment synth of thyroid hormone
  • Commonest cause is iodine deficiency
  • Common to see in puberty in girls
  • Ingestion of substances that interfere with thyroid hormone synthesis
  • Hereditary enzyme defects -> persistent stimulation of thyroid -> enlargement

Question 17

causes and effect of multinodular goitre

Answer 17

With time the simple goitre transforms into this
May be massive -> compression
May get autonomous nodule -> hyperthyroidism

Question 18

what is thyrotoxicosis

Answer 18

Hypermetabolic state with too much T3 and T4

Question 19

causes of thyrotoxicosis

Answer 19

Question 20

epi of graves

Answer 20

most common cause of endogenous hyperthyrioudism
more women

Question 21

triad of grave’s sx

Answer 21

Question 22

pathogenesis of Graves

Answer 22

autoimmune disease

Ab to TSH receptor and to thyroglobulin

Ab to TSH receptor cause release of hormones and enlargement of epithelium

Associated with other autoimmune disorders
* SLE
* pernicious anaemia
* t1DM
* Addison’s

Question 23

causes of hypothyroidism

Answer 23

Question 24

epidemiology of hashimotos disease

Answer 24

Question 25

presentation of hashimotos disease

Answer 25

painless thyroid enlargement

Question 26

histology of hashimotos

Answer 26

Infiltration of lymphoid cells and germinal centres in thyroid - reflecting fact it is autoimmune

Question 27

histology of epithelial cells in hashimotos

Answer 27

Become very enlarged - copious eosinophilic cytoplasm - referred to as hertle cells

Question 28

which thyroid nodules are more likely to be carcinoma

Answer 28

Solitary Solid Males Younger Nodules that don’t take up iodine ie are non-functional **Need to look at morphology - FNAC or core biopsy or remove nodule**

Question 29

features of adenomas of the thyroid

Answer 29

Question 30

epidemiology of carcinoma of thyroid

Answer 30

Question 31

pathogenesis of carcinoma of the thyroid

Answer 31

Question 32

epi and dx of papillary carcinoma of thyroid

Answer 32

Question 33

histo of papillary carcinomas

Answer 33

Question 34

features of papillary thyroid carcinoma

Answer 34

Question 35

epi of follicular carcinoma

Answer 35

middle age

Question 36

features of follicular carcinoma

Answer 36

Question 37

cancers that met to bone

Answer 37

Follicular thyroid ca Lung Breast Adrenal

Question 38

what are medullary carcinomas

Answer 38

Question 39

histology of medullary thyroid cancer

Answer 39

Question 40

characteristics of anaplastic thyroid carcinoma

Answer 40

Question 41

origin and location of parathyroid glands

Answer 41

Question 42

actions of PTH

Answer 42

Question 43

causes of hyperparathyroidism

Answer 43

Question 44

histo of parathyroid adenoma

Answer 44

Thin capsule Normal parathyroid is 50% fat and there is almost no fat in adenoma

Question 45

features of primary hyperparathyroidism

Answer 45

Question 46

cause and features of secondary hyperparathyroidism

Answer 46

Question 47

causes of hypoparathyroidism

Answer 47

surgery congenital absence autoimmune

Question 48

clinical features of hypoparathyroidism

Answer 48

Question 49

Answer 49

adrenal gland Cortex made of epithelial cells Medulla - neural cells

Question 50

zones of the adrenal cortex

Answer 50

Question 51

effects of adrenocortical hyperfunction

Answer 51

Question 52

features of cushings

Answer 52

Question 53

causes of cushings syndrome

Answer 53

Question 54

macro path of adrenals in different causes of cushings

Answer 54

Question 55

causes of hyperaldosteronism

Answer 55

Question 56

clinical features of hyperaldosteronism ## Footnote q

Answer 56

HTN low K

Question 57

causes of hyperandrogens

Answer 57

neoplasms - carcinoma > adenoma congenital adrenal hyperplasia

Question 58

what is congenital adrenal hyperplasia

Answer 58

autosomal recessive defect in enzymes in cortisol synth low cortisol = more ACTH = more androgens mostly present in child

Question 59

primary causes of adrenal insufficiency

Answer 59

Question 60

causes of secondary adrenal insufficiency

Answer 60

Question 61

function of adrenal medulla

Answer 61

Question 62

disease of adrenal medulla

Answer 62

phaeochromocytoma neuroblastoma

Question 63

features of phaeo

Answer 63

Question 64

what are MEN syndromes

Answer 64

multiple endocrine neoplasia syndromes inherited diseases -> proliferative lesions of multiple endocrine organs