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Path IV DJ > Endocrine Pathology > Flashcards

Endocrine Pathology Flashcards

1
Q

There are six hypothalamic hormones that regulate six anterior pituitary hormones. Outline which go with which, and give the target organs.
**it’s not one-to-one. very tricky.

A 
TRH(+) --> TSH --> thyroid 
Dopamine(-) --> Prolactin --> mammary/ovary
CRH(+) --> ACTH --> adrenal
GHRH(+)/GIH(-) --> GH --> most tissues
GnRH(+) --> FSH/LH --> gonads
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2
Q

What hormones come from the posterior pituitary? How does the posterior differ from the anterior in terms of how hormones are produced and released?

A

ADH and oxytocin are released from the posterior pituitary.

Posterior pituitary hormones are secreted in the hypothalamus and stored in the pituitary.
Anterior pituitary hormones are secreted by specific cells in the pituitary.

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3
Q

T/F: the majority of pituitary adenomas are non-functioning.

A

True.

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4
Q

MC & 2MC functional pituitary adenoma

A
  1. Prolactinoma

2. GH-secreting (somatotropinoma)

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5
Q

MC tumor in the brain

A

Pituitary adenoma

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6
Q

MC initial presentation of pituitary apoplexy

A

Sudden headache with rapidly worsening visual field defect

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7
Q

MC presentation of Sheehan syndrome

A

Agalactorrhea

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8
Q

Pituitary apoplexy

  • Definition
  • Usu occurs in present of existing…?
A
  • Acute hemorrhage or infarction of pituitary gland

- Pituitary adenoma

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9
Q

Pituitary adenoma

  • Gross appearance (typical)
  • Micro appearance
A
  • Soft, well-circumscribed lesion confined to sella turcica

- Small round cells with uniformly round nuclei arranged in nests or cords.

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10
Q

Sheehan syndrome

  • Population
  • Definition
A
  • Postpartum women
  • Necrosis of pituitary dt blood loss following childbirth.

(Pituitary enlarges during pregnancy to produce prolactin, no increase in blood supply. Excessive blood loss at childbirth can result in ischemia)

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11
Q

MC patient profile for empty sella syndrome

A

Multigravida who is hypertensive and obese

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12
Q

MC craniopharyngioma in adults? kids?

A

Adults: papillary
Kids: adamantinomatous

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13
Q

Characteristic signs of craniopharyngioma on histo (3)

A
  • circles
  • pallisading
  • wet keratinization
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14
Q

MC mets to pituitary

A

Breast, lung

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15
Q

MC cause of hypothyroidism in US

A

Hashimoto’s thyroiditis

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16
Q

What findings are associated with DeQuervain’s thyroiditis?

A

Thyroid granulomas and giant cells

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17
Q

MC cause of hyperthyroidism

A

Grave’s disease

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18
Q

MC thyroid cancer

A

Papillary carcinoma

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19
Q

MC mets of thyroid cancer

A

Cervical lymph nodes

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20
Q

MC cause of primary hyperparathyroidism

A

Single, sporadic parathyroid adenoma

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21
Q

MC cause of secondary hyperparathyroidism

A

Renal failure

22
Q

MC cause of primary hyperaldosteronism

A

Functional adrenal adenoma

23
Q

MC & 2MC cause of Cushing’s syndrome

A

1: Glucocorticoids
2: Pituitary or adrenal tumor

24
Q

MC cause of primary Addison’s disease

A

Autoimmune destruction of adrenal cortex

25
Q

MC cause of secondary Addison’s disease

A

Inadequate ACTH from pituitary

26
Q

MC solid, extracranial cancer in kids

A

Neuroblastoma

27
Q

When does DM1 typically manifest?

A

Puberty

28
Q

What main antibody target in DM1?

A

Glutamic acid decarboxylase (GAD)

29
Q

MC cause of vision loss in DM retinopathy

A

Macular edema

30
Q

MCH found in DM1 (2)

A

HLA-DR3, HLA-DR4

31
Q

MC & 2MC location of gastrinoma

A

1: Duodenum
2: Pancreas

32
Q

MC location of insulinoma

A

Pancreas

33
Q

What antibodies are responsible for Hashimoto’s thyroiditis?

A

Anti-thyroglobulin

Anti-TPO

34
Q

Micro appearance of Hashimoto’s, including characteristic cell

A

Lymphocytic infiltrate of thyroid gland

Hurthle cells: large, granular, eosinophilic

35
Q

Micro appearance of Grave’s disease

A

Hyperplastic epithelium with prominent infoldings and vacuoles in follicles

36
Q

What are the features (gross/histo and course) of thyroid follicular carcinoma?

A

Encapsulated

Aggressive metastasis

37
Q

What are the histo features of thyroid medullary carcinoma? What might you find in serum?

A

Amyloid stroma, C cell proliferation

Mildly elevated calcitonin

38
Q

Histo features of thyroid papillary carcinoma

A

Fronds

Psammoma bodies

39
Q

What are the classic symptoms of hyperparathyroidism?

A

“painful bones, renal stones, abdominal groans, porcelain thrones, and psychic moans”

40
Q

Micro appearance of parathyroid adenoma

A

Uniform, polygonal chief cells with small, central nuclei

41
Q

Micro appearance of parathyroid carcinoma

A

Nests of neoplastic cells with fibrotic septae

42
Q

What is Conn’s syndrome? How does it present?

A

Primary hyperaldosteronism

HTN with unexplained hypokalemia, hypernatremia, low renin

43
Q

What is the genetic cause of congenital adrenal hyperplasia?

A

21-hydroxylase deficiency

44
Q

What is the histo finding for neuroblastoma?

A

Rosettes: circles of dark tumor cells surrounding pale neurofibril center

45
Q

Histo appearance of DM1 vs DM2

A

1: lymphocytic infiltrate of pancreatic islets
2: pink hyalinization of pancreatic islets

46
Q

What do you see on PE with non-proliferative DM retinopathy?

A

Hemorrhages, edema, and exudates

Dilated capillaries leaking RBCs and plasma into retina

47
Q

What do you see on PE with proliferative DM retinopathy?

A

Proliferation of blood vessels –> vision loss

48
Q

What is the common pathology of DM nephropathy?

A

Nodular glomerulosclerosis

49
Q

What is the triad of Zollinger-Ellison Syndrome?

A

Gastrinomas, gastric acid hypersecretion, severe PUD

50
Q

There are four tumors we learned this term that may present with psammoma bodies. What are they?

A

Papillary thyroid carcinoma
Papillary renal cell carcinoma
Ovarian papillary serous cystadenoma
Prolactinoma

51
Q

Compare serum findings in DM 1, 1.5, and 2

A

1 and 1.5: low C-peptide, anti-islet cell antibodies

2: normal or high C-peptide

Path IV DJ (6 decks)

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