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Clinical Pathology > Endocrine Pathology > Flashcards

Endocrine Pathology Flashcards

1
Q

What are endocrine, paracrine and autocrine glands?

A

Endocrine - release hormones into blood and act systemically

Paracrine - hormones released that act locally

Autocrine - hormones secreted that act of cell itself

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2
Q

What are the main causes for pituitary hypofunction?

A

Tumours - secretory adenoma or malignant

Trauma

Inflammation

Infarction

Iatrogenic

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3
Q

What are the most common types of pituitary tumours? What are their effects?

A

Adenoma - can secrete any hormone originating from thyroid

  • Effects are secondary to hormone being produced (hyper functioning hormone)
  • Local effects due to pressure on optic chiasma/adjacent pituitary
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4
Q

What is the effect of a PROLACTINOMA?

A

Galactorrhea (milk from breast)

Menstrual disturbances

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5
Q

What is the effect of a growth hormone secreting adenoma?

A

Gigantism in children

Acromegaly in adults (excessive growth - massive facial features/hands)

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6
Q

What is the effect of of a ACTH secreting adenoma?

A

Cushing’s syndrome

- moon face etc

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7
Q

What is a potential complication of a thyroidectomy?

A

Damage to laryngeal nerve - hoarseness of voice

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8
Q

Where is the thyroid located?

A

between C5-7, anterior neck

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9
Q

What does ectopic mean?

A

Tissue somewhere where it shouldn’t

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10
Q

What is heterotopia?

A

Displacement of tissue

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11
Q

Where can ectopic/heterotopic thyroid glands occur?

A

Anywhere between foramen cecum (back of tongue to suprasternal notch

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12
Q

Where is the most common place for ectopic/hetertopic thyroid glands to occur? Whats the effect?

A

Lingual thyroid - base of tongue

As this is only thyroid tissue, most patients present with hypothyroidism

Not neoplastic but can cause obstruction

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13
Q

What is a thyroglossal duct cyst? What can it present?

A

Asymptomatic mass - cyst arising from embryological remnants

Dysphasia

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14
Q

What is acute thyroiditis? What are the clinical symptoms?

A

Inflammation of thyroid - due to virus, bacteria or fungus (generalised sepsis0

  • Presents with fever, chills, malaise, pain in neck, NECK SWELLING
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15
Q

What is palpable thyroiditis caused by? How does it present?

A

Excessive palpation/surgery

Presents with thyroid nodule (granulamtous foci replace follicles)

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16
Q

What is Riedel thyroiditis? How does it present?

A

Rare, fibrosing form of chronic thyroiditis

Presents with firm goitre - dysphagia, stridor, hoarseness

  • mistaken for thyroid carcinoma
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17
Q

What is Hashimoto’s thyroiditis? How does it present?

A

Autoimmune chronic inflammatory disorder of thyroid

  • diffuse enlargement of thyroid (non-tender)
  • high TSH/low T3 and T4 cells with thyroid antibodies
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18
Q

What are the clinical signs of hashimoto’s?

A

Hypothyroidism -

Enlarged thyroid (non-tender)

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19
Q

What are patients with Hashimoto’s at risk of developing?

A

Lymphoma

Papillary carcinoma of thyroid

20
Q

What is Graves disease? How does it present?

A

Autoimmune chronic inflammatory condition of thyroid that causes HYPERTHYROIDISM

Elevated T3 and T4 with low TSH and high thyroid antibodies

21
Q

What are the clinical features of Graves disease?

A

Exosphalmos
Tachycardia
Feeling hot
Hyperreflexia etc

22
Q

What are the complications of Graves disease?

A

Can develop hypothyroidism

23
Q

How does mutlinodular goitre present?

A

Can be functional i.e. normal

Multi nodular enlargement

However, symptoms are compression of trachea/dysphagia

24
Q

How to differentiate between a benign nodule and malignant carcinoma?

A
  • Solitary nodule/Painless lump
  • silent cold nodule on radioactive iodine imaging
  • Invasive
25
Q

What is the most common malignant cancer in the thyroid?

A

Papillary carcinoma

26
Q

What are the three types of hyperparathyroidism? Why do they present?

A

Primary - excessive secretion of one/more glands (single adenoma, or diffuse chief cell) - MEN2a

Secondary - hyperplasia of glands due to vit D deficiency, renal insufficiency and malnutrition

27
Q

What is the complications of primary hyperparathyroidism?

A

Hypercalcaemia
Osteoporosis
reduced renal function

28
Q

What is primary chief cell hyperplasia?

A

Increased in parathyroid cell mass (non-neoplastic)

Hypercalcaemia - stones, bones, groans and abdominal moans

29
Q

How does hyperparathyroidism present biochemically?

A

Increased calcium
Reduced phosphate
Increased PTH

30
Q

What is parathyroid adenoma associated with?

A

MEN1 and MEN2a

31
Q

How does parathyroid adenoma usually present?

A

One enlarged gland, remaining ones suppressed and small

32
Q

How do parathyroid carcinomas present?

A

Hypercalcaemia

33
Q

What does the adrenal cortex produce?

A

Aldosterone - mineralocorticoids
Cortisol - glucocorticoids
Androgens - testosterone and DHEA

34
Q

What does the adrenal medulla produce?

A

Catecholamines (adrenaline/noradrenaline)

35
Q

What is Cushings syndrome?

A

Excessive ACTH (pituitary adenoma) or excessive glucocorticoid secretion from adrenal cortex (cortisol) (adenoma)

36
Q

What are the diagnostic features of Cushing’s syndrome?

A

Elevated ACTH/cortisol in blood

  • moon face
  • central obesity
  • Striae
  • Hypertension
  • thinning hair
  • proximal muscle weakness
37
Q

What is Conn’s syndrome?

A

Excessive aldosterone release

adenoma

38
Q

What are the clinical features of Conn’s syndrome?

A

Hypertension (H2O and Na retention), potassium loss (muscle weakness/muscle arrythmias)

39
Q

What is addison syndrome?

A

Underproduction of cortisol and aldosterone

40
Q

What are the causes of addison syndrome

A

Primary adrenal cortical insufficiency or destruction

Autoimmune or TB

41
Q

How does addisons present clinically?

A

Postural hypotension
Hyponatreamia
hyper pigmentation

42
Q

What is the treatment for addison’s?

A

Steroid replacement therapy

fatal if undiagnosed

43
Q

What is the name for a catecholamine releasing tumour arising from the adrenal gland?

A

PHAEOCHROMOCYTOMA

44
Q

What are the symptoms of pheochromocytoma?

A

Symptoms related to excessive catecholamines

Hypertension
pallor
headaches,
sweating
nervousness.
45
Q

How are pheochromocytoma diagnosed?

A

Raised urine catecholamines

46
Q

What familial syndrome is pheochromocytoma potentially related to?

A

MEN2a/b

Clinical Pathology (50 decks)

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