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T IoD cellular pathology > Endocrine Pathology > Flashcards

Endocrine Pathology Flashcards

1
Q

where does the pituitary gland sit?

A

In the sella turcica of the sphenoid bone

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2
Q

what hormones does the anterior pituitary produce?

A 
growth hormone
prolactin
FSH
LH
TSH
ACTH
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3
Q

what hormones does the pituitary hormone release?

A

ADH

oxytocin

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4
Q

what is a pituitary adenoma?

A

tumours derived from the glandular tissue of the anterior pituitary

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5
Q

what syndrome can pituitary adenoma’s be a part of?

A

MEN 1

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6
Q

why can a pituitary adenoma cause bitemporal hemianopia?

A

The tumour can compres the optic chiasm ‘vision is missing in the outer half of both fields’

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7
Q

what are the main mass effects caused by a pituitary adenoma?

A

bitemporal hemianopia

Diplopia

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8
Q

what size do functional adenomas of the pituitary tend to be at presentation?

A

very small because they will have been producing symptoms related to the endocrine pathology

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9
Q

what is a prolactinoma?

A

A pituitary adenoma causing excess production of prolactin

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10
Q

What is the most common type of pituitary adenoma?

A

prolactinoma

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11
Q

what is the presentation of prolactinomas in women of reproductive age?

A

Present with oligomenorrhoea or galactorrhoea

often present early so have small tumours

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12
Q

how do prolactinomas present in men and post menopausal women?

A

mass effects such as headache/visual disturbance

larger at presentation

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13
Q

what does an ACTH secreting adenoma present as?

A

Cushings syndrome

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14
Q

what does a GH secreting adenoma present as?

A

acromegaly

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15
Q

what causes the metabolic effects from having a GH pituitary aedenoma?

A

the increased IGF1

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16
Q

what is there a higher mortality in acromegaly?

A

high incidence of left ventricular hypertrophy and hypertension

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17
Q

what are the signs and symptoms of acromegaly?

A
  • protruding supraorbital ridges
  • enlarged nose
  • coarse facial features
  • headaches
  • hypertension
  • insulin resistance
  • impotence
  • degenerative joint disease
  • peripheral neuropathy
  • large hands and feet
  • thicker skin
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18
Q

what are the three biggest causes of thyrotoxicosis?

A

Graves Disease
toxic multinodular goitre
functional thyroid adenoma

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19
Q

where is aldosterone secreted from?

A

aldosterone is a mineralocorticoid so comes from the zona glomerulosa

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20
Q

where is cortisol secreted from?

A

zona fasciculata

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21
Q

where are androgens secreted from?

A

zona reticularis

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22
Q

what does the adrenal medulla secrete?

A

catecholamines

23
Q

what is cushings syndrome?

A

High levels of glucocorticoids

24
Q

what are the signs of cushings syndrome?

A 
poor hair growth
moon face
buffalo hump
abdominal obesity
poor healing
bruising
proximal myopathy
hypertension 
striae
osteoporosis
25
Q

what is the common problem that presents in a patient with cushings?

A

weight gain

muscle weakness

26
Q

what are the most common causes of cushings syndrome?

A

exogenous steroid use

27
Q

why is important to bring patients off exogenous steroids slowly?

A

because the increased cortisol means the adrenal axis is downregulated meaning adrenal atrophy. coming off them slowly gives them a chance to increase production.

28
Q

what are four causes of cushings syndrome?

A
  1. exogenous steroids
  2. ACTH secreting pituitary adenoma
  3. adrenal cortical adenoma
  4. Paraneoplastic syndrome
29
Q

what is an ACTH secreting pituitary adenoma?

A

the adenoma secretes ACTH causing hyperplasia of the adrenal cortex as increased cortisol is made
Causes cushings disease

30
Q

what is an adrenal cortical adenoma?

A

A tumour in the zona fasciculate which secretes cortisol causing cushings syndrome

31
Q

what is paraneoplastic syndrome?

A

tumour cells that secreted ACTH

32
Q

in paraneoplastic syndrome what is the most common tumour to secrete ACTH?

A

Small cell lung cancer

33
Q

In an adrenal cortical adenoma what colour is the tumour compared to the adrenal cortex?

A

the same as the adrenal cortex

34
Q

what is the equation for blood pressure?

A

Blood pressure = TPR x CO

35
Q

what is the main determinant of cardiac output?

A

circulatory volume mainly on renal sodium

36
Q

what are the causes of primary hyperaldosterism?

A
  1. aldosterone producing cortical adenoma

2. bilateral cortical hyperplasia

37
Q

what Is conns syndrome?

A

there is an aldosterone producing adrenal cortical adenoma

38
Q

what is the most common cause of primary hyperaldosteronism?

A

Conns syndrome

39
Q

what are the effects of angiotensin II?

A
  • Stimulates aldosterone release
  • causes vasoconstriction
  • stimulates ADH release
40
Q

what is the effect of hyperaldosteronism?

A
  • excess Na and water reabsorption
  • vasoconstriction of arterioles
    This things cause high blood pressure
41
Q

what is the effect of high aldosterone on sodium and potassium levels?

A

Low potassium

High sodium

42
Q

what is a phaeochromocytoma?

A

A neuroendocrine tumour of the adrenal medulla.

43
Q

what is the colour of the phaeochromocytoma?

A

The tumour is the same colour as the medulla with a small cortex around the edge.

44
Q

what is secreted from a phaeochromocytoma?

A

Catecholamines mainly aldosterone

45
Q

what is the presentation of a phaeochromocytoma?

A

Normally patients have no symptoms but can have a throbbing headache, sweating and palpations.

46
Q

why is it important to identify phaeochromocytomas?

A

they are a treatable form of hypertension

47
Q

what is the specific investigation done for measuring catecholamines and metanephrines?

A

a 24 hour urinary collection

48
Q

what percentage of phaeochromocytomas are familial and what syndromes?

A

10%

von hippel lindau, neurofibromatosis, MEN type 2

49
Q

what germline mutation is in phaeochromocytomas?

A

SDH

50
Q

what is the combination of low potassium and high aldosterone suggestive off?

A

high aldosterone levels

51
Q

what is the effect of hyperparathyroidism on calcium levels?

A

they will be high

52
Q

what type of genetic disorder are MEN 1 and 2?

A

autosomal dominant

53
Q

what is MEN 2 due to?

A

a germline mutation in RET proto-oncogenes

T IoD cellular pathology (10 decks)

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