Endocrine Pathology

Question 1

Difference between endocrine and exocrine gland?

Answer 1

1. Endocrine gland - secretion into blood stream e.g hormone

2. Exocrine gland - pass secretion into gut, respiratory tract or exterior to body

Question 2

Explain hypothalamic pituitary axis

Answer 2

Hypothalamus - release TRH
Pituitary - release TSH
Thyroid/ adrenal glands - produce T4/T3 (increase metabolism)

Negative feedback loop T4/T3 cause negative feedback on hypothalamus and anterior pituitary

Question 3

Adrenal glands - which parts of cortex produce what?

Answer 3

Outer cortex - aldosterone - raise Na levels
Inner cortex - androgens
Middle cortex - cortisone - increase sugar levels

Question 4

What causes hypocorticism and what is it?

Answer 4

Insufficient production of adrenal hormones

1. Hypothalmic/ pituitary disorder
2. Primary adrenal failure
3. Destruction - malignancy/ steroid

Question 5

What is waterhouse-friderichsen syndrome?

Answer 5

Affect young children

Haemorrhage necrosis of adrenals - cause sepsis

Question 6

Effect hypocorticalism?

Answer 6

Skin pigmentation, hypotension, hypoglycaemia, muscle weakness and renal function

Question 7

What causes hypercorticalism?

Answer 7

Cushings syndrome/ disease

Conn’s - excess aldosterone

Question 8

Difference between Cushing disease and syndrome?

Answer 8

Syndrome - adrenal tumour or iatrogenic damage

Disease - pituitary tumour

Question 9

What does Cushing syndrome cause?

Answer 9

Central obesity, moon face, buffalo hump, hypertension, osteoporosis, acne, hyperglycaemia

Question 10

What is pheochromocytoma?

Answer 10

Tumour of chromaffin cells - cause familial, von Hippel- Lindau

Question 11

Causes of hypothyroidism and hyperthyroidism?

Answer 11

Hypo - iodine deficiency, radiotherapy, autoimmune, drug

Hyper - autoimmune, toxic adenoma, mass

Question 12

How diagnose thyroid disease?

What is disadv?

Answer 12

Cytology - safe and reduce need to biopsy benign lesions

Can only diff MAP tumours: medullary, anapaestic and papillary

Question 13

How diagnose follicular thyroid disease?

Answer 13

Histology

Question 14

Give some examples of autoimmune thyroid conditions?

Answer 14

1. Hashimoto Thryroiditis
   - Autoab against thyroglobulin and thyroid peroxidase
   - Middle aged women
   - Lymphocyte mediated destruction thyroid follicles
   - Tx: thyroxine
2. Graves
   - Thyroid stimulation Its and anti-TSH receptor ab
   - Increases T3/T4 and decreased TSH
   - Tx: anti-thyroid medication, surgery
   - Eye signs inc gritty eyes

Question 15

What are the different thyroid masses?

Answer 15

MAP F- can be benign or malignant

PFAM - most common to least

Question 16

Describe difference between MAP F carcinomas?

Answer 16

Medullary - elderly variable prognosis
Anaplastic - elderly w/ poor prognosis
Papillary - children and young adult - good prognosis
Follicular - young-middle - good prognosis