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Basic Human Pathology 2 > Endocrine System > Flashcards

Endocrine System Flashcards

1
Q

what do neural cells do

A

communicate with each other and with cells of sensory and effector tissues by means of neurons

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2
Q

where does the adenohypophysis (anterior pituitary) arise from

A

rathke’s pouch

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3
Q

what controls the pituitary

A

hypothalamus

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4
Q

what are the 6 hormones produced by the anterior pituitary

A

TSH
ACTH
LH
FSH
HGH (human growth hormone)
prolactin

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5
Q

what are the two hormones produced by the posterior pituitary

A

oxytocin
vasopressin (ADH)

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6
Q

which hormone inhibits growth hormone

A

somatostatin

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7
Q

which hormone inhibits prolactin

A

dopamine

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8
Q

what are the three main cell types of the adenohypophysis (anterior pituitary)

A

chromophobic
eosinophilic (acidophilic)
basophilic

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9
Q

what are lactotrophs and what do they secrete

A

anterior pituitary acidophilic cells that secrete prolactin

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10
Q

what are somatotrophs and what do they secrete

A

anterior pituitary acidophilic cells that secrete growth hormone or somatotrophin

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11
Q

what are corticotrophs and what do they produce

A

anterior pituitary basophilic cells that produce pro-opiomelanocortin (POMC) which becomes ACTH

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12
Q

what are thyrotrophs and what do they produce

A

anterior pituitary basophilic cells that produce TSH

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13
Q

what are gonadotrophs and what do they produce

A

anterior pituitary basophilic cells that produce gonadotropins

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14
Q

what is the most common cause of hyperpituitarism

A

anterior pituitary adenoma

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15
Q

what are the most common causes of hypopituitarism

A

ischemic injury, surgery, radiation, or inflammation

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16
Q

what are the 5 classifications of pituitary adenomas

A

hormone production
functional vs non-functional
cell type
sporadic vs inherited
size

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17
Q

what is a functional adenoma

A

one that produces excess hormone production that causes clinical manifestations

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18
Q

what is a non-functional adenoma

A

one that does not produce thyroid hormones - no clinical manifestations

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19
Q

how big is a microadenoma

A

less than 1 cm

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20
Q

how big is a macroadenoma

A

greater than 1 cm

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21
Q

what two things do atypical pituitary adenomas have

A

a TP53 mutation and brisk mitotic activity

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22
Q

what is the other name for a prolactinoma

A

lactotroph adenoma

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23
Q

which pituitary lesion has a cap-like “Golgi-pattern”

A

prolactinoma (lactotroph adenoma)

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24
Q

what is the most common hyperfunctioning pituitary adenoma

A

prolactinoma (lactotroph adenoma)

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25
Q

what is the second most common functional pituitary adenoma

A

growth hormone producing adenoma (somatotroph adenoma)

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26
Q

what is the other name for a growth hormone producing pituitary adenoma

A

somatotroph adenoma

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27
Q

what is the other name for an adrenocorticotrophic hormone producing pituitary adenoma

A

chromophobe

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28
Q

which stain is used to differentiate for an adrenocorticotrophic hormone producing pituitary adenoma (chromophobe)

A

Periodica-Acid Schiff (PAS) stain - stains positive for glycoprotein

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29
Q

what does an adrenocorticotrophic hormone producing pituitary adenoma (chromophobe) present with

A

Cushing syndrome and hyperpigmentation

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30
Q

what is the aggressive variant of an adrenocorticotrophic hormone producing pituitary adenoma (chromophobe)

A

Crooke’s cell adenoma

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31
Q

what technique is done to visualize Crooke’s cell adenoma and what is seen

A

touch prep - shows cytokeratin-rich perinuclear rings

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32
Q

what is the criteria for a malignant pituitary tumor

A

it must have metastasized

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33
Q

what is considered hypopituitarism

A

75% loss of anterior pituitary

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34
Q

what is Sheehan Syndrome

A

post pregnancy blood loss leads to ischemic necrosis of pituitary gland
causes hypopituitarism

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35
Q

what are the three cell types of the posterior pituitary gland (neurohypophysis)

A

pituicytes (glial cells)
axon processes from hypothalamus
herring bodies

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36
Q

what is a herring body

A

terminal end of axons from hypothalamus

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37
Q

where does the posterior pituitary gland (neurohypophysis) come from

A

it’s a downgrowth of the diencephalon that forms the floor of the third ventricle
mostly made of neuroectoderm

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38
Q

what do the neurons of the posterior pituitary gland produce

A

oxytocin and ADH

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39
Q

what does ADH do

A

promotes reabsorption of water in the collecting tubules of the kidney

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40
Q

ADH deficiency is associated with which condition

A

diabetes insipidus

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41
Q

what is a rathke’s cyst

A

a cyst in the rathke’s area between the anterior and posterior pituitary gland

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42
Q

what is a craniopharyngioma

A

benign tumor that arises from remnants of the Rathke’s pouch and stalk (infundibulum)

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43
Q

what are the 3 key microscopic features of an adamantinomatous craniopharyngioma

A

1.) squamous cells with peripheral palisading
2.) stellate reticulum
3.) wet keratin

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44
Q

what is primary empty sella syndrome (ESS)

A

defect in the diaphragma sella leading to a flattened pitutiary

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45
Q

what is secondary empty sella syndrome (ESS)

A

a pituitary mass enlarges the sella and damages it

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46
Q

what is pituitary cachexia (Simmonds disease)

A

destruction or physiological exhaustion of pituitary
can be caused by things like syphilis, TB, tumor, etc.
affects the thyroid, adrenals, and gonads

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47
Q

what is froehlich syndrome (adiposogenital dystrophy)

A

damage to the hypothalamus leads to obesity, atrophy of gonads, etc.

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48
Q

what type of tumor most commonly metastasizes to the pituitary

A

breast

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49
Q

what is the average weight of a thyroid gland

A

18-25 g

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50
Q

what are the two types of thyroid gland cells

A

follicular and parafollicular

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51
Q

what do the follicular cells of the thyroid gland do

A

secrete T3 and T4

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52
Q

what do the parafollicular cells of the thyroid gland do

A

make calcitonin

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53
Q

which is more abundant, T3 or T4

A

T4

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54
Q

what is thyrotoxicosis

A

hypermetabolic state due to elevated T3 and T4 or decreased TSH

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55
Q

what is Graves disease

A

autoimmune diseases of the thyroid which causes a beefy appearance

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56
Q

what is the most common cause of endogenous hyperthyroidism in the US

A

Graves disease

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57
Q

Exophthalmos is common in which condition that affects the thyroid

A

Graves disease

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58
Q

which condition has papillary infoldings and peripheral scalloping on microscopy

A

Graves disease

59
Q

what are the two types of goiter

A

diffuse and multinodular

60
Q

what is the most common cause of a goiter

A

dietary iodine deficiency

61
Q

what is a multinodular goiter

A

long standing diffuse goiter turns into a multinodular goiter
hyper functioning which can develop into hyperthyroidism

62
Q

what is Plummer-vinson syndrome

A

toxic multinodular goiter making it hard to swallow with esophageal webs

63
Q

what is cretinism

A

hypothyroidism that develops in infancy

64
Q

what is myxedema

A

severely advanced hypothyroidism due to the lack of thyroid hormone production in older children and adults

65
Q

what is thyroiditis

A

acute inflammation of the thyroid causing hypothyroidism

66
Q

what is Hashimoto thyroiditis

A

autoimmune disease of the thyroid

67
Q

what are the classic cells of Hashimoto thyroiditis

A

Hurthle (oxyphil) cells

68
Q

what is subacute granulomatous thyroiditis (De Quervian)

A

enlarged thyroid that mostly affects women with a history of upper respiratory infections
microscopy shows granulomas

69
Q

generally, is a hot thyroid nodule benign or malignant

A

benign

70
Q

generally, is a cold thyroid nodule benign or malignant

A

malignant

71
Q

what is a critical feature of a hyperfunctioning toxic adenoma

A

intact capsule

72
Q

what is a follicular adenoma

A

benign adenoma of the thyroid

73
Q

what are the four main types of thyroid carcinomas

A

papillary
follicular
anaplastic
medullary

74
Q

what is the most common type of thyroid cancer

A

papillary carcinoma

75
Q

how is papillary carcinoma of the thyroid diagnosed

A

fine needle aspiration

76
Q

Orphan Annie Eye is seen in which condition

A

papillary carcinoma of the thyroid

77
Q

what are some microscopic features of papillary carcinoma of the thyroid

A

papillae with dense fibrovascular cores, psammoma bodies, overlapping nuclei, and orphan Annie eyes

78
Q

cribriform pattern is seen in which condition

A

papillary microcarcinoma variant of papillary carcinoma of the thyroid

79
Q

tall cell variant (tall cuboid cells) is seen in which condition

A

tall cell variant of papillary carcinoma of the thyroid

80
Q

what is the sclerosing variant of papillary carcinoma of the thyroid

A

variant where the tumor involves the entire lobe and is made of dense fibrosis
common in children

81
Q

what is the most common variant of papillary carcinoma of the thyroid

A

follicular variant

82
Q

is follicular carcinoma most common in males or females

A

mid aged females

83
Q

what is the most distinguishing factor between a follicular carcinoma and adenoma

A

capsule invasion - must submit entire capsule

84
Q

what is anaplastic carcinoma of the thyroid

A

extremely aggressive tumors of follicular epithelium with distant metastasis

85
Q

what is medullary carcinoma of the thyroid

A

neuroendocrine neoplasm derived from parafollicular cells
tumors secrete calcitonin which can be altered to become amyloid deposits

86
Q

patients with which mutations will get a prophylactic thyroidectomy to protect them from medullary carcinoma

A

RET mutations

87
Q

which thyroid carcinoma has the worst prognosis

A

anaplastic carcinoma

88
Q

which tumor has a fish-flesh appearance

A

thyroid lymphoma

89
Q

what are the two types of parathyroid cells

A

chief cells
oxyphil cells

90
Q

what do the chief cells of the parathyroid secrete

A

parathyroid hormone (PTH)

91
Q

what does parathyroid hormone do

A

raise blood calcium levels

92
Q

what is the most common cause of asymptomatic hypercalacemia

A

hyperparathyroidism

93
Q

who, males or females, are more affected by hyperparathyroidism

A

females (4:1)

94
Q

what is the most common cause of primary hyperparathyroidism

A

parathyroid adenoma

95
Q

what is a nephrolithiasis

A

kidney stone

96
Q

what is nephrocalcinosis

A

calcium salt deposition in the renal parenchyma

97
Q

what is osteitis fibrosa cystica

A

condition caused by hyperparathyroidism
causes calcium to be released into blood and reabsorbed by the kidney

98
Q

what are brown tumors

A

masses that result from excess osteoclast activity in the mandible and maxilla
occurs due to hyperparathyroidism (PTH makes osteoclasts break down more bone to raise calcium levels)

99
Q

how much does a normal parathyroid gland weigh

A

less than 50 mg

100
Q

what are two consequences of a parathyroid adenoma

A

increased calcium and PTH

101
Q

what is the definitive feature to tell a parathyroid carcinoma from an adenoma

A

invasion and metastasis

102
Q

what is muscular opening of the duodenum into the pancreas called

A

sphincter of oddi

103
Q

what do the islets of langerhans of the pancreas do

A

secrete hormones to regulate blood glucose levels

104
Q

what are the four major cell types in the pancreas

A

alpha cells
beta cells
delta cells
PP (F) cells

105
Q

what do alpha cells of the pancreas do

A

secrete glucagon

106
Q

what do the beta cells of the pancreas do

A

produce insulin and amyloid

107
Q

what do the delta cells of the pancreas do

A

secrete somatostatin which stops release of glucagon and insulin

108
Q

what do the PP (F) cells of the pancreas do

A

secrete pancreatic polypeptides

109
Q

what do D1 cells of the pancreas do

A

secrete vasoactive intestinal polypeptide (VIP)

110
Q

what is diabetes mellitus

A

group of metabolic disorders that lead to hyperglycemia because of issues with either insulin production or insulin receptors

111
Q

what is the most common type of diabetes

A

type 2 - often affects those who are obese

112
Q

what is the classic triad of diabetes mellitus

A

polyuria
polydipsia
polyphagia

113
Q

what is polyuria

A

loss of water and electrolytes

114
Q

what is polydipsia

A

intense thirst

115
Q

what is polyphagia

A

increase appetite

116
Q

what does diabetes increase your risk for

A

pancreatic cancer

117
Q

what is an insulinoma

A

type of neuroendocrine pancreatic tumor
beta cell tumor of the pancreas that causes too much insulin to be produced

118
Q

what is Zollinger-Ellison syndrome

A

condition of having one or more gastrinomas

119
Q

what is a gastrinoma

A

type of neuroendocrine pancreatic tumor
tumor secretes large amounts of gastrin, therefore causing the stomach to produce too much acid

120
Q

what is a glucagonoma

A

type of neuroendocrine pancreatic tumor
alpha cell tumor that produces glucagon
most are malignant

121
Q

what is a somatostatinoma

A

type of neuroendocrine pancreatic tumor that produces somatostatin

122
Q

what is a VIPoma

A

type of neuroendocrine pancreatic tumor that produces vasoactive intestinal peptide (VIP)

123
Q

what is most important when staging a pancreatic tumor

A

size

124
Q

what is the most abundant portion of the renal cortex

A

zona fasciculata (more white appearing layer)

125
Q

what are the neuroendocrine cells of the medulla

A

chromaffin cells

126
Q

what is Cushing syndrome

A

elevated glucocorticoid (cortisol) levels

127
Q

what is Cushing disease

A

elevated glucocorticoid (cortisol) levels due to a pituitary adenoma

128
Q

what is the normal weight of an adrenal gland

A

5 g

129
Q

what is congenital adrenal hyperplasia (CAH)

A

bilateral hyperplasia of the adrenal glands

130
Q

what is Conn Syndrome

A

overproduction of aldosterone which leads to hypertension
can present with an aldosterone secreting carcinoma

131
Q

what is waterhouse-friderichsen syndrome

A

acute adrenocortical insufficiency caused by a bacterial infection
leads to excessive bleeding

132
Q

what is an adrenal cortical adenoma

A

tumor of adrenal cortex
ACTH independent - rather it’s caused by too much cortisol (cushing syndrome)
appears very yellow grossly

133
Q

what is a pheochromocytoma

A

paraganglioma of the chromaffin cells of the adrenal glands

134
Q

which condition presents with zellballen pattern microscopically

A

pheochromocytoma

135
Q

what is the staging system used for neuroblastoma of the adrenals

A

international neuroblastoma Risk Group Staging System (INRGSS)

136
Q

what is a paraganglioma

A

neuroendocrine tumor that comes from the chromaffin cells of the adrenals

137
Q

what is wermer’s syndrome (men type 1 syndrome)

A

disorder that affects the endocrine glands and leads to mostly benign tumors
manifests usually as primary hyperparathyroidism
ex. prolactinoma

138
Q

what are the most common of the MEN1 pituitary tumors

A

prolactinomas

139
Q

what are the three cells types of the pineal gland

A

epithelioid cells (pinealocytes)
neuroglia cells (astrocytes)
corpora arenacea (brain sand - not technically cells)

140
Q

what is the main function of the pineal gland

A

pinealocytes produce melatonin to support the sleep/wake cycle

141
Q

what is a pineocytoma and what is its main microscopic feature

A

solid mass of the pineal gland that can cause neuro symptoms like headaches and vomitting
microscopy: neurocytic rosettes

142
Q

what is the most aggressive tumor of the pineal gland

A

pineoblastoma

143
Q

what is the most common type of pineal germ cell tumor

A

germinoma

144
Q

which types of conditions fall under MEN-1

A

pituitary adenomas
parathyroid hyperplasia
pancreatic tumors

Basic Human Pathology 2 (14 decks)

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