Endocrine System Flashcards
what do neural cells do
communicate with each other and with cells of sensory and effector tissues by means of neurons
where does the adenohypophysis (anterior pituitary) arise from
rathke’s pouch
what controls the pituitary
hypothalamus
what are the 6 hormones produced by the anterior pituitary
TSH
ACTH
LH
FSH
HGH (human growth hormone)
prolactin
what are the two hormones produced by the posterior pituitary
oxytocin
vasopressin (ADH)
which hormone inhibits growth hormone
somatostatin
which hormone inhibits prolactin
dopamine
what are the three main cell types of the adenohypophysis (anterior pituitary)
chromophobic
eosinophilic (acidophilic)
basophilic
what are lactotrophs and what do they secrete
anterior pituitary acidophilic cells that secrete prolactin
what are somatotrophs and what do they secrete
anterior pituitary acidophilic cells that secrete growth hormone or somatotrophin
what are corticotrophs and what do they produce
anterior pituitary basophilic cells that produce pro-opiomelanocortin (POMC) which becomes ACTH
what are thyrotrophs and what do they produce
anterior pituitary basophilic cells that produce TSH
what are gonadotrophs and what do they produce
anterior pituitary basophilic cells that produce gonadotropins
what is the most common cause of hyperpituitarism
anterior pituitary adenoma
what are the most common causes of hypopituitarism
ischemic injury, surgery, radiation, or inflammation
what are the 5 classifications of pituitary adenomas
hormone production
functional vs non-functional
cell type
sporadic vs inherited
size
what is a functional adenoma
one that produces excess hormone production that causes clinical manifestations
what is a non-functional adenoma
one that does not produce thyroid hormones - no clinical manifestations
how big is a microadenoma
less than 1 cm
how big is a macroadenoma
greater than 1 cm
what two things do atypical pituitary adenomas have
a TP53 mutation and brisk mitotic activity
what is the other name for a prolactinoma
lactotroph adenoma
which pituitary lesion has a cap-like “Golgi-pattern”
prolactinoma (lactotroph adenoma)
what is the most common hyperfunctioning pituitary adenoma
prolactinoma (lactotroph adenoma)
what is the second most common functional pituitary adenoma
growth hormone producing adenoma (somatotroph adenoma)
what is the other name for a growth hormone producing pituitary adenoma
somatotroph adenoma
what is the other name for an adrenocorticotrophic hormone producing pituitary adenoma
chromophobe
which stain is used to differentiate for an adrenocorticotrophic hormone producing pituitary adenoma (chromophobe)
Periodica-Acid Schiff (PAS) stain - stains positive for glycoprotein
what does an adrenocorticotrophic hormone producing pituitary adenoma (chromophobe) present with
Cushing syndrome and hyperpigmentation
what is the aggressive variant of an adrenocorticotrophic hormone producing pituitary adenoma (chromophobe)
Crooke’s cell adenoma
what technique is done to visualize Crooke’s cell adenoma and what is seen
touch prep - shows cytokeratin-rich perinuclear rings
what is the criteria for a malignant pituitary tumor
it must have metastasized
what is considered hypopituitarism
75% loss of anterior pituitary
what is Sheehan Syndrome
post pregnancy blood loss leads to ischemic necrosis of pituitary gland
causes hypopituitarism
what are the three cell types of the posterior pituitary gland (neurohypophysis)
pituicytes (glial cells)
axon processes from hypothalamus
herring bodies
what is a herring body
terminal end of axons from hypothalamus
where does the posterior pituitary gland (neurohypophysis) come from
it’s a downgrowth of the diencephalon that forms the floor of the third ventricle
mostly made of neuroectoderm
what do the neurons of the posterior pituitary gland produce
oxytocin and ADH
what does ADH do
promotes reabsorption of water in the collecting tubules of the kidney
ADH deficiency is associated with which condition
diabetes insipidus
what is a rathke’s cyst
a cyst in the rathke’s area between the anterior and posterior pituitary gland
what is a craniopharyngioma
benign tumor that arises from remnants of the Rathke’s pouch and stalk (infundibulum)
what are the 3 key microscopic features of an adamantinomatous craniopharyngioma
1.) squamous cells with peripheral palisading
2.) stellate reticulum
3.) wet keratin
what is primary empty sella syndrome (ESS)
defect in the diaphragma sella leading to a flattened pitutiary
what is secondary empty sella syndrome (ESS)
a pituitary mass enlarges the sella and damages it
what is pituitary cachexia (Simmonds disease)
destruction or physiological exhaustion of pituitary
can be caused by things like syphilis, TB, tumor, etc.
affects the thyroid, adrenals, and gonads
what is froehlich syndrome (adiposogenital dystrophy)
damage to the hypothalamus leads to obesity, atrophy of gonads, etc.
what type of tumor most commonly metastasizes to the pituitary
breast
what is the average weight of a thyroid gland
18-25 g
what are the two types of thyroid gland cells
follicular and parafollicular
what do the follicular cells of the thyroid gland do
secrete T3 and T4
what do the parafollicular cells of the thyroid gland do
make calcitonin
which is more abundant, T3 or T4
T4
what is thyrotoxicosis
hypermetabolic state due to elevated T3 and T4 or decreased TSH
what is Graves disease
autoimmune diseases of the thyroid which causes a beefy appearance
what is the most common cause of endogenous hyperthyroidism in the US
Graves disease
Exophthalmos is common in which condition that affects the thyroid
Graves disease
which condition has papillary infoldings and peripheral scalloping on microscopy
Graves disease
what are the two types of goiter
diffuse and multinodular
what is the most common cause of a goiter
dietary iodine deficiency
what is a multinodular goiter
long standing diffuse goiter turns into a multinodular goiter
hyper functioning which can develop into hyperthyroidism
what is Plummer-vinson syndrome
toxic multinodular goiter making it hard to swallow with esophageal webs
what is cretinism
hypothyroidism that develops in infancy
what is myxedema
severely advanced hypothyroidism due to the lack of thyroid hormone production in older children and adults
what is thyroiditis
acute inflammation of the thyroid causing hypothyroidism
what is Hashimoto thyroiditis
autoimmune disease of the thyroid
what are the classic cells of Hashimoto thyroiditis
Hurthle (oxyphil) cells
what is subacute granulomatous thyroiditis (De Quervian)
enlarged thyroid that mostly affects women with a history of upper respiratory infections
microscopy shows granulomas
generally, is a hot thyroid nodule benign or malignant
benign
generally, is a cold thyroid nodule benign or malignant
malignant
what is a critical feature of a hyperfunctioning toxic adenoma
intact capsule
what is a follicular adenoma
benign adenoma of the thyroid
what are the four main types of thyroid carcinomas
papillary
follicular
anaplastic
medullary
what is the most common type of thyroid cancer
papillary carcinoma
how is papillary carcinoma of the thyroid diagnosed
fine needle aspiration
Orphan Annie Eye is seen in which condition
papillary carcinoma of the thyroid
what are some microscopic features of papillary carcinoma of the thyroid
papillae with dense fibrovascular cores, psammoma bodies, overlapping nuclei, and orphan Annie eyes
cribriform pattern is seen in which condition
papillary microcarcinoma variant of papillary carcinoma of the thyroid
tall cell variant (tall cuboid cells) is seen in which condition
tall cell variant of papillary carcinoma of the thyroid
what is the sclerosing variant of papillary carcinoma of the thyroid
variant where the tumor involves the entire lobe and is made of dense fibrosis
common in children
what is the most common variant of papillary carcinoma of the thyroid
follicular variant
is follicular carcinoma most common in males or females
mid aged females
what is the most distinguishing factor between a follicular carcinoma and adenoma
capsule invasion - must submit entire capsule
what is anaplastic carcinoma of the thyroid
extremely aggressive tumors of follicular epithelium with distant metastasis
what is medullary carcinoma of the thyroid
neuroendocrine neoplasm derived from parafollicular cells
tumors secrete calcitonin which can be altered to become amyloid deposits
patients with which mutations will get a prophylactic thyroidectomy to protect them from medullary carcinoma
RET mutations
which thyroid carcinoma has the worst prognosis
anaplastic carcinoma
which tumor has a fish-flesh appearance
thyroid lymphoma
what are the two types of parathyroid cells
chief cells
oxyphil cells
what do the chief cells of the parathyroid secrete
parathyroid hormone (PTH)
what does parathyroid hormone do
raise blood calcium levels
what is the most common cause of asymptomatic hypercalacemia
hyperparathyroidism
who, males or females, are more affected by hyperparathyroidism
females (4:1)
what is the most common cause of primary hyperparathyroidism
parathyroid adenoma
what is a nephrolithiasis
kidney stone
what is nephrocalcinosis
calcium salt deposition in the renal parenchyma
what is osteitis fibrosa cystica
condition caused by hyperparathyroidism
causes calcium to be released into blood and reabsorbed by the kidney
what are brown tumors
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)
how much does a normal parathyroid gland weigh
less than 50 mg
what are two consequences of a parathyroid adenoma
increased calcium and PTH
what is the definitive feature to tell a parathyroid carcinoma from an adenoma
invasion and metastasis
what is muscular opening of the duodenum into the pancreas called
sphincter of oddi
what do the islets of langerhans of the pancreas do
secrete hormones to regulate blood glucose levels
what are the four major cell types in the pancreas
alpha cells
beta cells
delta cells
PP (F) cells
what do alpha cells of the pancreas do
secrete glucagon
what do the beta cells of the pancreas do
produce insulin and amyloid
what do the delta cells of the pancreas do
secrete somatostatin which stops release of glucagon and insulin
what do the PP (F) cells of the pancreas do
secrete pancreatic polypeptides
what do D1 cells of the pancreas do
secrete vasoactive intestinal polypeptide (VIP)
what is diabetes mellitus
group of metabolic disorders that lead to hyperglycemia because of issues with either insulin production or insulin receptors
what is the most common type of diabetes
type 2 - often affects those who are obese
what is the classic triad of diabetes mellitus
polyuria
polydipsia
polyphagia
what is polyuria
loss of water and electrolytes
what is polydipsia
intense thirst
what is polyphagia
increase appetite
what does diabetes increase your risk for
pancreatic cancer
what is an insulinoma
type of neuroendocrine pancreatic tumor
beta cell tumor of the pancreas that causes too much insulin to be produced
what is Zollinger-Ellison syndrome
condition of having one or more gastrinomas
what is a gastrinoma
type of neuroendocrine pancreatic tumor
tumor secretes large amounts of gastrin, therefore causing the stomach to produce too much acid
what is a glucagonoma
type of neuroendocrine pancreatic tumor
alpha cell tumor that produces glucagon
most are malignant
what is a somatostatinoma
type of neuroendocrine pancreatic tumor that produces somatostatin
what is a VIPoma
type of neuroendocrine pancreatic tumor that produces vasoactive intestinal peptide (VIP)
what is most important when staging a pancreatic tumor
size
what is the most abundant portion of the renal cortex
zona fasciculata (more white appearing layer)
what are the neuroendocrine cells of the medulla
chromaffin cells
what is Cushing syndrome
elevated glucocorticoid (cortisol) levels
what is Cushing disease
elevated glucocorticoid (cortisol) levels due to a pituitary adenoma
what is the normal weight of an adrenal gland
5 g
what is congenital adrenal hyperplasia (CAH)
bilateral hyperplasia of the adrenal glands
what is Conn Syndrome
overproduction of aldosterone which leads to hypertension
can present with an aldosterone secreting carcinoma
what is waterhouse-friderichsen syndrome
acute adrenocortical insufficiency caused by a bacterial infection
leads to excessive bleeding
what is an adrenal cortical adenoma
tumor of adrenal cortex
ACTH independent - rather it’s caused by too much cortisol (cushing syndrome)
appears very yellow grossly
what is a pheochromocytoma
paraganglioma of the chromaffin cells of the adrenal glands
which condition presents with zellballen pattern microscopically
pheochromocytoma
what is the staging system used for neuroblastoma of the adrenals
international neuroblastoma Risk Group Staging System (INRGSS)
what is a paraganglioma
neuroendocrine tumor that comes from the chromaffin cells of the adrenals
what is wermer’s syndrome (men type 1 syndrome)
disorder that affects the endocrine glands and leads to mostly benign tumors
manifests usually as primary hyperparathyroidism
ex. prolactinoma
what are the most common of the MEN1 pituitary tumors
prolactinomas
what are the three cells types of the pineal gland
epithelioid cells (pinealocytes)
neuroglia cells (astrocytes)
corpora arenacea (brain sand - not technically cells)
what is the main function of the pineal gland
pinealocytes produce melatonin to support the sleep/wake cycle
what is a pineocytoma and what is its main microscopic feature
solid mass of the pineal gland that can cause neuro symptoms like headaches and vomitting
microscopy: neurocytic rosettes
what is the most aggressive tumor of the pineal gland
pineoblastoma
what is the most common type of pineal germ cell tumor
germinoma
which types of conditions fall under MEN-1
pituitary adenomas
parathyroid hyperplasia
pancreatic tumors
