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Pathology > Endocrine System Pathology > Flashcards

Endocrine System Pathology Flashcards

1
Q

sudden onset of neurologic impairment due to a rapidly enlarging adenoma

A

pituitary apoplexy

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2
Q

cut off value to determine micro and macroadenomas

A

1cm

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3
Q

most common cause of hyperpituitarism

A

prolactin cell adenoma

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4
Q

second most common cause of hyperpituitarism

A

somatotroph adenoma

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5
Q

[diagnosis: pituitary cell type]

galactorhea, amenorrhea (in females), seuxal dysfunction, infertility

A

lactotroph

Hormone: prolactin

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6
Q

[diagnosis: pituitary cell type]

gigantism (children), acromegaly (adults)

A

Somatotroph

hormone: GH

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7
Q

[diagnosis: pituitary cell type]

cushing syndrome, presence of large, nelson syndrome

A

Corticotroph

hormone: ACTH

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8
Q

___ syndrome

destructive adenoma after adrenalectomy for treatment of cushing syyndrome

A

Nelson syndrome

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9
Q

[diagnosis: pituitary cell type]

Hyperthyroidism

A

Thyrotroph

Hormone: TSH

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10
Q

[diagnosis: pituitary cell type]

Hypogonadism, mass effect, hypopituitarism

A

Gonadotroph

Hormone: FSH, LH

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11
Q

[diagnosis: pituitary]

uniform, polygonal cells in sheets and cords, sparse reticulin network, invasion and increased mitosis: atypical adenomas

A

pituitary adenoma

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12
Q

[diagnosis: pituitary]

atypical adenomas + metastasis (CSF/systemic)

A

pituitary CA

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13
Q

hormone that is lost first following hypopituitarism

A

FSH and LH

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14
Q

hormone that is lost last following hypopituitarism

A

prolactin

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15
Q

[diagnosis: pituitary hormone deficiency]

amenorrhea, infertility, decreased libidi, impotence, loss of pubic and axillary hair

A

FSH, LH

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16
Q

[diagnosis: pituitary hormone deficiency]

pallor

A

MSH

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17
Q

[diagnosis: pituitary syndromes]

Serum Na: increased
Plasma Osm: increased
Urine Na: decreased
Urine Osm: Decreased

UO increased
CVP decreased

ADH is low

A

Central DI

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18
Q

[diagnosis: pituitary syndromes]

Serum Na: increased
Plasma Osm: increased
Urine Na: decreased
Urine Osm: Decreased

UO increased
CVP decreased

ADH is high

A

nephrogenic DI

due to unresponsiveness of renal tubules to ADH

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19
Q

[diagnosis: pituitary syndromes]

Serum Na: low
Plasma Osm: low
Urine Na: high
Urine Osm: high

UO low
CVP high

ADH is high

A

SIADH

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20
Q

[diagnosis]

vestifgial remnant of rathke pouch, mass effect, compress pituitary parenchyma

A

craniopharyngioma

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21
Q

[diagnosis: pituitary]

nest of squamous cells with peripheral palisading around a spongy reticulum

tumor nests float on wet keratin

A

cranipharyngioma

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22
Q

most common cause of congenital hypothyroidism world wide

A

iodine deficiency

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23
Q

most common cause of hypothyroidism in iodine-sufficient areas

A

Hashimoto Thyroiditis

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24
Q

[diagnosis]

infancy to early childhood, impaired CNS development, short stature, coarse facial features, protruding tongue, umbilical hernia

A

cretinism

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25
Q

[diagnosis]

late adulthood to adult, slowing of physical activity, overweight, hypercholesterolemia, non-pitting edema, coarse facial features, macroglossia, deepening of voice

A

myxedema

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26
Q

[diagnosis]

fibrosis of the thyroid gland + contiguous neck structures

A

Reidel Thyroiditis

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27
Q

[diagnosis]

hyperplastic follicles forming pseudopapillary structures, moth eaten colloid

A

graves ophthalmopathy

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28
Q

[diagnosis]

painless goiter, transient hyperthyroidism then hypothyroidism

autoantibodies against TG and TPO

A

hashimoto thyroiditis

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29
Q

[diagnosis]

painless goiter, transient hyperthyroidism then hypothyroidism

autoantibodies against TPO; usually associated with a history of autoimmune disease

A

Subacute Lymphocytic or postpartum

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30
Q

[Diagnosis]

painful, variable thyroid enlargement, transient hyperthyroidism then hypothyroidism then normal

antigen-mediated immune damage to follicular cells (by cytotoxic T cells)

notable history of URTI

A

Granulomatous

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31
Q

[diagnosis]

hurthle cell change present, present fibrosis, absent granulomas

present: lymphocyte, monocyte, plasma cell, and germinal center

A

Hashimoto

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32
Q

[diagnosis]

hurthle cell change absent, absent fibrosis, absent granulomas

present: lymphocyte, monocyte, plasma cell, and germinal center

A

Subacute Lymphocytic/postpartum

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33
Q

[diagnosis]

hurthle cell change absent, absent fibrosis, present granulomas with multinucleated giant cell

Acute phase: PMNs

A

Granulomatous

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34
Q

[diagnosis]

Hyperthyroidism
Ophthalmopathy
Dermopathy

A

Graves disease

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35
Q

Type of hypersensitivity of graves disease

A

Type II hypersensitivity

Autoantibodies against TSH receptor

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36
Q

[diagnosis]

low TSH
high FT3/FT4

A

Graves

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37
Q

[diagnosis: phase of goiter]

Trophic effects of TSH on gland, diffuse, symmetrical enlargement, colloid is less abundant

A

hyperplastic phase

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38
Q

[diagnosis: phase of goiter]

sufficient iodine intake/ decrease thyroid demand

brown, glassy, translucent cut surface

flattened and cuboidal follicular epithelium

abundant colloid

A

colloid or involution phase

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39
Q

cassava causes goiter since it contains

A

thiocyanate

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40
Q

____ syndrome

autonomous nodule in a long-standing TMNG, but no ophthalmopathy, no pretibial myxedema

A

Plummer Syndrome

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41
Q

[diagnosis]

non-functional thyroid nodule, enclosed by and intact, well-formed capsule

A

thyroid adenoma

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42
Q

[diagnosis]

non-functional thyroid nodule, no capsule noted

A

adenomatous nodule

43
Q

[diagnosis]

non-functional thyroid nodule, capsular and vascular invasion noted

A

follicular CA

44
Q

most common thyroid CA

45
Q

second most common thyroid CA

A

follicular

46
Q

thyroid CA arising from the parafollicular C cells

47
Q

thyroid CA that is warm on scintiscan

A

follicular thyroid CA

48
Q

Medullary Thyroid CA is associated with what MEN

49
Q

[diagnosis]

high VIP, High ACTH, high calcitonin, hypocalcemia, MEN2

A

Medullary thyroid CA

50
Q

[diagnosis: thyroid CA]

orphan annie nuclei, psammoma bodies, lymphatic invasion

51
Q

[diagnosis: thyroid CA]

small, polygonal to spindle shape, acellular amyloid deposit, parafollicular C cell hyperplasia

A

medullary thyroid CA

52
Q

[diagnosis: thyroid CA]

osteoclast-like multinucleated giant cells, spindle-shaped cells, Cytokeratin (+), Thyroglobulin (-)

A

Anaplastic thyroud CA

53
Q

most common cause of secondary hyperparathyroidism

A

renal failure

54
Q

most common cause of primary hyperparathyroidism

A

parathyroid adenoma

55
Q

Stones, Thrones, Bones, Graons, psych overtones are clinical manifestations of?

A

hyperparathyroidism

56
Q

___ disease of bone

increased osteoclast activity, peritrabecular fibrosis, cystic brown tumor

A

Von Recklinghausen disease

57
Q

reliable criteria for parathyroid malignancy

A

metastasis and local invasion

58
Q

[diagnosis]

calcifications of basal ganglia, frank psychosis, emotional instability, parkinsonian-like movement disorders

calcification of lens, QT prolongation

A

hypoparathyroidsm

59
Q

cut off FBS value for impaired glucose tolerance

A

100-125 mg/dL

60
Q

cut off FBS value for diabetes

A

> /126 mg/dL

61
Q

cut off RBS value for diabetes

A

> / 200 mg/dL + 3 Ps

62
Q

Cut off HBA1c value for diabetes

63
Q

cut off value for 2hour 75g OGTT

A

> /200 mg/dL

64
Q

Diabetic coma are due to

A

ketoacidosis, volume depletion

65
Q

Type I DM is classified as ___ hypersensitivity reaction

66
Q

most important susceptibility gene in Type I DM is located in what chromosome

A

Chromosome 6

67
Q

Triad of T2DM

A

genetic, environmental, proinflammatory state

68
Q

most important environmental factor in T2DM pathogenesis

A

central or visceral obesity

69
Q

[diagnosis]

hyperglycemia + ketoacidosis

70
Q

[diagnosis]

hyperglycemia without ketoacidosis

A

Hyperosmotic hyperglycemic state

71
Q

most common acute complication of DM

A

hypoglycemia

72
Q

Microvascular changes in the kidneys due to T2DM

A

diffuse thickening of BM and leaky capillarues

73
Q

[diagnosis]

nodular glomerulosclerosis or intercapillary glomerulosclerosis

(+) PAS
positive acellular nodules in glomerulus

A

Kimmelstiel-Wilson Disease

74
Q

most common pancreatic neuroendocrine tumor

A

insulinomas

75
Q

___ triad

Hypoglycemia (<50mg/dL)
Neuroglycopenic symptoms
Relief upon administration of parenteral glucose

A

Whipple triad

76
Q

[diagnose]

hyperinsulinsm, whipple triad
usually benign

Histo: recapitulate normal pancreatic islet, amyloid deposition

A

insulinoma

77
Q

___ syndrome

  1. Pancreatic islet tumor
  2. Hypersecretion of gastric acid
  3. severe peptic ulceration
A

Zollinger-Ellison syndrome

78
Q

[diagnose]

Hypergastrinemia
Zollinger-Ellison Syndrome

usually malignant

Histo: recapitulate normal pancreatic islet

A

Gastrinoma

79
Q

[diagnose]

DM, necrolytic migratory erythema, anema

A

alpha cell tumor

Glucagon

Glucagonomas

80
Q

[diagnose]

DM, cholelithiasis, steatorrhea, hypochlorydia

A

gamma cell tumor

Somatostatin

Somatostatinomas

81
Q

[diagnose]

watery diarrhea, hypokalemia, achlorydia

82
Q

___ syndrome

VIPoma

A

Verner-Morrison Syndrome

83
Q

[diagnose]

facial flushing, diarrhea, bronchoconstriction

A

Pancreatic Carcinoid

Serotonin

84
Q

Most common cause of cushing syndrome (overall)

A

iatrogenic (exogenous steroids)

85
Q

most common endogenous cause of Cushing syndrome

A

ACTH-secreting pituitary adenoma

86
Q

[diagnose]

abdomina striae, obesity, buffalo hump, moon facies

A

cushing syndrome

87
Q

[diagnose]

crooke-hyaline change (homogenous, paler cytoplasm of ACTH-secreting cells), increased 24 hour urine free cortisol, decreased plasma ACTH

A

ACTH-independent

88
Q

[diagnose]

crooke-hyaline change (homogenous, paler cytoplasm of ACTH-secreting cells),
increased 24 hour urine free cortisol,
increased plasma ACTH

A

ACTH-dependent

89
Q

[diagnose]

increased plasma aldosterone,
decreased plasma renin activity

A

primary hyperaldosteronism

90
Q

[diagnose]

increased plasma aldosterone,
increased plasma renin activity

A

secondary hyperaldosteronism

91
Q

most common cause of primary hyperaldosteronism

A

bilateral idiopathic hyperaldosteronism

92
Q

most common cause of congenital adrenal hyperplasi

A

21-hydroxylase deficiency

93
Q

waterhouse-friedrichsen syndrome can be complication of a disseminated bacterial infection. The causative agent is usually

A

N. meningitides

94
Q

most common cause of primary chronic adrenocortical insufficiency

A

autoimmune adrenalitis

95
Q

[diagnose]

irregularly shrunken adrenals with lymphoid infiltrates, hyperpigmentation is present

ACTH stimulation test: negative

A

addison disease

96
Q

[diagnose]

adrenal has a variable size, hyperpigmentation is absent

ACTH stimulation test: positive

A

secondary adrenocortical insufficiency

97
Q

[diagnose: adrenocortical neoplasm]

hypercortisolism and hyperaldosteronism

grossly: yellow, lipid-rich mass
minimal atypia, no necrosis,

98
Q

[diagnose]

virilization

gross:hemorrhage and cystic change

anaplastic, marked mitosis, marked necrosis,

A

adrenal carcinoma

99
Q

____ originates from chromaffin cells of medulla

A

pheochromocytoma

100
Q

[diagnose]

nests of cell surrounded by sustentacular cells, salpt and paper chromatin, rich vascular network

A

pheochromocytoma

101
Q

the only criteria for malignancy of pheochromocytoma

A

metastasis

102
Q

[diagnose]

  1. Prolactinoma
  2. Primary hyperparathyroidism
  3. Insulinoma or gastrinoma
A

MEN 1

Wermer Syndrome

103
Q

[diagnose]

  1. Pheochromocytoma
  2. parathyroid hyperplasia
A

MEN 2A

Sipple syndrome

104
Q

[diagnose]

1, pheochromocytoma

  1. Neuroma
  2. Ganglioneuromas
  3. Marfanoid habitus

Pathology (36 decks)

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