Endocrine System Pathology Flashcards by Clyde Silverio

sudden onset of neurologic impairment due to a rapidly enlarging adenoma

pituitary apoplexy

How well did you know this?

Not at all

Perfectly

cut off value to determine micro and macroadenomas

1cm

How well did you know this?

Not at all

Perfectly

most common cause of hyperpituitarism

prolactin cell adenoma

How well did you know this?

Not at all

Perfectly

second most common cause of hyperpituitarism

somatotroph adenoma

How well did you know this?

Not at all

Perfectly

[diagnosis: pituitary cell type]

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

lactotroph

Hormone: prolactin

How well did you know this?

Not at all

Perfectly

[diagnosis: pituitary cell type]

gigantism (children), acromegaly (adults)

Somatotroph

hormone: GH

How well did you know this?

Not at all

Perfectly

[diagnosis: pituitary cell type]

cushing syndrome, presence of large, nelson syndrome

Corticotroph

hormone: ACTH

How well did you know this?

Not at all

Perfectly

___ syndrome

destructive adenoma after adrenalectomy for treatment of cushing syyndrome

Nelson syndrome

How well did you know this?

Not at all

Perfectly

[diagnosis: pituitary cell type]

Hyperthyroidism

Thyrotroph

Hormone: TSH

How well did you know this?

Not at all

Perfectly

[diagnosis: pituitary cell type]

Hypogonadism, mass effect, hypopituitarism

Gonadotroph

Hormone: FSH, LH

How well did you know this?

Not at all

Perfectly

[diagnosis: pituitary]

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

pituitary adenoma

How well did you know this?

Not at all

Perfectly

[diagnosis: pituitary]

atypical adenomas + metastasis (CSF/systemic)

pituitary CA

How well did you know this?

Not at all

Perfectly

hormone that is lost first following hypopituitarism

FSH and LH

How well did you know this?

Not at all

Perfectly

hormone that is lost last following hypopituitarism

prolactin

How well did you know this?

Not at all

Perfectly

[diagnosis: pituitary hormone deficiency]

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

FSH, LH

How well did you know this?

Not at all

Perfectly

[diagnosis: pituitary hormone deficiency]

pallor

MSH

How well did you know this?

Not at all

Perfectly

[diagnosis: pituitary syndromes]

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

UO increased
CVP decreased

ADH is low

Central DI

How well did you know this?

Not at all

Perfectly

[diagnosis: pituitary syndromes]

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

UO increased
CVP decreased

ADH is high

nephrogenic DI

due to unresponsiveness of renal tubules to ADH

How well did you know this?

Not at all

Perfectly

[diagnosis: pituitary syndromes]

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

UO low
CVP high

ADH is high

SIADH

How well did you know this?

Not at all

Perfectly

[diagnosis]

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

craniopharyngioma

How well did you know this?

Not at all

Perfectly

[diagnosis: pituitary]

nest of squamous cells with peripheral palisading around a spongy reticulum

tumor nests float on wet keratin

cranipharyngioma

How well did you know this?

Not at all

Perfectly

most common cause of congenital hypothyroidism world wide

iodine deficiency

How well did you know this?

Not at all

Perfectly

most common cause of hypothyroidism in iodine-sufficient areas

Hashimoto Thyroiditis

How well did you know this?

Not at all

Perfectly

[diagnosis]

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

cretinism

How well did you know this?

Not at all

Perfectly

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

myxedema

[diagnosis] fibrosis of the thyroid gland + contiguous neck structures

Reidel Thyroiditis

[diagnosis] hyperplastic follicles forming pseudopapillary structures, moth eaten colloid

graves ophthalmopathy

[diagnosis] painless goiter, transient hyperthyroidism then hypothyroidism autoantibodies against TG and TPO

hashimoto thyroiditis

[diagnosis] painless goiter, transient hyperthyroidism then hypothyroidism autoantibodies against TPO; usually associated with a history of autoimmune disease

Subacute Lymphocytic or postpartum

[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

Granulomatous

[diagnosis] hurthle cell change present, present fibrosis, absent granulomas present: lymphocyte, monocyte, plasma cell, and germinal center

Hashimoto

[diagnosis] hurthle cell change absent, absent fibrosis, absent granulomas present: lymphocyte, monocyte, plasma cell, and germinal center

Subacute Lymphocytic/postpartum

[diagnosis] hurthle cell change absent, absent fibrosis, present granulomas with multinucleated giant cell Acute phase: PMNs

Granulomatous

[diagnosis] Hyperthyroidism Ophthalmopathy Dermopathy

Graves disease

Type of hypersensitivity of graves disease

Type II hypersensitivity Autoantibodies against TSH receptor

[diagnosis] low TSH high FT3/FT4

Graves

[diagnosis: phase of goiter] Trophic effects of TSH on gland, diffuse, symmetrical enlargement, colloid is less abundant

hyperplastic phase

[diagnosis: phase of goiter] sufficient iodine intake/ decrease thyroid demand brown, glassy, translucent cut surface flattened and cuboidal follicular epithelium abundant colloid

colloid or involution phase

cassava causes goiter since it contains

thiocyanate

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

Plummer Syndrome

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

thyroid adenoma

[diagnosis] non-functional thyroid nodule, no capsule noted

adenomatous nodule

[diagnosis] non-functional thyroid nodule, capsular and vascular invasion noted

follicular CA

most common thyroid CA

papillary

second most common thyroid CA

follicular

thyroid CA arising from the parafollicular C cells

medullary

thyroid CA that is warm on scintiscan

follicular thyroid CA

Medullary Thyroid CA is associated with what MEN

MEN 2

[diagnosis] high VIP, High ACTH, high calcitonin, hypocalcemia, MEN2

Medullary thyroid CA

[diagnosis: thyroid CA] orphan annie nuclei, psammoma bodies, lymphatic invasion

papillary

[diagnosis: thyroid CA] small, polygonal to spindle shape, acellular amyloid deposit, parafollicular C cell hyperplasia

medullary thyroid CA

[diagnosis: thyroid CA] osteoclast-like multinucleated giant cells, spindle-shaped cells, Cytokeratin (+), Thyroglobulin (-)

Anaplastic thyroud CA

most common cause of secondary hyperparathyroidism

renal failure

most common cause of primary hyperparathyroidism

parathyroid adenoma

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

hyperparathyroidism

___ disease of bone increased osteoclast activity, peritrabecular fibrosis, cystic brown tumor

Von Recklinghausen disease

reliable criteria for parathyroid malignancy

metastasis and local invasion

[diagnosis] calcifications of basal ganglia, frank psychosis, emotional instability, parkinsonian-like movement disorders calcification of lens, QT prolongation

hypoparathyroidsm

cut off FBS value for impaired glucose tolerance

100-125 mg/dL

cut off FBS value for diabetes

>/126 mg/dL

cut off RBS value for diabetes

>/ 200 mg/dL + 3 Ps

Cut off HBA1c value for diabetes

>/ 6.5%

cut off value for 2hour 75g OGTT

>/200 mg/dL

Diabetic coma are due to

ketoacidosis, volume depletion

Type I DM is classified as ___ hypersensitivity reaction

Type IV

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

Chromosome 6

Triad of T2DM

genetic, environmental, proinflammatory state

most important environmental factor in T2DM pathogenesis

central or visceral obesity

[diagnosis] hyperglycemia + ketoacidosis

DKA

[diagnosis] | hyperglycemia without ketoacidosis

Hyperosmotic hyperglycemic state

most common acute complication of DM

hypoglycemia

Microvascular changes in the kidneys due to T2DM

diffuse thickening of BM and leaky capillarues

[diagnosis] nodular glomerulosclerosis or intercapillary glomerulosclerosis (+) PAS positive acellular nodules in glomerulus

Kimmelstiel-Wilson Disease

most common pancreatic neuroendocrine tumor

insulinomas

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

Whipple triad

[diagnose] hyperinsulinsm, whipple triad usually benign Histo: recapitulate normal pancreatic islet, amyloid deposition

insulinoma

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

Zollinger-Ellison syndrome

[diagnose] Hypergastrinemia Zollinger-Ellison Syndrome usually malignant Histo: recapitulate normal pancreatic islet

Gastrinoma

[diagnose] DM, necrolytic migratory erythema, anema

alpha cell tumor Glucagon Glucagonomas

[diagnose] DM, cholelithiasis, steatorrhea, hypochlorydia

gamma cell tumor Somatostatin Somatostatinomas

[diagnose] | watery diarrhea, hypokalemia, achlorydia

VIPoma

___ syndrome VIPoma

Verner-Morrison Syndrome

[diagnose] facial flushing, diarrhea, bronchoconstriction

Pancreatic Carcinoid Serotonin

Most common cause of cushing syndrome (overall)

iatrogenic (exogenous steroids)

most common endogenous cause of Cushing syndrome

ACTH-secreting pituitary adenoma

[diagnose] abdomina striae, obesity, buffalo hump, moon facies

cushing syndrome

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

ACTH-independent

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

ACTH-dependent

[diagnose] increased plasma aldosterone, decreased plasma renin activity

primary hyperaldosteronism

[diagnose] increased plasma aldosterone, increased plasma renin activity

secondary hyperaldosteronism

most common cause of primary hyperaldosteronism

bilateral idiopathic hyperaldosteronism

most common cause of congenital adrenal hyperplasi

21-hydroxylase deficiency

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

N. meningitides

most common cause of primary chronic adrenocortical insufficiency

autoimmune adrenalitis

[diagnose] irregularly shrunken adrenals with lymphoid infiltrates, hyperpigmentation is present ACTH stimulation test: negative

addison disease

[diagnose] adrenal has a variable size, hyperpigmentation is absent ACTH stimulation test: positive

secondary adrenocortical insufficiency

[diagnose: adrenocortical neoplasm] hypercortisolism and hyperaldosteronism grossly: yellow, lipid-rich mass minimal atypia, no necrosis,

adenoma

[diagnose] virilization gross:hemorrhage and cystic change anaplastic, marked mitosis, marked necrosis,

adrenal carcinoma

____ originates from chromaffin cells of medulla

pheochromocytoma

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

pheochromocytoma

the only criteria for malignancy of pheochromocytoma

metastasis

[diagnose] 1. Prolactinoma 2. Primary hyperparathyroidism 3. Insulinoma or gastrinoma

MEN 1 Wermer Syndrome

[diagnose] 1. Pheochromocytoma 2. parathyroid hyperplasia

MEN 2A Sipple syndrome

[diagnose] 1, pheochromocytoma 2. Neuroma 3. Ganglioneuromas 4. Marfanoid habitus

MEN 2B