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Path year 5 > Histopath - Endocrine > Flashcards

Histopath - Endocrine Flashcards

1
Q

Hypothalamic- pituitary feedback axis

A
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2
Q

What are the 6 anterior pituitary hormones?

A
  1. Prolactin
  2. TSH
  3. ACTH
  4. GH
  5. FSH
  6. LH
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3
Q

Hyperpituitarism

A

Excess hormone secretion due to a functional adenoma (based on hormone secreted)

(Panhyperpituitarism also exists but rare)

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4
Q

Which type of functional adenoma is most common?

A

Prolactinoma

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5
Q

Prolactinoma presentation

A
  • Amenorrhoea
  • Galactorrhoea
  • Loss of libido
  • Infertility
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6
Q

GH adenoma presentation

A
  • Gigantism or acromegaly
  • DM, muscle weakness, HTN, CCF
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7
Q

ACTH adenoma presentation

A

Cushing’s syndrome

Cushing’s disease even - as coming from pituitary.

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8
Q

Most common type of hypopituitarism

A

Pan-hypopituitarism

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9
Q

Causes of hypopituitarism

A
  • Non-secreting/functional pituitary adenoma (compression)
  • Ischaemic necrosis
    • Sheehan’s syndrome (bleeding into pituitary)
    • DIC
    • shock
  • Iatrogenic
    • Surgery
    • Irradiation
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10
Q

(Pan-)hypopituitarism presentation

A
  • GH deficiency
    • Growth failure in children
  • GnRH deficiency (V SIMILAR syx TO PROLACTINOMA)
    • Amenorrhoea
    • Infertility
    • Decreased libido
    • Impotence
  • TSH and ACTH deficiency
    • Hypothyroidism
    • Hypoadrenalism
  • Prolactin deficiency
    • Failure of PP lactation
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11
Q

What can large pituitary tumours cause?

A
  • Bitemporal hemianopia due to compression of optic chiasm
  • Signs + syx of raised intracranial pressure
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12
Q

Which 2 hormones are secreted from the posterior pituitary?

A

Oxytocin and ADH

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13
Q

What does excess ADH release result in?

A

SIADH

Euvolaemic hyponatraemia

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14
Q

What does ADH deficiency result in?

A

Diabetes insipidus

  • Absolute deficiency -> cranial cause*
  • Resistance -> nephrogenic cause*
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15
Q

Hypothalamus - ant pit - thyroid axis

A
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16
Q

Hyperthyroidism presentation

A
  • Weight loss (or gain)
  • Increased sweating/heat intolerance
  • Diarrhoea
  • Nervousness/anxiety
  • Light and short periods
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17
Q

Hypothyroidism presentation

A
  • Cold intolerance
  • Weight gain
  • Constipation
  • Depression and irritability
  • Irregular and heavy periods
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18
Q

Hyperthyroidism causes

A
  • Primary (issue with thyroid)
    • Grave’s disease
      • MOST COMMON
    • Multinodular goitre/hyperfunctioning adenoma
    • Thyroiditis (inflammed -> loads of thyroxine produced and then all released so hypo after)
      • DeQuervain’s
      • Viral
  • Secondary (issue with pituitary)
    • TSH producing adenoma (rare)
  • Other
    • Exogenous thyroid intake
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19
Q

Iodide uptake scan results for Grave’s, multinodular and thryoiditis

A
  • Grave’s: diffuse increased uptake
  • Multinodular: one or multiple hot nodules
  • Thyroiditis: no change
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20
Q

Grave’s disease presentation

A
  • Thyrotoxicosis
  • Exophthalmos
  • Pretibial myxoedema

F>M, younger adults

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21
Q

Grave’s associated antibody

A

Anti-TSHr antibodies

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22
Q

Which autoimmune disorders are associated with Grave’s disease?

A
  • SLE
  • Pernicious anemia
  • T1DM
  • Addisons
23
Q

Hypothyroidism causes

A

Primary

  • Iatrogenic
    • post treatment for hyperthyroidism
  • Autoimmune -> Hashimoto’s
    • Most common cause in UK
    • 45-65y/o, F>M
    • Painless enlargement
  • Iodine deficiency
    • Most common cause worldwide

Secondary

  • Pituitary failure (rare)
24
Q

What are the 4 types of thyroid carcinoma?

A
  • Papillary
  • Follicular
  • Medullary
  • Anaplastic
25
Q

*Which thyoid carcinoma is most common?

A

Papillary

26
Q

*Histopath of papillary thyroid carcinoma

A

Psammoma bodies

27
Q

*Histopath of medullary thyroid carcinoma

A

From parafollicular C cells

28
Q

*What syndrome is medullary thyroid carcinoma associated with?

A

MEN syndrome

29
Q

*Which is the most aggressive type of thyroid carcinoma?

A

Anaplastic

30
Q

Parathyroid functions + feedback loop

A

Responsible for Ca homeostasis

31
Q

Hyperparathyroidism causes

A
  • Primary
    • Solitary adenoma > gland hyperplasia > carcinoma
  • Secondary
    • Most commonly due to renal failure
32
Q

Biochemistry for primary and secondary hyperparathyroidism (PTH and Ca)

A

Primary: high PTH, high Ca2+

Secondary: high PTH, low Ca2+

33
Q

Hyperparathyroidism presentation

A

Same as hypercalcaemia

  • (Painful) bones
  • (Renal) stones
  • (Abdominal) groans
  • (Psychic) moans
34
Q

Hypoparathyroidism causes

A
  • Iatrogenic
  • Congenital absence
  • Autoimmune
35
Q

Hypoparathyroidism presentation

A

CATS

  • Convulsions
  • Arrhythmias
  • Tetany
  • Spasms
36
Q

What are the 4 zones of the adrenal cortex? (From outermost)

A
  • Zona glomerulosa
  • Zona fasciculata
  • Zona reticularis
37
Q

Which hormones are released from the Zona glomerulosa?

A

Mineralocorticoids

e.g., Aldosterone

38
Q

Which hormones are released from the Zona fasciculata?

A

Gluccocorticoids

e.g., Cortisol

39
Q

Which hormones are released from the Zona reticularis?

A

Androgens

e.g., Dehydroepiandrosterone

40
Q

Which hormones are released from the adrenal medulla?

A

Stress hormones

e.g., epinephrine/adrenalin

41
Q

What is Conn’s syndrome?

A

Hyperaldosteronism due to

Aldosterone secreting adenoma (in adrenal)

42
Q

Hyperaldosteronism causes

A
  • Conn’s syndrome (aldosterone secreting adenoma)
  • Bilateral adrenal hyperplasia (more common)
43
Q

Hyperaldosteronism presentation

A
  • Hypertension
  • Hypokalaemia
    • Aldosterone resp for secr potassium in urine
44
Q

What is Cushing’s syndrome?

A

Too much cortisol

45
Q

Causes of Cushing’s syndrome

A
  • Exogenous
    • MOST COMMON - toomuchsteroids
  • Endogenous
    • Cushing’s disease -> ACTH producing adenoma (in pituitary)
    • Adrenal causes -> adenoma/carcinoma/bilateral hyperplasia
    • Ectopic ACTH production -> small cell carcinoma of the lung
46
Q

Cushing’s syndrome presentation

A
  • Truncal obesity
  • Moon facies
  • Buffalo hump/ dorsocervical fat pad
  • Cutaneous striae
  • HTN
47
Q

What happens to adrenals in 1) Cushing’s disease (/pituitary cushing syndrome), 2) Adrenal cushing syndrome, 3) paraneoplastic cushing syndrome, 4) iatrogenic/exogenous

A
  1. Adrenal hyperplasia
  2. Tumour, or nodular hyperplasia
  3. Adrenal hyperplasia
  4. Adrenal atrophy
48
Q

Adrenal insufficiency causes

A

Acute

  • Sudden withdrawal of long-term steroids
  • Sepsis with DIC (Waterhouse-Friderichson syndrome)
    • Insufficient blood supply -> ischaemic -> unable to produce hormones
  • Haemorrhage
    • Insufficient blood supply -> ischaemic -> unable to produce hormones

Chronic

  • Autoiummune -> Addison’s
    • Most common in the UK
  • TB
    • Most common worldwide
49
Q

What is Addison’s?

A

Autoimmune adrenal insufficiency

50
Q

What is a pathology of the adrenal medulla?

A

Phaeochromocytoma

51
Q

What is phaeochromocytoma?

A

Excess catecholamine secretion (adrenaline, noradrenaline)

52
Q

Phaeochromoctymoa presentation

A
  • Resistant HTN
  • Episodic palpitations
  • Abdo pain

Often young pt

53
Q

What is the rule of 10s in Phaeochromocytoma?

A

10% familial syndromes

10% bilateral

10% malignant

54
Q

*Which thyroid ca most likely to spread via blood?

A

Follicular

Path year 5 (48 decks)

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