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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
\*Which thyoid carcinoma is most common?
Papillary
26
\*Histopath of papillary thyroid carcinoma
Psammoma bodies
27
\*Histopath of medullary thyroid carcinoma
From parafollicular C cells
28
\*What syndrome is medullary thyroid carcinoma associated with?
MEN syndrome
29
\*Which is the most aggressive type of thyroid carcinoma?
Anaplastic
30
Parathyroid functions + feedback loop
Responsible for Ca homeostasis
31
Hyperparathyroidism causes
* Primary * Solitary adenoma \> gland hyperplasia \> carcinoma * Secondary * Most commonly due to renal failure
32
Biochemistry for primary and secondary hyperparathyroidism (PTH and Ca)
Primary: high PTH, high Ca2+ Secondary: high PTH, low Ca2+
33
Hyperparathyroidism presentation
Same as hypercalcaemia * (Painful) bones * (Renal) stones * (Abdominal) groans * (Psychic) moans
34
Hypoparathyroidism causes
* Iatrogenic * Congenital absence * Autoimmune
35
Hypoparathyroidism presentation
CATS * Convulsions * Arrhythmias * Tetany * Spasms
36
What are the 4 zones of the adrenal cortex? (From outermost)
* Zona glomerulosa * Zona fasciculata * Zona reticularis
37
Which hormones are released from the Zona glomerulosa?
Mineralocorticoids e.g., Aldosterone
38
Which hormones are released from the Zona fasciculata?
Gluccocorticoids e.g., Cortisol
39
Which hormones are released from the Zona reticularis?
Androgens e.g., Dehydroepiandrosterone
40
Which hormones are released from the adrenal medulla?
Stress hormones e.g., epinephrine/adrenalin
41
What is Conn's syndrome?
Hyperaldosteronism due to ## Footnote *Aldosterone secreting adenoma (in adrenal)*
42
Hyperaldosteronism causes
* Conn's syndrome (aldosterone secreting adenoma) * Bilateral adrenal hyperplasia (more common)
43
Hyperaldosteronism presentation
* Hypertension * Hypokalaemia * Aldosterone resp for secr potassium in urine
44
What is Cushing's syndrome?
Too much cortisol
45
Causes of Cushing's syndrome
* 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
Cushing's syndrome presentation
* Truncal obesity * Moon facies * Buffalo hump/ dorsocervical fat pad * Cutaneous striae * HTN
47
What happens to adrenals in 1) Cushing's disease (/pituitary cushing syndrome), 2) Adrenal cushing syndrome, 3) paraneoplastic cushing syndrome, 4) iatrogenic/exogenous
1. Adrenal hyperplasia 2. Tumour, or nodular hyperplasia 3. Adrenal hyperplasia 4. Adrenal atrophy
48
Adrenal insufficiency causes
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
What is Addison's?
Autoimmune adrenal insufficiency
50
What is a pathology of the adrenal medulla?
Phaeochromocytoma
51
What is phaeochromocytoma?
Excess catecholamine secretion (adrenaline, noradrenaline)
52
Phaeochromoctymoa presentation
* Resistant HTN * Episodic palpitations * Abdo pain ## Footnote *Often young pt*
53
What is the rule of 10s in Phaeochromocytoma?
10% familial syndromes 10% bilateral 10% malignant
54
\*Which thyroid ca most likely to spread via blood?
Follicular

Path year 5 (48 decks)

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