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Year 5 Pathology Revision > Histopathology 4: Endocrine pathology > Flashcards

Histopathology 4: Endocrine pathology Flashcards

1
Q

Which 2 hormones are secreted from the posterior pituitary gland

A

ADH

Oxytocin

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2
Q

What is the most common pituitary adenoma ?

A

Prolactinoma

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3
Q

Which cells produce calcitonin ?

A

Parafollicular cells (C-cells)

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4
Q

What is the most common cause of non-toxic goitre world wide ?

A

Iodine deficiency

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5
Q

What is the most common cause of hyperthyroidism ?

A

Grave’s disease

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6
Q

List the triad of features seen in Grave’s disease ?

A

Hyperthyroidism
Exophthalmus
Pretibial myxoedema

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7
Q

Hypothyroidism with Hurthle cells on histology.

Most likely diagnosis ?

A

Hashimoto’s thyroiditis

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8
Q

Most common carcinoma of the thyroid ?

A

Pappilary carcinoma

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9
Q

Thyroid histology shows psamomma bodies, empty looking nuclei and intranuclear inclusions.

Most likely diagnosis ?

A

Pappilary carcinoma

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10
Q

Congo red staining of the thyroid shows apple green birefringence. The cancer is affecting the parafollicular cells. The patient is known to have MEN2a

Most likely diagnosis ?

A

Medullary thyroid carcinoma

Calcitonin is produced from the parafolicular cells and is broken down to form amyloid which deposits in the thyroid gland.

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11
Q

What is a common cause of secondary hyperparathyroidism ?

A

Renal failure

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12
Q

List 5 physical signs seen in hypoparathyroidism ?

A

CATS go numb

Convulsions
Arrhythmias
Tetany
Spasms

Numbness

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13
Q

Which paediatric tumour affects the adrenal medulla ?

A

Neuroblastoma

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14
Q

List 3 syndromes which feature phaeochromocytomas?

A

MEN
von Hippel Lindau
Sturge-Weber

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15
Q

what cells make up the anterior pituitary

A

epithelial

blood supply from pituitary portal system

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16
Q

qhat cells make up the posterior pituitary

A

nerve cells

supplied by nerves originating in the supraoptic nucleus and periventricular nucleus

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17
Q

list 3 main effects of functioning pituitary adenomas

A

prolactinomas - amenorrhoea…
GH adenomas - gigantism, acromegaly, DM, muscle weakness, hypertension, CCF
Corticotroph cell adenoma - CD

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18
Q

causes of hypopituitarism

A

non-secreting pituitary adenoma
ischaemic necrosis - esp post partum ( Sheehan syndrome), DIC, SCA, elevated ICP, shock
iatrogenic - ablation of pituitary by surgery or radiation

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19
Q

what 2 syndromes involve ADH

A

diabetes insipidus

SIADH

20
Q

local mass effect of pituitary tumours

A

compression of optic chiasm - bitemporal hemianopia
larger - raised ICP
severe - obstructive hydrocephalus

21
Q

4 primary causes of thyrotoxicosis

A

graves
hyperfunctioning multinodular goitre
hyperfunctioning adenoma
thyroiditis

22
Q

causes of hypothyroidism

A

primary:

  • post ablative
  • AI (hashimotos)
  • iodine deficiency

secondary:
- pit/hypothalamic failure

23
Q

features of hashimotos thyroiditis

A

common
F>M
painless enlargement of thyroid gland
hist - epithelial cells become large with lots of eosinophilic cytoplasm (Hurthle cells)

24
Q

what are thyroid adenomas

A

benign neoplasms of the follicular epithelium
usually solitary
well circumscribed
well formed capsule
small proportion functional and cause thyrotoxicosis

25
what features suggest thyroid carcinomas
``` solitary rather than multiple solid rather than cystic younger M nodules do not take up iodine ```
26
types of thyroid carcionoma
papillary (80%) follicular medullar anaplastic
27
RF for thyroid carcinoma
genetics eg MEN | ionising radiation
28
diagnosis of papillary carcinoma
papillary architecture nuclear features - optically clear nuclei, intranucleus inclusions may have psammoma bodies (foci of calcifications) may present with cervical LN calcifications good prognosis
29
features of follicular carcinoma
peak middle age follicular morphology metastasise via blood to lungs, bone, liver
30
features of medullary carcinoma
neuroendocrine tumour derived from parafolicular C cells mainly sporadic (80%) 20% familial - MEN calcitonin produced by tumour cells broke down and deposited as amyloid within the thyroid amyloid visualised using congo red under polarised light
31
features of anaplastic carcionoma
occurs in elderly very aggressive mets are common local invasion - patients die within a year
32
key features of the parathyroid gland
derived from developing pharyngeal pouches | 4 glands total
33
5 actions of PTH
``` activates osteoclasts increases renal absorption of calcium increases activation of vitamin D increases urinary phosphate excretion increases intestinal calcium absorption ```
34
causes of hyperparathyroidism
80-90% due to a solitary adenoma 10-20% due to hyperplasia of all 4 glands - MEN1 <1% due to carcinoma almost no fat in adenomatous parathyroid
35
clinical features of hyperparathyroidism
hypercalcaemia... stones, bones, groans, moans bones - osteitis fibrosa cystica
36
causes of hypoparathyroidism
surgical ablation congenital absence AI
37
clinical features of hypoparathyroidism
``` CATS go numb Convulsions Arrhythmias Tetany Spasms ``` numbness
38
cell types in the adrenal gland
``` cortex = epithelial cells medulla = neural cells ```
39
which hormone is produced in each layer of the adrenal gland
G - aldosterone F - glucocorticoids R - glucocorticoids + androgens M - adrenaline and noradrenaline
40
most common endogenous and exogenous cause of cushings
endogenous - DC - pituitary disease | exogenous - glucocorticoids
41
4 causes of cushings syndrome
pituitary - adrenal hyperplasia adrenal - nodular hyperplasia paraneoplastic - adrenal hyperplasia iatrogenic - adrenal atrophy
42
causes of hyperaldosteronism
35% due to adenoma - Conns 60% bilateral adrenal hyperplasia HYPERTENSION + HYPOKALAEMIA virilising syndromes (excess androgens) may be associated with neoplasms
43
types of adrenal insufficiency
primary secondary acute - sudden withdrawal of steroid therapy, haemorrhage (neonates), sepsis with DIC (waterhouse-friederichson syndrome) chronic - AI, TB, HIV, metastatic tumour (rare= amyloidosis, fungal, hemochromatosis, sarcoidosis)
44
two types of adrenocortical neoplasms
adenomas - mainly functional | carcinomas - rare, usually large, common with virilising syndromes
45
name 2 diseases of the adrenal medulla
phaeochromocytoma | neuroblastoma
46
rule of 10s with phaeos
10 % associatred iwth MEN, CHL, sturge-weber syndromes 10% bilateral 10% malignant 10% paragangliomas
47
what in MEN syndrome
group of inherited conditions causing proliferative lesions of endocrine glands younger age tumours preceded by hyperplasia more aggressive and harder to treat

Year 5 Pathology Revision (106 decks)

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