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Path Y > Histopathology - Endocrine disease > Flashcards

Histopathology - Endocrine disease Flashcards

1
Q

What are the most common causes of hyper- and hypo-pituitarism?

A

Hyperpituitarism: functional adenoma
Hypopituitarism: nonsecretory adenomas/ ischaemic necrosis (post-partum)

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2
Q

What are the 3 symptoms of local mass effect of pituitary tumours?

A 
Bitemporal hemianopia (compression of optic chiasm) 
Elevated ICP 
Obstructive hydrocephalus
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3
Q

Recall 4 differentials for primary hyperthyroidism

A
  1. Grave’s
  2. Hyperfunctioning multinodular goitre
  3. Hyperfunctioning adenoma
  4. de quervain’s thyroiditis
  5. post partum thyroiditis
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4
Q

What is the cause of secondary hyperthyroidism?

A

TSH-secreting pituitary adenoma (rare)

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5
Q

How can struma ovarii cause thyroid disease?

A

Ovarian teratomas can secrete ectopic thyroxine

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6
Q

What autoimmune condition can cause hypothyroidism?

A

Hashimoto’s

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7
Q

Differentiate the type of auto-antibodies involved in Grave’s vs Hashimoto’s

A

Grave’s: anti-TSH
Hashimoto’s: anti-TPO and anti-TG (thyroglobulin)

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8
Q

What is the histological appearance of a Hashimoto’s thyroid?

A

hurtle cell
lymphoid cells

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9
Q

What are the main symptoms of Hashimoto’s?

A

clinically hypothyroid
Painless goitre

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10
Q

Recall 4 differentials for the cause of hypothyroidism

A
  1. Atrophic
  2. Iodine deficiency
  3. Riedel’s thyroidits
  4. Autoimmune (Hashimoto’s)
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11
Q

What is a thyroid adenoma?

A

Benign neoplasm of follicular thyroid epithelium

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12
Q

How are thyroid adenomas diagnosed?

A

FNA and cytology

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13
Q

What is the most common type of thyroid cancer?

A

Papillary

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14
Q

What are the key histological features of papillary thyroid cancer?

A

Optically clear nuclei
Psammoma bodies

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15
Q

Which type of thyroid adenoma is associated with Multiple Endocrine Neoplasia?

A

Medullary

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16
Q

Which type of thyroid cancer is most aggressive?

A

Anaplastic

17
Q

What are the 4 subtypes of thyroid cancer?

A

Follicular
Papillary
Medullary
Anaplastic

18
Q

What is the most common cause of primary hyperparathyroidism?

A

parathyroid adenoma

19
Q

What is secondary hyperparathyroidism almost always caused by?

A

Renal failure

20
Q

Recall 3 possible causes of hypoparathyroidism

A

Surgical ablation
Congenital absence
Auto-immune

21
Q

Recall 4 possible symptoms of hypoparathyroidism

A

Those of hypocalcaemia:
Muscle spasms/ tetany
Cardiac arrhythmias
Fits
Cataracts

22
Q

Recall the synthetic function of each zone of the adrenals

A

GFR Medulla
GFR = adrenal cortex

Zona Glomerulosa =aldosterone [OUTER]

Fasciculata = glucocorticoids

Reticularis = androgens and glucocorticoids (cortex = epithelial cells)

Medulla = noradrenaline/adrenaline [INNER]
(medulla) = neural cells

23
Q

What is Waterhouse-Friedrichson syndrome?

A

acute adrenal insufficiency with sepsis and DIC (bleeding into adrenal gland)

24
Q

which thyroid cancer leads to amyloid deposits in thyroid?

A

medullary
calcitonin broken down and deposited as amyloid
visualised using Congo red stain

25
Q

triad of graves disease

A

exomthalmos
thyrotoxicosis
pretibial myoedoma

26
Q

phaechromo is a tumour of what part of adrenal gland

A

medulla = adrenaline/noradrenaline production

27
Q

2 signs of conn’s

A

Hypertension –
Hypokalaemia

28
Q

what’s cushings syndrome. give 6 features

A

excess glucocorticoids
 HTN Weight gain Truncal obesity “Moon face”
 “Buffalo hump” Cutaneous striae

29
Q

give ACTH dependent and ACTH independent causes of cushings

A

ACTH dependent
Pituitary tumour
– “Cushing’s
disease” (85%)
Ectopic ACTH-producing tumour (5%) (small cell lung cancer, carcinoid tumour)

ACTH independent
drenal adenoma/cancer (10%), adrenal nodular hyperplasia, iatrogenic steroid use

30
Q

what 2 tests for Addisons and cushings

A

Addisons - SynACTHen test
Cushings - 1st line: Overnight dexamethasone suppression test or 24h urinary free cortisol

31
Q

most common virilising syndrome

A

CAH
21 hydroxylase deficiency
Autosomal recessive

Path Y (81 decks)

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