L2 - Nuts and Bolts of Endo (pathology) COPY Flashcards
ENDOCRINE GLANDS
i) duct or no duct?
ii) which organ is both exo and endocrine?
iii) describe the neuroendocrine action of a hormone - give an example
iv) what type of secretory cells are present?
v) which cell type support the secretory cells?
vi) name two endocrine glands that dont have a lumen and secrete directly into the blood
i) ductless glands
ii) pancreas
iii) neural stimulation of endocrine cells causes them to secrete hormones
- happens in the medulla of the adrenal gland
iv) cuboidal secretory cells
v) myoepithelial cells support the secretory cells
vi) pituitary and parathyroid glands secrete directly into the blood
ANTERIOR PITUITARY GLAND
i) what are the three cell types present in the ant pit based on the dyes they take up?
ii) what colour cytoplasm does each have? label A and B on the diagram
iv) name the five morphological cell types in the ant pit and what they secrete
v) what two hormones are secreted by the post pit and what is their function?
i) acidophils (take up acid), basophils (take up basic dyes) and chromophobe (no spec staining)
ii) acidophil = cyto is pink and dark nuclei
basophil - cyto is blue
A = acidophil and B = basophil
iv) thyrotrope - TSH
- gonadotrope - FSH and LH
- lactotrope - prolactin
- somatotroph - growth hormone
- corticotrope - ACTH
v) oxytocin = contrac of uterine smooth mucle in chilbirth and ejection of milk in breastfeeding
ADH = abs of water in kidneys which concentrates urine
PATHOLOGY OF THE PIT GLAND
i) which lobe do pituitary adenomas arise from? what are the two types
ii) what % of intracranial neoplasms do they constitute
iii) what can productive adenomas cause?
iv) what can pressure effect of tumours cause?
v) name three symptoms associated with space occupying effects of adenomas
i) anterior lobe
- functional (hormone prod) or non func (non hormone prod)
ii) 10%
iii) productive adenomas can cause hyperpituitarism
iv) pressure effects can cause hypopituitarism
v) nausea, headaches, impaired vision/diplopia
THYROID GLAND
i) which two hormones does it synth and what do these regulate?
ii) which ion does synthesis of these hormones require? what does lack of this ion cause in the thyroid gland? why?
iii) what do the follicles in the thyroid gland contain? what other cells are found?
iv) is the thyroid gland very vascular? what is the arrangement of epthelial cells that like the caps? what does this allow?
i) T3 and T4 regulate metabolic rate
ii) synthesis needs iodine
- lack of iodine causes enlargement of the thyroid (goitre) to allow it abs the max conc of iodine
iii) follicles contain colloid
- also have myoepithelial cells
iv) thyoid is very vascular
- endo cells are fenestrated in capillaries which allows passage of hormones into the circulation
PATHOLOGY OF THE THYROID GLAND
i) what thyroid function may be seen in
a) goitre, b) graves disease, c) hashimoto disease, d) adenoma, e) cancer
ii) what leads to goitre formation? name two ways the thyroid cells have changed? why are these patients euthyroid
iii) what complication can occur post thyroidectomy? explain. how can this be avoided?
i) goitre = euthyroid
graves disease = hyperthyroid
hashimoto = hypothyroid
adenoma = euthyroid
cancer = euthyroid
ii) lack of iodine causes goitre formation
- hyperplasia and hypertrophy of the thyroid cells
- euthyroid as increase in size overcomes hormone defic
iii) tracheomalacia due to goitre compressing trachea so when it is removed the trachea collapses and obstructs airway
- avoid by assessing radiology pre op
GRAVES DISEASE
i) what happens?
ii) what happens to the thyroid/thyroid cells
iii) name two ways in which it can present
iv) what TSH, T3 and T4 levels will be seen?
v) what may be seen in the colloid of thyroid follicles?
i) auto antibodies stimulate TSH receptors
ii) thyroid increases in size and there is hyperplasia
iii) presents with
- infiltrative opthalmology - accum of soft tissue and inflam cells behind eye > proptosis (protrusion of eyeball)
- infiltravtive dermopathy - thickening of skin on anterior shin called pre-tibial myxoedema
iv) low TSH, high T3 and T4
v) colloid will have ‘soapy’ appearance/bubbly colloid
HASHIMOTOS THYROIDITIS
i) what is it the most common cause of? what happens?
ii) what happens to thyroid cells?
iii) what TSH, T3 and T4 levels are seen?
iv) what may be seen on histological section?
i) most common cause of hypothyroidism
- autoimmune destruction of thyroid tissue
ii) depletion of thyroid cells that are replaced by inflammation and fibrosis
iii) high TSH and low T3/T4
iv) histol = prominent lymphocytic infiltration and inflammation
which conditions are characteristic of histol slides A and B
A = Graves disease (bubbly colloid) B = hashimoto disease (lymphocytic infiltration)
THYROID TUMOURS
i) what is the most common type of thyroid tumour? is this malignant or benign?
ii) what are the four main types of carcinoma? what is the most common type?
iii) which type of carcinoma is associated with MEN 2 syndrome? which cells does this arise from?
iv) which carcinoma mostly affects older patients and has a poorer prognosis?
i) most common = follicular adenoma = benign tumour of follicle cells
ii) carcinoma = papillary, follicular, medullary and anaplastic
iii) medullary is associated with MEN2 and arises from C cells
iv) anaplastic carcinoma mostly affects elderly and has poor prognosis
PARA FOLLICULAR CELLS
i) what are they aka?
ii) what do they secrete? what does this cause in the blood?
iii) where are they found?
iv) which cancer originates from these cells?
i) C cells
ii) secrete calcitonin which reduces calcium concentration in the blood
iii) found between the follicles
iv) origin of medullary carcinoma of the thyroid
PARATHYROID GLANDS
i) what do they secrete? what is this in response to?
ii) which cell type in the PT glands secretes the hormone? do they have a lumen?
iii) does the PT gland have secretory or myoepithelial cells?
iv) what tumour can be found in the PT glands? how many glands does this affect? what does this cause?
v) what pathology involves all four glands? what does this cause?
i) secrete parathyroid hormone in response to low blood calcium
ii) chief cells secrete PTH - dont have a lumen
iii) no secretory or myoep cells - secretes straight into the blood
iv) adenoma (benign prolif of chief cells) can be found in one gland
- causes hypercalcaemia
v) hyperplasia = all four glands
- also causes hypercalcaemia
ADRENAL GLANDS
i) what colour are they normally? why?
ii) name the three cortical layers and what each produces
iii) why do cells appear pale on histology?
iv) what type of cells are seen in each layer? label A, B, C
i) orange/yellow because they are rich in lipids
ii) zona glomerulosa - mineralocorticoid
zona fasciculata - glucocorticoid
zona reticularis - sex hormones
iii) chemical processing washes out the lipid
iv) ZG - close packed round cells (A)
ZF - cells in cords (B)
ZR - small and dark cells (C)
ADRENAL GLANDS - PATHOLOGY
i) name three rare causes of adrenal hyperactivity
ii) name three syndromes that are characterised by adrenocortical hyperactivity and what is overproduced in each
iii) what disease is charac by adrenocortical insufficiency
i) hyperplasia, adenoma and cancer
ii) cushings - excess cortisol
conns - excess aldosterone
adrenogenital - excess androgens
iii) addisons disease
ADRENAL MEDULLA
i) which two hormones are produced from compact cells?
ii) what does secretion of these result in? which fibres does this involve
iii) do medullary cells stain darker or lighter than the adrenal cortical cells?
i) adrenaline and noradrenaline
ii) secretion results in vasoconstriction, inc HR and blood sugar
- involves post ganglionic symp fibres
iii) medullary cells stain darker
PHEOCHROMOCYTOMA
i) what is it a tumour of?
ii) which five things does pheo account for 10% of?
iii) what is the most common presentation? why is this
iv) name four things a patient may also present with
i) the adrenal medulla
ii) 10% are familial (MEN2), malignant, bilateral, childhood and extra adrenal
iii) high blood pressure is the most common pres as there are high levels of catecholamines
iv) high BP + tachycardia, palpitations, headache, sweats, tremor
