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Endocrine Exam 2 > Path: Thyroid and Parathyroid > Flashcards

Path: Thyroid and Parathyroid Flashcards

1
Q

How can a parathyroid adenoma be differentiated from normal pituitary tissue on microscopy?

A

Normal tissue has lipid droplets scattered in the tissue, adenomas will not.

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2
Q

Most common cause of primary hyperparathyroidism.

A

Solitary Parathyroid Adenoma

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3
Q

What type of primary hyperparathyroidism typically involves all four parathyroid glands?

A

Primary Hyperplasia of the Parathyroids

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4
Q

Cell type that is characteristic for Primary Parathyroid Hyperplasia.

A

Water-clear cells

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5
Q

Best way to differentiate a parathyroid carcinoma from hyperplasia or an adenoma.

A

The carcinoma will inavade the surrounding tissue and have a dense fibrous capsule.

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6
Q

What is Osteitis Fibrosa Cystica?

A

Fibrous tissue formation in the bone marrow along with hemorrhage and cyst formation resulting from osteoporotic changes due to hyperparathyroidism.

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7
Q

What are brown tumors?

A

Tumors that are brown in color.

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8
Q

What really are brown tumors?

A

Aggregates of osteoclasts, reactive giant cells, and hemorrhagic debris seen in hyperparathyroidism

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9
Q

Type of calcification that occurs in the lungs, stomach, kidneys, myocardium and blood vessels in hyperparathyroidism.

A

Metastatic Calcification: calcium aggregation due to malfunction in calcium metabolism

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10
Q

When present, what are the symptoms of hyperparathyroidism?

A

Bones, stones, groans, moans

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11
Q

Most common cause of secondary hyperparathyroidism.

A

Renal Failure

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12
Q

Mechanism of hyperparathyroidism secondary to renal failure.

A
  1. Renal failure leads to decreased excretion of phosphates
  2. Phosphates acuumulate in the blood and bind free calcium.
  3. Parathyroids detect low levels of free calcium and secretes tons of PTH.
  4. PTH causes bone resorption and calcium reabsorption in kidneys leading to hypercalcemia
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13
Q

What is calciphylaxis?

A

Vascular calcification associated with secondary hyperparathyroidism, ischemic changes to the skin and other organs occurs.

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14
Q

Most common congenital cause of hypoparathyroidism.

A

DiGeorge Syndrome

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15
Q

Hallmark of hypocalcemia

A

Tetany

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16
Q

What is pseudohypoparathyroidism and how is it diagnosed?

A

It is PTH resistance.

Patients will have symptoms of hypoparathyroidism but the PTH levels will be elevated.

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17
Q

3 most common causes of Thyrotoxicosis (a form of hyperthyroidism).

A
  1. Diffuse hyperplasia of thyroid due to Graves
  2. Hyperfunctional Multinodular Goiter
  3. Hyperfunctional Adenoma of the Thyroid
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18
Q

Most common cause of hypothyroidism in the developed world.

A

Autoimmune Hypothyroidism

Hashimoto Thyroiditis

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19
Q

Three major Ab types seen in Autoimmune Hypothyroidism.

A
  1. Anti-microsomal
  2. Anti-Thyroid Peroxidase
  3. Anti-thyroglobulin
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20
Q

What are causes of secondary hypothyroidism?

A

Any damage to the anterior pituitary leading to decreased levels of TSH:
pituitary tumor, postpartum pituitary necrosis (Sheehan), trauma

(anything that affects the hypothalamus can have an effect also)

21
Q

Pathology of Hashimoto thyroiditis

A

Either Anti-microsomal Abs, Anti-Thyroglobulin Abs, or Anti-TPO Abs. Or even a combination of the three. Leads to inflammation and destruction of thyroid tissue.

22
Q

Microscopic characteristic of Hashimoto Thyroiditis.

A

Hurthle Cells

-eosinophilic granular cytoplasm

23
Q

Most common cause of thyroid pain.

A

Subacute Granulomatous Thyroiditis (De Quervain Thyroiditis)

24
Q

Cause of DeQuervain Thyroiditis.

A

Viral

-Coxsackie, mumps, measles, adeno

25
Q

Microscopic Characteristic of DeQuervain Thyroiditis.

A

Multinucleate Giant cells

  • early manifestation will have neutrophilic infiltrate
  • later will have lymphocytic
26
Q

Pathology of Subacute Lymphocytic Thyroiditis.

A

Painless Thyroiditis

Anti-TPO Abs lead to a lymphocytic infiltration of thyroid follicles.

27
Q

What is Reidel Fibrosing Thyroiditis?

A

Chronic thyroid inflammation with extensive fibrosis that involves surrounding musculature and even the airway.

28
Q

Triad of Graves Disease

A

Hyperthyroidism
Exophthalmos
Pre-tibial myxedema

29
Q

How do the thyroid follicles appear in Graves Disease?

A

Pale with scalloped margins

30
Q

Type of diffuse goiter that is caused by ingestion of substances that interfere with thyroid hormones or enzymatic defects that prevent thyroid hormone synthesis.

A

Sporadic Goiter

31
Q

Type of diffuse goiter commonly seen in Andes and Himalayan regions due to iodine deficiency.

A

Endemic Goiter

32
Q

Type of goiter that has a huge amount of colloid surrounded by small inactive epithelial follicular cells.

A

Multi-nodular goiter.

Most simple diffuse goiters eventually form into a multi-nodular goiter.

33
Q

Average mass of multinodular goiters.

A

Can be over 2kg

34
Q

Best way to diagnose and assess thyroid neoplasms.

A

Radioactive Iodide Uptake
Greater uptake = hot nodule: Graves Disease
Less uptake = cold nodule: adenoma, carcinoma

35
Q

Hallmark of Follicular Adenoma on microscopy.

A

Presence of Intact, well formed, capsule around the tumor.

No nuclear changes in the follicular cells

36
Q

Thyroid carcinoma that often metastasizes by Hematogenous spread to the bone, lungs, liver.

A

Follicular Carcinoma

37
Q

Thyroid carcinoma that has Orphan Annie Eye Nuclei (dispersed chromatin)

A

Papillary Carcinoma

38
Q

Thyroid carcinoma that has psammoma bodies

A

Papillary carcinoma

39
Q

Thyroid carcinoma that is almost 100% deadly.

A

Anaplastic Carcinoma

40
Q

Thyroid carcinoma that metastasizes to lymph nodes.

A

Papillary Carcinoma

41
Q

Thyroid carcinoma that has Amyloid deposition.

A

Medullary Carcinoma

42
Q

Thyroid carcinoma that is caused by ionizing radiation exposure.

A

Papillary Carcinoma

43
Q

Thyroid carcinoma that derived from parafollicular cells and secretes calcitonin.

A

Medullary Carcinoma

44
Q

Which type of Diabetes Mellitus has Amyloid deposition?

A

Type 2

45
Q

What is the most consistent morphological feature of Diabetes Mellitus?

A

Diabetic Microangiopathy

-diffuse thickening of vessel basement membrane

46
Q

Most common glomerular lesion seen in diabetes.

A

Nodular Glomerulosclerosis

  • Kimmelstiel-Wilson Disease
  • dilated capillary loops due to microvessel basement membrane thickening
  • intercapillary fibrosis
47
Q

Most common pancreatic endocrine neoplasm.

A

Insulinoma

-episodes of hypoglycemia leading to confusion, stupor, syncope

48
Q

What is Zollinger Ellison Syndrome?

A

Gastrinoma of the pancreatic islet cells.

  • results in severe peptic ulceration due to hypersecretion of gastric acid
  • jejunal ulcers also occur

Endocrine Exam 2 (11 decks)

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