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Endocrine Pathology > Pathology > Flashcards

Pathology Flashcards

1
Q

Nonfunctional tumors often present with mass effect like…

A

Bitemporal hemianopsia(Due to Optic Chiasm compression)
Hypopituitarism(due to pituitary compression)
Headache

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2
Q

What is the most common type ofpituitary adenoma?

A

Prolactinoma

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3
Q

Prolactinoma presents as…

A

galactorrhea and amenorrhea in Females
decreased libido and headache in males

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4
Q

Treatment of Prolactinoma is?

A

dopamine agonists (e.g., bromocriptine or cabergoline), decreases Prolactin secretion, shrinking tumor
Or
Surgery for larger tumors

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5
Q

Symptoms of Growth hormone cell adenoma are?

A

Gigantism in children(increased linear bone growth (epiphyses are not fused))
Acromegaly in adults
i. Enlarged bones ofhands, feet, and jaw
ii. Growth ofvisceral organs leading to dysfunction (e.g., cardiac failure)
iii. Enlarged tongue

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6
Q

Secondary diabetes mellitus is often present in?

A

Growth hormone cell adenoma because GH causes liver gluconeogenesis.

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7
Q

How do you diagnose a Growth hormone cell adenoma?

A

There is elevated GH and insulin growth factor-1 (IGF-1) levels along with lack ofGH suppression by oral glucose

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8
Q

What is the treatment for Growth hormone cell adenoma?

A

Treatment is octreotide (somatostatin analog that suppresses GH release), GH receptor antagonists, or surgery.

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9
Q

ACTH cell adenomas leads to?

A

Cushing syndrome

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10
Q

HYPOPITUITARISM is defined as?

A

Insufficient production ofhormones by the anterior pituitary gland; symptoms arise when > 75% ofthe pituitary parenchyma is lost.

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11
Q

HYPOPITUITARISM can be due to?

A
  1. Pituitary adenomas (adults) or craniopharyngioma (children) - due to mass effect or pituitary apoplexy (bleeding into an adenoma)
  2. Sheehan syndrome - pregnancy-related infarction of the pituitary gland
    i. Gland doubles in size during pregnancy, but blood supply does not increase significantly; blood loss during parturition precipitates infarction.

3.Empty sella syndrome-congenital defect of the sella
i. Herniation of the arachnoid and CSF into the sella compresses and destroys the pituitary gland.
ii. Pituitary gland is “absent” (empty sella) on imaging.

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12
Q

Symptoms of Sheehan symdromes are?

A

poor lactation, loss of pubic hair, and fatigue

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13
Q

Most common cause of Hyperpituitarism is?

A

Adenoma

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14
Q

Pathogenesis of pituitary adenomas?

A

•G-protein mutations
•Familial pituitary adenomas
•Mutations of p53

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15
Q

What genes cause Familial pituitary adenomas?

A

MEN1, CDKN1B, PRKAR1A, and AIP(men, apes, couldnt park in 1b amd 1a)

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16
Q

What gene cause pituitary carcinomas?

A

Carcinoma:HRAS( carcinomas harrass)

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17
Q

What genes cause Aggressive adenoma?

A

CyclinD1,Rb,P53

18
Q

Hyperprolactinemia can be due to?

A

pregnancy
nipple stimulation
response to many types of stress
estrogens
renal failure,
hypothyroidism,
stalk effect.
several classes of drugs like dopamine inhibitory drugs.

19
Q

GH stimulates ….?

A

the hepatic secretion of insulin-like growth factor I

20
Q

Hypopituitarism accompanied by evidence of posterior pituitary dysfunction in the form of diabetes insipidus is almost always of ….?

A

hypothalamic origin.

21
Q

What are some clinical manifestations of Hypopituitarism?

A

 Children can develop growth failure (pituitary dwarfism) due to growth hormone deficiency.
 Gonadotropin (GnRH) deficiency
 Women: amenorrhea and infertility
 Men: decreased libido, impotence, and loss of pubic and axillary hair in men.
 TSH and ACTH deficiencies
 hypothyroidism and hypoadrenalism,
 Prolactin deficiency: lack of post partum lactation
 MSH deficiency: pallor

22
Q

ADH deficiency causes what?

A

Diabetes insipidus

23
Q

Symptoms of Nephrogenic DI?

A

• excessive urination(polyuria)
• Serum sodium and osmolality ↑
• thirst and polydipsia

24
Q

How many glands in the Parathyroid gland?

A

4

25
Q

Describe the parathyroid gland

A

yellow-brown, ovoid encapsulated nodule

26
Q

the most common endocrine disorder is?

A

Primary Hyperparathyroidism

27
Q

Hyperparathyroidism is an important cause of?

A

hypercalcemia

28
Q

Parathyroid adenomas are almost always …..?

A

solitary

29
Q

Parathyroid adenomas look …..?

A

well-circumscribed, soft, tan to reddish-brown nodule, and 0.5 to 5.0grams
Often on 1/4 of the glands
Other glands are normal or shrunk
Well defined capsule

30
Q

Pathogenesis of parathyroid adenomas includes:

A

Cyclin D1 inversions
Men1 mutations

31
Q

Parathyroid hyperplasia has….?

A

Affects are 4 glands
Chief cell hyperplasia
Stromal fat is inconscipcuous
Water clear

32
Q

Parathyroid carcinoma is diagnosed by…?

A

white, irregular masses

invasion of surrounding tissues and metastasis are the only reliable criteria of malignancy

Single gland

33
Q

Morphologic changes that occur in other organs due to hyperparathyroidism

A
  1. osteitis fibrosa cystica.
  2. Brown tumor(aggregates of osteoclasts)
    Urinary tract stones (nephrolithiasis)
    Metastatic calcification secondary to hypercalcemia
    GI disturbance: peptic ulcer, gall stone
34
Q

Causes of secondary hyperparathyroidism:

A

• Renal failure (the most common cause)
• Inadequate dietary intake of calcium,
• steatorrhea,
• vitamin D deficiency,

35
Q

causes of hypoparathyroidism:

A
  1. Surgically induced hypoparathyroidism
  2. Congenital absence of all glands
36
Q

The major clinical manifestations of hypoparathyroidism are

A

referable to hypocalcemia
• Increased neuromuscular irritability(tingling, muscle spasm carpopedal spasm, tetany)
• Cardiac arrhythmia
• Increased ICP
• seizure

37
Q

Primary Causes of thyrotoxicosis associated with hyperthyroidism:

A

Diffuse toxic hyperplasia(Grave’s disease)
Hyperfunctioning multinodal goiter
Hyper functioning adenoma

38
Q

Secondary causes of toxicosis associated with hypertbyroidism:

A

TSH-secreting pituitart adenoma(rare)

39
Q

Causes of thryotoxicosis not associated with hyperthyroidism

A

Subacute granuloumatous thyroiditis(painful)

Subacute lymphocytic thyroiditis(painless)

Struma ovarii(ovarian teratoma)

Factitious thyrotoxicosis(from exogenous intake of thyroxine)

40
Q

Most common cause of primary hyperthyroidism is?

A

Grave’s disease

Endocrine Pathology (2 decks)

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