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Endocrine > Pathology > Flashcards

Pathology Flashcards

0
Q

Prevents unbalanced bone resorption by being a decoy receptor for RANKL

A

Osteoprotegrin

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1
Q

Common complication of malignancy

A

Hypercalcemia
Malignancy is the most common cause of clinically apparent hypercalcemia. It is the result of bone resorption.
Hyperparathyroidism is the most common cause of a symptomatic elevated blood calcium (incidental hypercalcemia).

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2
Q

Causes hypercalcemia in cancers that have not mets

A

PTHrP

Promotes expression of RANKL which binds to RANK on osteoclasts

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3
Q

Symptoms of hypercalcemia

A

Fatigue, weakness, constipation

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4
Q

Symptoms of hyperparathyroidism

A

Nephrolithiasis

Bone disease

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5
Q

Most common cause of secondary hyperparathyroidism

A

Renal failure (causes hypocalcemia)

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6
Q

responsible for narrowed arteriolar lumen and loss of normal medial function in type 2 DM

A

deposition of extracellular matrix = hyaline arteriolosclerosis

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7
Q

enlargement of the lower jaw

A

prognathism

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8
Q

palpable nodule in a normal size thyroid
euthyroid
“cold” or nonfunctional on scintiscan
Orphan Annie nuclei; psammoma bodies

A

papillary carcinoma of thyroid

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9
Q

bilateral asymetrical enlargement of the thyroid
irregularly nodular to palpation
euthyroid

A

multinodular goiter

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11
Q
  • granular eosinophilic cytoplasm = Hurthle cells
  • heavy infiltration by lymphocytes (breakdown in self-tolerance) & germinal center formation
  • diffuse hyperplasia of follicular cells
  • autoimmune disorder with increased susceptibility to other autoimmune disorders
  • low T4
  • elevated TSH
  • painless enlargement of thyroid (diffuse & symmetric)
A

Hashimoto thyroiditis

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11
Q

thyroid nodule that is “cold” on scintiscan is likely to be benign or malignant?

A

malignant (occurs in only 5% of cold nodules but still must be addressed)
“hot” nodules are more likely to be benign

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12
Q

enlargement of part of the thyroid gland with PAIN
inflammatory infiltrate is accompanied by giant cells that surround pre-existing follicles.
age 40-50
likely triggered by a viral infection
multinucleate giant cells

A

DeQuervain thryoiditis (granulomatous)

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13
Q

exposure to this in utero can cause clear cell carcinoma of the vagina and uterine cervix

A

diethylstilbestrol = synthetic estrogen given to women with high risk pregnancies

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14
Q

less aggressive breast carcinoma with islands of cells floating in basophilic mucous

A

colloid carcinoma

usually ER+, PR+, HER2 -

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15
Q

large, polyhedral cells with distinct cell membranes
clear cytoplasm
prominent nucleoli
testicular

A

seminoma

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16
Q

acute adrenal insufficiency with fulminant sepsis and DIC associated most frequently with Neisseria meningitidis

A

Waterhouse-Friderichsen syndrome

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17
Q

tumors composed of two or more derivatives of the three primary germ cell layers

A

teratoma

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18
Q

mass containing hair, sebum & teeth, commonly found in the ovary but rarely in the testis

A

dermoid cyst = mature cystic teratoma

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19
Q

Mass consisting of small, uniform, tightly crowded tubules lined by Sertoli cells. The Sertoli cells have abundant pale cytoplasm and regular, uniform nuclei without atypia or mitotic activity. Inguinal hernia. Commonly associated with what?

A

complete androgen insensitivity syndrome

female with congenital absence of uterus and karyotype XY

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20
Q

most common cause of amenorrhea in women in reproductive years

A

pregnancy

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21
Q

Why are high levels of androgens observed in PCO?

A

high levels of insulin inhibit synthesis of sex hormone binding globulin
Typical labs: low FSH, high LH, low estradiol, high DHEA & testosterone

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22
Q

clinical syndrome of (usually unilateral) pain and inflammation of the epididymis and often teste that lasts less than six weeks

A

acute epididymitis

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23
Q

metabolic bone disease that occurs as a complication (one of the causes for bone pain) of primary hyperparathyroidism

A

Osteitis fibrosa cystica

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24
Q

postpartum pituitary ischemic necrosis associated with hemorrhage and shock during childbirth

A

Sheehan syndrome
Pituitary enlarges during pregnancy, but it’s blood supply doesn’t enlarge proportionally. Posterior pituitary gets blood supply from arterial branches so is less susceptible to ischemia

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25
Q

surgically treatable HTN from aldosterone-secreting adenoma

A

Conn syndrome = adrenal cortical adenoma

26
Q

deletion of chromosome 22q produces abnormalites in the 3rd and 4th pharyngeal pouches, which form thymus and parathyroids. Absence of parathyroids leading to hypocalcemia and hypoparathyroidism

A

DiGeorge syndrome

27
Q 
tumor that originates from the remnant of the Rathke pouch
Most are suprasellar
dystrophic calcification; cyst formation
Bimodal distribution
Adult: headaches, visual disturbances
Child: growth retardation
A

craniopharyngioma

28
Q

enzyme deficiency in congenital adrenal hyperplasia

A

21 alpha hydroxylase

29
Q

carcinomas of thyroid first present as a lymph node metastasis

30
Q

causes cretinism

A

absence of thyroid gland

31
Q

pheochromocytoma, medullary carcinoma of the thyroid, and parathyroid hyperplasia
Associated with RET germline gain of function mutation

A

MEN2A = Sipple syndrome

32
Q

associated with poor outcome of neuroblastoma

33
Q

local deposition of amyloid is associated with what type of thyroid tumor?

A

medullary carcinoma

Medullary carcinoma of the thyroid originates in C cells

34
Q

Causes bacterial vaginosis

A

Gardnerella

Tx: metronidazole

35
Q

Rashes that involve the palms and soles of feet

A
  1. Rocky Mtn Spotted Fever
  2. Secondary syphilis
  3. Hand, foot, mouth disease (Coxsackie virus)
36
Q

What type of condyloma is associated with syphilis?

A

condyloma lata

37
Q

cell clearing associated with HPV

A

koilocytosis

This is not associated with malignant neoplasms

38
Q

tumor in young children that resembles grapes

A

embryonal rhabdomyosarcoma

39
Q

Is the finding of superficial cells in an 80 yr old female a normal finding?

A

no. Basal cell maturation in the vagina to superficial cells is under the influence of estrogen.

40
Q

Where are cervical neoplasms most likely?

A

Transformation zone of the endocervix

41
Q

most frequent cause of death in squamous cell carcinoma of the cervix

A

renal failure (uremia) from obstructed ureter

42
Q

large amount of bleeding at time other than menstruation

A

metrorrhagia

43
Q

bleeding at time of menstruation

A

menorrhagia

44
Q

large amount of bleeding at menstruation and other times

A

menometrorrhagia

45
Q

inactivation of this tumor suppressor gene is associated with what uterine condition?

A

endometrial hyperplasia

Not a problem until unopposed estrogen present

47
Q

benign uterine neoplasms of the smooth muscle; very common (1 in 4) and responsive to the hormones of pregnancy

A

leiomyomata = fibroids

Note: leiomyosarcomas ARE malignant

48
Q
  1. Primary hyperParathyroidism
  2. tumors of endocrine Pancreas (gastrinoma, insulinomas)
  3. Prolactinoma in anterior pituitary
    “3 P’s”
A

MEN-1 = Wermer syndrome

germline mutations in MEN1 tumor suppressor gene

49
Q
  1. medullary thyroid carcinoma
  2. pheochromocytoma
  3. neuroma or ganglioneuroma (skin, eyes, GI tract, resp tract)
    long axial skeleton (like marfan)
    constitutive activation of RET
50
Q

What is the therapeutic recommendation for all germline mutations of RET?

A

prophylactic thyroidectomy to avoid medullary carcinoma

51
Q

hallmark of hypocalemia

52
Q

cell type that is the source of pancreatic tumors that cause carcinoid syndrome

A

enterochromaffin cells

These synthesize serotonin.

53
Q

blood glucose

A

insulinoma (pancreatic tumor -> usually benign)

54
Q

tumor of the endocrine cells of the gut or pancreas
severe peptic ulceration**
some seen with MEN-1

A

Zollinger-Ellison syndrome (gastrinoma)

55
Q

typical presentation for nonfunctioning pituitary adenoma

A

mass effects

56
Q

typically presentation: obese female with history of multiple pregnancies
visual defects
OR hx of radiation or surgery to pituitary

A

empty sella syndrome

57
Q

most common causes of thyrotoxicosis

A
  1. diffuse hyperplasia associated with Graves disease
  2. hyperfunctional multinodular goiter
  3. hyperfunctional adenoma of thyroid
58
Q

What causes the symptoms of thyrotoxicosis?

A

increased metabolic rate

overactivity of the sympathetic nervous system

59
Q

cause of congenital hypothyroidism

A

endemic iodine deficiency

60
Q

most common cause of hypothyroidism in iodine-sufficient areas of the world

A

autoimmune, most of which are Hashimoto thyroiditis

61
Q 
severe mental retardation
short stature
coarse facial features
protruding tongue
umbilical hernia
A

cretinism

degree depends on if there was maternal thyroid deficiency before development of fetal thyroid

62
Q

extensive fibrosis of the thyroid & contiguous neck structures

A

Reidel thyroiditis

63
Q

What causes acute endometritis?

A

retained products of conception

Group A strep, staph

64
Q

pruritus, labial atrophy, introitus narrows, skin has a thinned whitish appearance

A

Lichen sclerosis et atrophicus

Increased risk of vulvar squamous carcinoma

Endocrine (11 decks)

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