Pathology Flashcards
Acute Primary adrenal insufficiency from adrenal hemorrhage associated with Neisseria Meningitidis septicemia, DIC, and endotoxic shock
Waterhouse-Friderichsen Syndrome
Pituitary change from normal granular, basophilic ACTH-producing cell cytoplasm to pale and homogenous cytoplasm from Keratin filament deposition
Crooke Hyaline Change
Episodic Hyperadrenergic Symptoms associated with Pheochromocytoma
Pressure (increased BP), Pain (Headache), Perspiration, Palpitations (tachycardia), Pallor
Pheochromocytoma Cells Derived From
Chromaffin Cells of the Neural Crest
Rule of 10’s with Pheochromocytoma
10% malignant 10% bilateral 10% extra-adrenal 10% calcify 10% kids
Arrhythmia associated with hyperthyroidism
Atrial Fibrillation
Most common cause of hypothyroidism in iodine sufficient areas due to autoimmune disorder associated with HLA-DR5.
Hashimoto’s Thyroiditis
Atrophic Thyroid Follicles with eosinophilic granular cytoplasm in residual follicular cells
Hurthle Cells
Histology includes Hurthle Cells and lymphocytic infiltrate with germinal centers.
Hashimoto’s Thyroiditis
Findings include moderately enlarged, nontender thyroid with antithyroglobulin and/or antimicrosomal antibodies
Hashimoto’s Thyroiditis
- Pot-bellied, Pale, Puffy-faced child with Protruding Umbilicus and Protuberant Tongue.
- Findings also include mental retardation, short stature, and coarse facial features
Cretinism
Due to severe fetal hypothyroidism.
Cretinism
Self-limited hypothyroidism often following a flu-like illness with granulomatous inflammation (Multinucleate Giant Cells).
Subacute Thyroiditis (de Quervain’s or Granulomatous)
Findings include increased ESR, jaw pain and very TENDER thyroid
Subacute thyroiditis (de Quervain’s or Granulomatous)
Thyroid replaced by fibrous tissue with fixed, rock hard, painless goiter. Thought to be a manifestation of IgG4 related systemic disease.
Riedel’s Thyroiditis (young females)
Findings include Hypercalcemia, hypercalciuria (renal stones), hypophosphatemia, increased PTH, increased ALP, increased cAMP in urine. May present with weakness and constipation.
Primary Hyperparathyroidism (Stones, Bones, and Groans!) - Usually due to adenoma!
Findings include Hypocalcemia, hyperphosphatemia in chronic renal failure, increased ALP, and increased PTH.
Secondary Hyperparathyroidism
Secondary Hyperparathyroidism presents with hyperplasia, why?
Renal Disease –> decreased Vit D –> decreased Ca 2+ –> increased phosphate –> increased PTH (and subsequent hyperplasia) –> increased ALP
Cystic bone spaces filled with brown fibrous tissue (lotsa pain!)
Osteitis Fibrosa Cystica (associated with primary hyperparathyroidism)
Tapping of Facial Nerve leads to contraction of facial muscles
Chvostek’s Sign
Occlusion of brachial artery with BP cuff leads to carpal spasm
Trousseau’s Sign
Autosomal dominant kidney unresponsiveness to PTH results in hypocalcemia, shortened 4th/5th digits, short stature, and increased PTH due to a defect in the Gs protein
Albright’s Hereditary Osteodystrophy
Presents with Parathyroid Tumors, Pituitary Tumors (Prolactin or GH), and Pancreatic Endocrine Tumors (Zollinger-Ellison syndrome, insulinomas, VIPomas, or glucagonomas) and commonly presents with kidney stones and stomach ulcers.
Multiple Endocrine Neoplasia 1 (MEN-1, Wermer’s Syndrome)
- Remember to draw a diamond connecting the Pituitary, the two Parathyroids, and the Pancreas.
Presents with medullary thyroid carcinoma (secretes calcitonin), Pheochromocytoma, and Parathyroid Tumors
MEN-2A, remember to draw a square (2 P’s)
