Pathology Flashcards
S/S of prolactinoma?
dec LH and FSH
amenorrhea
galactorrhea
M: dec libido, impotence
tropic tissues involved w/ production of oxytocin?
suckling reflex of breast
internal and external changes involved in acromegaly?
Int: enlarged organs, CHF, HTN, H/A
Ext: prognathism, radial bone growth, teeth seperation, macroglossia
Criteria for macroadenoma? Symptoms?
> 10 mm
bitemporal hemianopsia
criteria for microadenoma?
who gets sheehan’s syndrome?
pregnant, post partum hemorrhaging women
what are the features of empty sella syndrome?
thin flat pituitary due to herniated CSF, seen in obese multiparous women w/ HTN
what is the etiology and diagnostic method for a craniopharyngioma?
suprasellar usually, typical macroadenoma symptoms
DI also high incidence
Post MVA diabetes insipidus, renal function?
lack of con urine -> water loss
what are the effects of ADH?
conc urine, inc water permeability in DCT and CD
what hormones are affected in hypofunction of pituitary?
Children: GH espec, -> dwarfism
Adults: thyroid and adrenal issues, DI
what treatment is done for prolactin secreting adenomas?
bromocryptine (dopamine agonist)
transphenoidal resection
hormones produced by acidophils?
GH and prolactin
hormones produced by basophils?
FSH, LH, ACTH, TSH
hypophyseal portal is between which two organs?
hypothalamus and ant pituitary
what hormones are produced in the post pituitary?
ADH and oxytocin
what axon body secretes ADH?
supraoptic
what axon body secretes oxytocin?
paraventricular
what structure is formed by rathkes pouch?
pars tuberalis, pars distalis, adenohypophosis
what is required for normal secretion of T4 and T3?
Iodine, tyrosine
what is the pathology associated w/ lack of I-?
goiter
major neoplastic conversion seen in hashimoto?
B cell lymphoma
what causes hashimoto thyroiditis?
CD4 act B cell produced ant TPO and anti TG
IgG
what drug is known for bein goiterogenic?
lithium
what countries have high endemic goiters still?
africa, china, himalayas
Reidel’s thyroiditis pathology?
hard fibrosis
one lobe
idiopathic
subabute thyroiditis pathology?
post viral URI
what causes exopthalmos
swollen (lymphocyte stimulating fibroblasts) extra ocular muscles causes proptosis
most characteristic histologic feature of graves?
“moth eaten” colloid
aka scalloped
tropic tissues involved w/ production of oxytocin?
suckling reflex of breast
internal and external changes involved in acromegaly?
Int: enlarged organs, CHF, HTN, H/A
Ext: prognathism, radial bone growth, teeth seperation, macroglossia
Criteria for macroadenoma? Symptoms?
> 10 mm
bitemporal hemianopsia
criteria for microadenoma?
who gets sheehan’s syndrome?
pregnant, post partum hemorrhaging women
what are the features of empty sella syndrome?
thin flat pituitary due to herniated CSF, seen in obese multiparous women w/ HTN
what is the etiology and diagnostic method for a craniopharyngioma?
suprasellar usually, typical macroadenoma symptoms
DI also high incidence
Post MVA diabetes insipidus, renal function?
lack of con urine -> water loss
what are the effects of ADH?
conc urine, inc water permeability in DCT and CD
what hormones are affected in hypofunction of pituitary?
Children: GH espec, -> dwarfism
Adults: thyroid and adrenal issues, DI
what treatment is done for prolactin secreting adenomas?
bromocryptine (dopamine agonist)
transphenoidal resection
hormones produced by acidophils?
GH and prolactin
hormones produced by basophils?
FSH, LH, ACTH, TSH
hypophyseal portal is between which two organs?
hypothalamus and ant pituitary
what hormones are produced in the post pituitary?
ADH and oxytocin
what axon body secretes ADH?
supraoptic
what axon body secretes oxytocin?
paraventricular
what structure is formed by rathkes pouch?
pars tuberalis, pars distalis, adenohypophosis
what is required for normal secretion of T4 and T3?
Iodine, tyrosine
what is the pathology associated w/ lack of I-?
goiter
major neoplastic conversion seen in hashimoto?
B cell lymphoma
what causes hashimoto thyroiditis?
CD4 act B cell produced ant TPO and anti TG
IgG
what drug is known for bein goiterogenic?
lithium
what countries have high endemic goiters still?
africa, china, himalayas
Reidel’s thyroiditis pathology?
hard fibrosis
one lobe
idiopathic
subabute thyroiditis pathology?
post viral URI
what causes exopthalmos
swollen (lymphocyte stimulating fibroblasts) extra ocular muscles causes proptosis
most characteristic histologic feature of graves?
“moth eaten” colloid
aka scalloped
most characteristic histologic feature of graves?
“moth eaten” colloid
aka scalloped
define toxic and non toxic regarding adenomas and goiters?
toxic: causing a state of hyperthyroid
non toxic: euthyroid
what creates granulomatous thyroiditis?
URI
what are the clinical features of hypofunctioning thyroid
Skin: pretibial myxedema
NS: lethargy, slow mentation, paranoia, depression
Heart: dec CO, cardiomegaly, pericardial effusion
GI: constipation
GU: irregular menses, progesterone deficit
Men: erectile dysfunction, oliospermia
characteristics of myxedema?
madness, megacolon, dermopathy, cardiac
metastasis route of papillary carcinoma?
lymphatic
metastasis route of follicular carcinoma?
blood stream
what thyroid cancer doesnt arise from follicles?
Medullary carcinoma ( c cells)
what thyroid cancer is mostly seen in kids?
papillary carcinoma
what thyroid cancer is most common?
papillary carcinoma
what protein is produced by medullary carcinoma?
amyloid
what stain is used to see amyloid?
congo red
would see apple green bifringence
follicular adenoma vs carcinoma characteristics?
adenoma: cold, 1-3 cm, solitary, capsulated, nodule
carcinoma: invading capsule
Psammoma bodies are associated w/ ?
papillary carcinoma
what are the three hereditary components of MEN 2 syndrome?
medullary carcinoma
pheochromocytoma
parathyroid hyperplasia
what are the thyroid hormones and what are their functions?
Triiodothyrinine, thyroxine
regulate metabolism
describe the embryologic migration of thyroid tissue?
behind the tongue, through foramen cecum under the hyoid
location of thyroglossal duct
midline trachea, between hyoid and the isthemus
what does the ultimobranchial body arise from? what does it become?
5th pouch, becomes parafollicular c cells
most common primary hyperparathyroid state
PT adenoma
most common cause of secondary hyperparathyroid?
Chronic renal failure
what are the 3 organ systems involved in PT regulation?
bones, kidneys, GI
NO PITUITARY
what 2 cell types are found in PT?
Principle or chief cells
Oxyphil cells
clinical manifestations of hyperparathyroid
excess PTH high Ca low PO4 osteopenia osteitis fibrosa cystica rena ca stones depression, mental changes hyperreflexia constipation pancreatic issues
clinical manifestations of hypoparathyroid
hypo Ca Hyper PO4 arrhythmia tetany psychosis paranoia depression
what is the function of PTH
inc # and act of osteoclasts in bone
upregulates resorption of Ca, Mg and PO4 in GI
increases resorption of Ca, Mg in kidney
inc excretion of PO4
what organ carries the inferior PT during development and migration?
thymus
Treatment for PT adenoma vs hyperplasia
Adenoma: one enlarged gland removed
Hyperplasia: all 4 glands enlarged, remove three and leave one
What is the most common thyroid tumor in adolescence
Papillary carcinoma
most common cell type involved in benign pituitary prolactinoma?
lactotroph
how do you treat a prolactinoma?
give dopamine agonist like bromocriptine
What type of adenoma is a prolactinoma?
microadenoma
What type of adenoma is a somatotropic adenoma?
macroadenoma
What is the general treatment for macroadenomas?
transphenoidal surgery
what type of adenoma is a corticotropic adenoma?
microadenoma
what are the symptoms of a corticotropic adenoma?
cushings dz
weakness
fatigue
mental instability
What type of adenoma are thyrotropic and gonadotropic?
macroadenomas
what two things do you need to make thyroid hormones?
iodine and tyrosine
What are the symptoms in males for thyrotropic/gonadotropic anenomas?
headache
visual disturbance
hypogonadism
What is the only posterior pituitary disease? what causes it?
diabetes insipidus
caused by decreased ADH
Characteristic signs of diabetes insipidus
diuresis, thirst, polyuria, polydipsia, urinating hypotonic urine
most common cause of hypopituitarism?
adenoma
what two diseases can cause hypopituitarism
hemochromatosis
langerhans cell histocytosis
What are the risk factors for empty sella syndrome?
woman middle aged multiparous HTN obese
What area are craniopharyngiomas found? and how old is the pt?
suprasellar; child or adolescent
what is characteristic of de quarvian thyroiditis?
previous URT
what does colloid look like in graves disease?
looks scalloped or moth eaten
what is myxedema madness?
paranoid ideation and depression w/ hypothyroidism
what is myxedema megacolon?
constipation with hypothyroidism
what is myxedema heart
dilated enlarged heart with pericardial effusion
which thyroiditis is associated with B cell lymphoma
hashimotos thyroiditis
what does the thyroid look like grossly in graves?
firm and dark red
what does the thyroid look like with hashimotos
pale tan and fleshy
what is the characteristic of reidel thyroiditis
stone hard or “woody”
what are the 4 types of thyroid carcinoma
papillary follicular, medullary anaplastic
what carcinoma is associated with orphan annie and psammoma bodies
papillary carcinoma
what thyroid carcinoma is associated with stromal amyloid
medullary carcinoma
which is the worst thyroid cancer and is also associated with a hx of low grade carcinoma of another area?
anaplastic carcinoma
what two things do lithium cause?
parathyroid hyperplasia
hypothyroid
what chromosome is associated with pseudohypoparathyroidism? and what is it?
chromosome 20
target organ insensitivity to PTH
