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REM II > Pathology > Flashcards

Pathology Flashcards

1
Q

S/S of prolactinoma?

A

dec LH and FSH
amenorrhea
galactorrhea
M: dec libido, impotence

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2
Q

tropic tissues involved w/ production of oxytocin?

A

suckling reflex of breast

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3
Q

internal and external changes involved in acromegaly?

A

Int: enlarged organs, CHF, HTN, H/A
Ext: prognathism, radial bone growth, teeth seperation, macroglossia

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4
Q

Criteria for macroadenoma? Symptoms?

A

> 10 mm

bitemporal hemianopsia

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5
Q

criteria for microadenoma?

A
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6
Q

who gets sheehan’s syndrome?

A

pregnant, post partum hemorrhaging women

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7
Q

what are the features of empty sella syndrome?

A

thin flat pituitary due to herniated CSF, seen in obese multiparous women w/ HTN

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8
Q

what is the etiology and diagnostic method for a craniopharyngioma?

A

suprasellar usually, typical macroadenoma symptoms

DI also high incidence

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9
Q

Post MVA diabetes insipidus, renal function?

A

lack of con urine -> water loss

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10
Q

what are the effects of ADH?

A

conc urine, inc water permeability in DCT and CD

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11
Q

what hormones are affected in hypofunction of pituitary?

A

Children: GH espec, -> dwarfism
Adults: thyroid and adrenal issues, DI

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12
Q

what treatment is done for prolactin secreting adenomas?

A

bromocryptine (dopamine agonist)

transphenoidal resection

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13
Q

hormones produced by acidophils?

A

GH and prolactin

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14
Q

hormones produced by basophils?

A

FSH, LH, ACTH, TSH

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15
Q

hypophyseal portal is between which two organs?

A

hypothalamus and ant pituitary

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16
Q

what hormones are produced in the post pituitary?

A

ADH and oxytocin

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17
Q

what axon body secretes ADH?

A

supraoptic

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18
Q

what axon body secretes oxytocin?

A

paraventricular

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19
Q

what structure is formed by rathkes pouch?

A

pars tuberalis, pars distalis, adenohypophosis

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20
Q

what is required for normal secretion of T4 and T3?

A

Iodine, tyrosine

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21
Q

what is the pathology associated w/ lack of I-?

A

goiter

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22
Q

major neoplastic conversion seen in hashimoto?

A

B cell lymphoma

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23
Q

what causes hashimoto thyroiditis?

A

CD4 act B cell produced ant TPO and anti TG

IgG

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24
Q

what drug is known for bein goiterogenic?

A

lithium

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25
Q

what countries have high endemic goiters still?

A

africa, china, himalayas

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26
Q

Reidel’s thyroiditis pathology?

A

hard fibrosis
one lobe
idiopathic

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27
Q

subabute thyroiditis pathology?

A

post viral URI

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28
Q

what causes exopthalmos

A

swollen (lymphocyte stimulating fibroblasts) extra ocular muscles causes proptosis

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29
Q

most characteristic histologic feature of graves?

A

“moth eaten” colloid

aka scalloped

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30
Q

tropic tissues involved w/ production of oxytocin?

A

suckling reflex of breast

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31
Q

internal and external changes involved in acromegaly?

A

Int: enlarged organs, CHF, HTN, H/A
Ext: prognathism, radial bone growth, teeth seperation, macroglossia

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32
Q

Criteria for macroadenoma? Symptoms?

A

> 10 mm

bitemporal hemianopsia

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33
Q

criteria for microadenoma?

A
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34
Q

who gets sheehan’s syndrome?

A

pregnant, post partum hemorrhaging women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what are the features of empty sella syndrome?

A

thin flat pituitary due to herniated CSF, seen in obese multiparous women w/ HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what is the etiology and diagnostic method for a craniopharyngioma?

A

suprasellar usually, typical macroadenoma symptoms

DI also high incidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Post MVA diabetes insipidus, renal function?

A

lack of con urine -> water loss

How well did you know this?
1
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2
3
4
5
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38
Q

what are the effects of ADH?

A

conc urine, inc water permeability in DCT and CD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what hormones are affected in hypofunction of pituitary?

A

Children: GH espec, -> dwarfism
Adults: thyroid and adrenal issues, DI

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40
Q

what treatment is done for prolactin secreting adenomas?

A

bromocryptine (dopamine agonist)

transphenoidal resection

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41
Q

hormones produced by acidophils?

A

GH and prolactin

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42
Q

hormones produced by basophils?

A

FSH, LH, ACTH, TSH

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43
Q

hypophyseal portal is between which two organs?

A

hypothalamus and ant pituitary

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44
Q

what hormones are produced in the post pituitary?

A

ADH and oxytocin

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45
Q

what axon body secretes ADH?

A

supraoptic

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46
Q

what axon body secretes oxytocin?

A

paraventricular

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47
Q

what structure is formed by rathkes pouch?

A

pars tuberalis, pars distalis, adenohypophosis

48
Q

what is required for normal secretion of T4 and T3?

A

Iodine, tyrosine

49
Q

what is the pathology associated w/ lack of I-?

A

goiter

50
Q

major neoplastic conversion seen in hashimoto?

A

B cell lymphoma

51
Q

what causes hashimoto thyroiditis?

A

CD4 act B cell produced ant TPO and anti TG

IgG

52
Q

what drug is known for bein goiterogenic?

A

lithium

53
Q

what countries have high endemic goiters still?

A

africa, china, himalayas

54
Q

Reidel’s thyroiditis pathology?

A

hard fibrosis
one lobe
idiopathic

55
Q

subabute thyroiditis pathology?

A

post viral URI

56
Q

what causes exopthalmos

A

swollen (lymphocyte stimulating fibroblasts) extra ocular muscles causes proptosis

57
Q

most characteristic histologic feature of graves?

A

“moth eaten” colloid

aka scalloped

58
Q

most characteristic histologic feature of graves?

A

“moth eaten” colloid

aka scalloped

59
Q

define toxic and non toxic regarding adenomas and goiters?

A

toxic: causing a state of hyperthyroid

non toxic: euthyroid

60
Q

what creates granulomatous thyroiditis?

A

URI

61
Q

what are the clinical features of hypofunctioning thyroid

A

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

62
Q

characteristics of myxedema?

A

madness, megacolon, dermopathy, cardiac

63
Q

metastasis route of papillary carcinoma?

A

lymphatic

64
Q

metastasis route of follicular carcinoma?

A

blood stream

65
Q

what thyroid cancer doesnt arise from follicles?

A

Medullary carcinoma ( c cells)

66
Q

what thyroid cancer is mostly seen in kids?

A

papillary carcinoma

67
Q

what thyroid cancer is most common?

A

papillary carcinoma

68
Q

what protein is produced by medullary carcinoma?

A

amyloid

69
Q

what stain is used to see amyloid?

A

congo red

would see apple green bifringence

70
Q

follicular adenoma vs carcinoma characteristics?

A

adenoma: cold, 1-3 cm, solitary, capsulated, nodule
carcinoma: invading capsule

71
Q

Psammoma bodies are associated w/ ?

A

papillary carcinoma

72
Q

what are the three hereditary components of MEN 2 syndrome?

A

medullary carcinoma
pheochromocytoma
parathyroid hyperplasia

73
Q

what are the thyroid hormones and what are their functions?

A

Triiodothyrinine, thyroxine

regulate metabolism

74
Q

describe the embryologic migration of thyroid tissue?

A

behind the tongue, through foramen cecum under the hyoid

75
Q

location of thyroglossal duct

A

midline trachea, between hyoid and the isthemus

76
Q

what does the ultimobranchial body arise from? what does it become?

A

5th pouch, becomes parafollicular c cells

77
Q

most common primary hyperparathyroid state

A

PT adenoma

78
Q

most common cause of secondary hyperparathyroid?

A

Chronic renal failure

79
Q

what are the 3 organ systems involved in PT regulation?

A

bones, kidneys, GI

NO PITUITARY

80
Q

what 2 cell types are found in PT?

A

Principle or chief cells

Oxyphil cells

81
Q

clinical manifestations of hyperparathyroid

A 
excess PTH
high Ca
low PO4 
osteopenia
osteitis fibrosa cystica
rena ca stones
depression, mental changes
hyperreflexia
constipation
pancreatic issues
82
Q

clinical manifestations of hypoparathyroid

A 
hypo Ca
Hyper PO4
arrhythmia
tetany
psychosis
paranoia
depression
83
Q

what is the function of PTH

A

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

84
Q

what organ carries the inferior PT during development and migration?

A

thymus

85
Q

Treatment for PT adenoma vs hyperplasia

A

Adenoma: one enlarged gland removed
Hyperplasia: all 4 glands enlarged, remove three and leave one

86
Q

What is the most common thyroid tumor in adolescence

A

Papillary carcinoma

87
Q

most common cell type involved in benign pituitary prolactinoma?

A

lactotroph

88
Q

how do you treat a prolactinoma?

A

give dopamine agonist like bromocriptine

89
Q

What type of adenoma is a prolactinoma?

A

microadenoma

90
Q

What type of adenoma is a somatotropic adenoma?

A

macroadenoma

91
Q

What is the general treatment for macroadenomas?

A

transphenoidal surgery

92
Q

what type of adenoma is a corticotropic adenoma?

A

microadenoma

93
Q

what are the symptoms of a corticotropic adenoma?

A

cushings dz
weakness
fatigue
mental instability

94
Q

What type of adenoma are thyrotropic and gonadotropic?

A

macroadenomas

95
Q

what two things do you need to make thyroid hormones?

A

iodine and tyrosine

96
Q

What are the symptoms in males for thyrotropic/gonadotropic anenomas?

A

headache
visual disturbance
hypogonadism

97
Q

What is the only posterior pituitary disease? what causes it?

A

diabetes insipidus

caused by decreased ADH

98
Q

Characteristic signs of diabetes insipidus

A

diuresis, thirst, polyuria, polydipsia, urinating hypotonic urine

99
Q

most common cause of hypopituitarism?

A

adenoma

100
Q

what two diseases can cause hypopituitarism

A

hemochromatosis

langerhans cell histocytosis

101
Q

What are the risk factors for empty sella syndrome?

A 
woman
middle aged
multiparous
HTN
obese
102
Q

What area are craniopharyngiomas found? and how old is the pt?

A

suprasellar; child or adolescent

103
Q

what is characteristic of de quarvian thyroiditis?

A

previous URT

104
Q

what does colloid look like in graves disease?

A

looks scalloped or moth eaten

105
Q

what is myxedema madness?

A

paranoid ideation and depression w/ hypothyroidism

106
Q

what is myxedema megacolon?

A

constipation with hypothyroidism

107
Q

what is myxedema heart

A

dilated enlarged heart with pericardial effusion

108
Q

which thyroiditis is associated with B cell lymphoma

A

hashimotos thyroiditis

109
Q

what does the thyroid look like grossly in graves?

A

firm and dark red

110
Q

what does the thyroid look like with hashimotos

A

pale tan and fleshy

111
Q

what is the characteristic of reidel thyroiditis

A

stone hard or “woody”

112
Q

what are the 4 types of thyroid carcinoma

A

papillary follicular, medullary anaplastic

113
Q

what carcinoma is associated with orphan annie and psammoma bodies

A

papillary carcinoma

114
Q

what thyroid carcinoma is associated with stromal amyloid

A

medullary carcinoma

115
Q

which is the worst thyroid cancer and is also associated with a hx of low grade carcinoma of another area?

A

anaplastic carcinoma

116
Q

what two things do lithium cause?

A

parathyroid hyperplasia

hypothyroid

117
Q

what chromosome is associated with pseudohypoparathyroidism? and what is it?

A

chromosome 20

target organ insensitivity to PTH

REM II (11 decks)

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