Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrine > Pathology > Flashcards

Pathology Flashcards

1
Q

What embryological structure forms the anterior pituitary?

A

Rathke’s Pouch

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

Differentiate the trophic and non-trophic hormones secreted by the anterior pituitary

A

Trophic: TSH, ACTH, FSH, LH

Non-trophic: GH and Prolactin

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

What type of cells make up the posterior pituitary gland?

A

modified glial cells and axonal processes

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

What hormones does the posterior pituitary gland secrete?

A 
Secretes ADH (vasopressin) 
and oxytocin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The hormone secreting cells in the anterior pituitary are either Acidophils or Basophils. Classify them into both groups.

A

ACIDOPHILS:
Somatotrophs – secrete GH
Mammotrophs – secrete PROLACTIN

BASOPHILS:
Corticotrophs – secrete ACTH
Thyrotrophs – secrete TSH
Gonadotrophs – secrete FSH / LH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What name is given to a cell which does not absorb acidic nor basic dye?

A

Chromophobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What pathologies of the anterior pituitary usually result in HYPERfunction?

A

Adenoma

Carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What conditions of the anterior pituitary often cause HYPOfunction?

A
  • Surgery/radiation
  • Sudden Haemorrhage into gland
  • Ischaemic necrosis
  • Sheehan Syndrome (post-partum necrosis)
  • Tumours extending into sella turnica
  • Inflammatory conditions (e.g. Sarcoidosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does the posterior pituitary cause Diabetes insipidus?

A
  • Lack of ADH secretion

- Can lead to life threatening dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What condition is characterised by ectopic secretion of ADH by tumours?

A

Syndrome of Inappropriate ADH secretion (SIADH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pituitary adenomas are always sporadic. TRUE/FALSE?

A

FALSE

can also be associated with MEN1 gene mutation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pituitary adenomas can secrete more than one hormone. TRUE/FALSE?

A

TRUE

although some tumours can be non-functioning also

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What symptoms can large adenomas cause locally?

A
  • Atrophy of surrounding normal tissue due to pressure
  • Visual field defects
  • Infarction leading to panhypopituitarism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the most common FUNCTIONAL tumour found in the anterior pituitary?

A

Prolactinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does a prolactinoma usually present?

A

Infertility
lack of libido
amenorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A tumour secreting GH causes an increase in what peripheral hormone? And what can this cause?

A
  • Insulin Like Growth Factors (IGF)
  • Stimulates growth of bone, cartilage and CT
  • causes Gigantism (if bones yet to fuse) or acromegaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What type of tumours usually secrete ACTH?

A

Microadenoma

OR Bilateral adrenocortical hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What hormones do pituitary carcinomas usually secrete?

A

Prolactin or ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pituitary carcinomas tend to metastasise early. TRUE/FALSE?

A

FALSE

metastasise LATE after multiple recurrences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Craniopharyngiomas are slow growing. TRUE/FALSE

A

TRUE

Also often cystic and may calcify

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Where do most Craniopharyngiomas arise?

A

Most are suprasellar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What symptoms are usually present in Craniopharyngiomas?

A
  • Headaches and visual disturbances

- Children may have growth retardation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Craniopharyngiomas have a good prognosis. TRUE/FALSE?

A

TRUE (If <5cm)

Risk of SCC after radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is “Nephrogenic” Diabetes Insipidus?

A

Renal resistance to the effects of ADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How much does one adrenal gland roughly weigh?

A

4-5 grams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the two distinct anatomical regions of the adrenal gland?

A

Cortex and Medulla

27
Q

What conditions can cause hyperfunction in the adrenal cortex?

A

Hyperplasia
Adenoma
Carcinoma

28
Q

Adrenal cortex hypofunction can be acute or chronic. What are the causes of each?

A

Acute
- Waterhouse-Friderichsen (septic infection)

Chronic
- Addison’s disease

29
Q

Congential Adrenocortical Hyperplasia is Autosomal Dominant. TRUE/FALSE?

A

FALSE

Autosomal Recessive

30
Q

Describe the pathogenesis of Congential Adrenocortical Hyperplasia

A

Enzyme deficiency
=> cant make aldosterone/ cortisol
=> all shunted to androgen production
Reduced cortisol stimulates ACTH release and cortical hyperplasia

31
Q

What does the androgen production in CAH lead to?

A

Virilisation

Precocious Puberty

32
Q

Describe the pathogenesis of acquired Adrenocortical Hyperplasia

A

Endogenous ACTH production from:
- Pituitary adenoma
OR Ectopic ACTH from:
- Paraneoplastic syndrome (small cell lung carcinoma)

Causes Bilateral adrenal enlargement to meet Cortisol demands from all excess ACTH

33
Q

Adrenocortical tumours are usually an incidental finding in adults. TRUE/FALSE

A

TRUE

34
Q

Describe the appearance of an adrenocortical adenoma

A
  • Well circumscribed
  • Usually small (2 to 3cm)
  • Yellow/brown surface (lipid)
  • Composed of cells resembling adrenocortical cells
  • Can be functional, but unlikely
35
Q

Where do adrenocortical carcinomas usually spread to?

A

Local invasion – retroperitoneum, kidney

Metastasis – vascular (liver, lung and bone)

Peritoneum and pleura

Regional lymph nodes

36
Q

What is the 5 year survival for adrenocortical carcinomas?

A

20-35%

50% are dead within the first 2 years

37
Q

Adrenocortical Adenomas and Carcinomas look very similar. What can help to differentiate between them?

A
  • Large size (often >20cm)
  • Haemorrhage and necrosis
  • Frequent mitoses, atypical mitoses
  • Lack of clear cells
  • Capsular or vascular invasion
38
Q

What syndrome is related to an oversecretion of aldosterone from the adrenal cortex?

A

Conn’s

= Primary Aldosteronism

39
Q

What are the most common causes of Conn’s syndrome?

A 
60% = diffuse or nodular hyperplasia of both adrenal glands
35% = Adenoma 
RARE = carcinoma
40
Q

What hormone is secreted to excess in Cushing’s syndrome?

A

Cortisol

41
Q

What are the most common causes of Cushing’s?

A

Exogenous Cause: Iatrogenic (steroid therapy)

Endogenous Cause:

  • ACTH secreting pituitary adenoma
  • Ectopic ACTH (e.g. Small cell lung cancer)
  • Adrenal adenoma/carcinoma
  • Adrenal gland atrophy => no lesions
42
Q

What can cause ACUTE adrenocortical insufficiency?

A
  • Rapid withdrawal of steroid treatment
  • increasing dose of steroid treatment
  • Acute adrenal Crisis if pts have chronic disease
  • Massive adrenal haemorrhage
  • Newborn
  • Anticoagulant treatment
  • Septiceamic infection – Waterhouse Friderichsen
43
Q

What are the most common causes of Addison’s disease?

A
  • Autoimmune adrenalitis
  • Infections (TB/fungal/HIV)
  • Metastatic malignancy (Lung, breast)
44
Q

What are the more unusual causes of Addison’s disease?

A

Amyloid
Sarcoidosis
Haemochromatosis

45
Q

How much of the gland is already destroyed by the time Addison’s disease presents?

A

90%

46
Q

What vague symptom differentiates Addison’s disease from hypopituitarism?

A

Raised Pigmentation

=> patients often seem tanned (or even orange)

47
Q

Biochemically, how do patients with Addison’s Disease present?

A

Hyperkalaemia (High K+)
hyponatraemia (Low Na+)
Volume depletion => hypotension (Low BP)
Hypoglycaemic

48
Q

How do patients in Acute Addison’s crisis present?

A
  • Vomiting
  • abdominal pain
  • hypotension
  • shock and death
49
Q

What innervates the Adrenal medulla?

A

Pre-synaptic fibres from sympathetic nervous system

50
Q

What cells are found in the adrenal medulla and what do they secrete?

A

Neuroendocrine (chromaffin) cells

=> secrete catecholamines

51
Q

What two types of tumour are most commonly found in the adrenal medulla?

A

Phaechromocytoma

Neurblastoma

52
Q

What do Phaechromocytomas secrete?

A

Secrete catecholamines

53
Q

Phaechromocytomas can rarely cause secondary Hypertension. TRUE/FALSE?

A

TRUE

54
Q

What complications can arise from the secondary hypertension of Phaechromocytoma?

A

Cardiac failure
infarction
arrhythmias

55
Q

How should a Phaechromocytoma be investigated for in the lab?

A

Detection of urinary excretion of catecholamines and metabolites

56
Q

Why is Phaechromocytoma known as the 10% tumour?

A 
10% are extra-adrenal
10% are bilateral 
10% are  malignant
10% are NOT associated with hypertension
25% are familial
57
Q

How do Phaechromocytomas usually look?

A

Yellow, red/brown due to haemorrhagic and necrotic nature

Tumour turns dark brown due to oxidation of catecholamines in tumour cells

58
Q

Where do Phaechromocytomas metastasise to?

A

skeletal metastasis
regional lymph nodes
liver
lung

59
Q

What subtypes of Multiple Endocrine Neoplasia does a Phaechromocytoma usually present in?

A

MEN2a

MEN2b

60
Q

What are the 3 zones found in the adrenal cortex?

A

Zona Glomerulosa
Zona Fasciculata
Zona Reticularis

61
Q

What hormones are secreted by the Zona Glomerulosa?

A

Mineralocorticoids

=> Aldosterone

62
Q

What hormones are secreted by the Zona Fasciculata?

A

Glucocorticoids

=> Cortisol

63
Q

What hormones are secreted by the Zona Reticularis?

A

Sex Steroids + Glucocorticoids

Endocrine (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions