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Endrocrine Exam 2 > Pathology- Endocrine Pancreas > Flashcards

Pathology- Endocrine Pancreas Flashcards

1
Q

What is a characteristic of nondiabetic newborns of diabetic mothers?

A

Increase in the number and size of islets

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2
Q

What happens to fetal islets secondary to meternal hyperglycemia?

A

They undergo hyperplasia

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3
Q

What are prime targets of diabetes?

A

Kidneys

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4
Q

What is second only to MU as cause of death in diabetes?

A

Renal failure

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5
Q

What are 3 lesions seen in kidneys with diabetes?

A
  1. Glomerular lesions
  2. Renal vascular lesions
  3. Pyelonephritis (including necrotizing papilitis)
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6
Q

What is nodular glomerulosclerosis also called?

A
  1. Intercapillary glomerulusclerosis

2. Kimmelstiel-Wilson disease

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7
Q

What is seen in nodular glomerulosclerosis?

A

Ovoid or spherical, laminated, nodules of matrix

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8
Q

Where are nodules in the glomerulus in nodular glomerulosclerosis?

A

Peripephery

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9
Q

True or False: Nodules in nodular glomerulosclerosis are PAS positive?

A

TRUE

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10
Q

What are nodules surrounded by in nodular glomerulosclerosis?

A

Patent peripheral capillary loops or loops that are markedly dilated

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11
Q

What is seen in advanced nodular glomerulosclerosis?

A

Enlarged nodules

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12
Q

What are 3 consequences of glomerular and arteriolar lesions?

A
  1. Kidney suffers from ischemia
  2. Develops tubular atrophy
  3. Interstitial fibrosis
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13
Q

What does the picture of nodular glomerulosclerosis look like?

A

Petals on a flower

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14
Q

What is an insulinoma?

A

B-cell tumor

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15
Q

True or False: Insulinoma is the most common of pancreatic endocrine neoplasms?

A

TRUE

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16
Q

What happens in an insulinoma that induces clinically significant hypoglycemia?

A

Elaboration of sufficient insulin

17
Q

What is the clinical picture of an insulinoma?

A

Hypoglycemia episodes: Blood glucose under 50, CNS manifestations (confusion, stupor, loss of consciousness), precipitated by fasting or exercise (promptly relieved by feeding/parenteral administration of glucose)

18
Q

Describe some characteristics of insulinoma

A

Benign, solitary, small (under 2 cm), encapsulated, pale to red-brown nodules

19
Q

What % of cases of insulinoma are carcinomas?

A

10%… local invasion and distant mets

20
Q

What is seen microscopically in an insulinoma?

A

Giant islets with preservation of regulat cords and preservation of orientation to vasculature

21
Q

What is deposited in extracellular tissue in an insulinoma?

A

Amyloid

22
Q

What labs are seen with insulinoma?

A

High circulating levels of insulin

High insulin-to-glucose ratio

23
Q

What is treatment for an insulinoma?

A

Surgical removal of tumor… followed by prompt reversal of the hypoglycemia

24
Q

What is in the Ddx of insulinoma?

A
  1. Abnormal insulin sensitivity
  2. Diffuse liver disease
  3. Inherited glycogenoses
  4. Ectopic production of insulin (retroperitoneal fibromas and fibrosarcomas)
  5. Self-injection of insulin
25
Q

What has a marked hypersecretion of gastrin?

A

Gastrinoma

26
Q

What is Zollinger-Ellison Syndrome?

A
  1. Pancreatic islet cell lesions
  2. Hypersecretion of gastric acid
  3. Severe peptic ulceration
27
Q

Where is a gastrinoma located?

A

Pancreas, peripancreatic region, or wall of duodenum

28
Q

True or False: More than 50% of gastrin-producing tumors are locally invasive and have already metastasized at the time of diagnosis

A

TRUE

29
Q

Are MEN-1 associated gastrinomas multifocal or single?

A

Multifocal

30
Q

Are sporadic gastinomas multifocal or single?

A

Single

31
Q

How is a gastrinoma histologically?

A

BLAND

32
Q

What do the duodenal and gastric ulcers in gastrinoma look like?

A

Multiple, but identical to those found in the general population and unresponsive to therapy

33
Q

What is weird about uclers with gastrinoma?

A

Can occur in weird locations like jejunum

34
Q

If you have intractible jejunal ulcers, what do you have?

A

ZES

35
Q

What is a big symptom with gastrinoma?

A

Diarrhea

36
Q

What is treatment of gastinoma?

A

Control gastric acid secretions using a H, K-ATPase inhbiitor and exision of the neoplasm

37
Q

What shortens life expectancy with gastrinoma?

A

Hepatic mets…progressive tumor growth and liver failure within 10 years

38
Q

What kind of adenoma is separated from the pancreas by a thin collagenous capsule?

A

Islet cell adenoma (gastrinoma)

Endrocrine Exam 2 (7 decks)

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