Pathology of Endocrine Flashcards
Where do hormones in Endocrine act?
On target cells distant from site of synthesis
Where do hormones get synthesised and stored?
In glands
Balance in Endocrine is maintained by
feedback inhibition
What is Hyperplasia
increased number and secretory activity of cells
Which two hormones regulate basal metabolic rate
Thyroxine (T4)
Triiodothyronine (T3)
Which hormone regulates calcium homeostasis
Calcitonin
What does colloid contain
Thyroglobulin
Epithelial cells resorption and release
T4 and T3
C Cells secrete what
Calcitonin
Hyperthyroidism can manifest as
Thyrotoxicosis
Most common cause of Hyperthyroidism
Diffuse Toxic Hyperplasia (Graves)
Graves Disease Peak Age
20-40
In Graves disease what is there an autoimmune production of
Anti TSH Receptor Antibodies
In Graves Disease what happens to cell activity and cell numbers in histology
increase
Hashimoto thyroiditis peak age
45-65
What is there destruction of in Hashimoto Thyroiditis
Autoimmune destruct of thyroid epithelial cells
Commonest cause of Hypothyrodism
Hashimoto Thyroiditis
What happens to histology in hypothyrodism
Hurthle Cell Change
Intense Infiltrate of Lymphocyte and Plasma Cell
Multinodular Goitre does what to TSH
Increase
What happens to thyroid epithelium in multi nodular goitre
hypertrophy and hyperplasia
Impaired Synthesis of T3 and T4 in Multinodular Goitre leads to
Increase TSH
Commonest cause of Multinodular Goitre
Iodine Deficiency
Most common type of Thyroid Carcinoma
Papillary
How to investigate thyroid nodule (3)
TFT
Ultrasound
FNA - Cytology
Follicular Carcinomas Thyroid metastases to
Blood
Bone
Follicular Carcinoma of Thyroid mutation
RAS Mutation or PAX8/PPARG Translocation
Papillary Carcinoma in Thyroid usually affects
<50yrs
What mutation in Papillary Carcinoma in Thyroid
BRAF Mutation
RET/PTC Gene Rearrangement
Papillary Carcinoma in Thyroid associated with
exposure to ionising radiation
Papillary Carcinoma in Thyroid spreads via
lymphatics
Papillary Carcinoma in Thyroid prognosis
85% survival
Histology of Papillary Carcinoma in Thyroid (4)
Empty Nuclei
Psammoma Bodies
May be Cystic
Papillary Projections
Thyroid Medullary Carcinoma is malignant tumour of
c cells
Which hormone does Thyroid Medullary Carcinoma produce
Calcitonin
Calcitonin promotes
bony absorption of calcium and prevents bone resorption
Radioactive Iodine is unsafe when? (4)
During Pregnancy
6 Months after Pregnancy
Men should avoid fathering child for 4 months after
During Breastfeeding
Follicular and PTC Thyroid Cancer Treatment
Surgery and Radioactive Iodine
Medullary Thyroid Cancer Treatment
Surgery and External Radiotherapy
Parathyroid Hormone regulates
Plasma Ca2+
Primary Hyperparathyrodism is often associated with
Asymptomatic Hypercalcaemia and Adenoma
Secondary Hyperparathyrodism is a
physiological response to decrease Ca2 renal failure
Where is Pituitary Gland situated
Sella Turcica
Anterior Pituitary Gland is affected by
Adenohypophysis
Which hormones does Ant Pituitary secrete (5)
ACTH TSH GH Prolactin FSH/LH
Anterior Pituitary Gland blood supply from
From Hypothalamus
Posterior Pituitary secretes which hormones (2)
ADH
Oxytocin
Most common cause of Pituitary Hyperfunction
Pituitary Adenoma
Post Partum Ischemic Necrosis of Pituitary is
Sheehan Syndrome
How much Pituitary Function needs to be lost for Pituitary Hypofunction
75%
Zona Glomerulosa secretes
Mineralcorticoids - Aldosterone
Zona Fasiculata secretes
Glucocorticoids - Cortisol
Zona Reticularis secretes
Sex Steroids - Oestrogen, Androgens
Hypercortisolism is also known as
Cushings Syndrome
Hyperaldosteronism is also known as
Conns Syndrome
Exogenous cause of Hypercortisolism/Cushings
Iatrogenic Steroids
Endogenous causes of Hypercortisolism/Cushings
Tumours most common Pituitary Adenoma
What happens to Hyperplasia in Hyperaldosteronism/Conns Syndrome
Bilateral Idiopathic Hyperplasia
What causes Hyperaldosteronism/Conns
Functioning Adrenal Adenoma
What happens to Kidney nephron in Hyperaldosteronism/Conns
Increases sodium retention in nephron
How does Secondary Hyperaldosteronism happen
Decreased Renal perfusion leads to increased renin angiotensin
Acute Adrenal Insufficiency is known as
Meningococcal Septiciema or Waterhouse Friderichsen
Primary Chronic Adrenal Insufficiency is
Addisons
Secondary Chronic Adrenal Insufficiency is
Pituitary Failure
In Adrenocortical Tumour Adenoma what happens to Adrenal Syndromes and Cortex
Hyperadrenal Syndromes
Atrophy of Cortex
Histology of Adrenocortical Tumour Adenoma
Small Nuclei
Endocrine Atypia
How do Primary Adrenocortical Carcinoma metastasise
Lymphatics and Blood
Rare
Phaeochromocytoma is what type of tumour
Adrenal Medulla Neuroendocrine Cells
Phaeochromocytoma secretes
Catecholamines
Histology of Phaeochromocytoma (2)
Nests Zellballen of Polygonal Cells in Vascular Network
Granular cytoplasm containing catecholamines
MEN Syndromes are inherited as
autosomal dominant disorders
MEN1 is also known as
Wermer Syndrome
Where is the defect protein in MEN 1
Menin Protein involved in regulating cell growth
