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Year 2- Endocrine System > Pathology of Endocrine Disease > Flashcards

Pathology of Endocrine Disease Flashcards

1
Q

RECAP- what are the four main glands of the endocrine system?

A

Thyroid gland
Parathyroid gland
Adrenal glands
Pancreas

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2
Q

RECAP- what controls the four main glands of the endocrine system?

A

Pineal gland
Hypothalamus
Pituitary gland

-> hypothalamus is CEO, pituitary is general manager

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3
Q

RECAP- what does the pineal gland produce?

A

Melatonin

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4
Q

Hypertropy?

A

Increased number and secretory activity of cells

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5
Q

Atrophy?

A

Reduction of cells due to lack of stimulation

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6
Q

What can cause tissue damage?

A

Inflammation, autoimmune disease, compression, trauma, infarction

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7
Q

Neoplasia?

A

Uncontrolled growth, either benign or malignant

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8
Q

What is meant by a functioning adenoma compared to a non-functioning adenoma?

A

Functioning adenoma produces hormones, it is a secretory tumour

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9
Q

Describe from a pathological POV what a benign neoplasm would look like down a microscope.

A

Often circumcised, localised, cannot invade and does not usually transform

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10
Q

Describe from a pathological POV what a malignant neoplasm would look like down a microscope.

A

Synonymous with cancer
Invades, metastasises
If untreated, fatal

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11
Q

All endocrine glands are regulated through the feedback mechanism.
Where do these always loop trhough?

A

The hypothalamus
Pituitary
Target organ

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12
Q

Most endocrine organs have a high reserve capacity. What does this mean in terms of clinical presentation?

A

Often late to present, often organs are damaged by up to 70%

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13
Q

Where is the pituitary gland located?

A

Sella turcica

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14
Q

How is the pituitary gland connected to the hypothalamus?

A

Via pituitary stalk

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15
Q

RECAP- the anterior pituitary is the biggest part of the pituitary gland.
Which hormones does it secrete?

A

ACTH- adrenal cortical trophic hormone
TSH- thyroid stimulating hormone
GH- growth hormone
LH/FSH
Prolactin

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16
Q

RECAP- what hormones does the posterior pituitary gland produce?

A

ADH
Oxytocin

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17
Q

What is the most common cause of pituitary hyperfunction?

A

Pituitary adenoma

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18
Q

If a pituitary adenoma is-
1. functional
2. non-functional

what will happen?

A
  1. Will secrete hormones
  2. Will increase in size
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19
Q

If a pituitary tumour is secreting GH, what could this cause as a result?

A

Acromegaly
Gigantism

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20
Q

If a pituitary tumour is secreting ACTH, what could this cause as a result?

A

Cushing’s disease

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21
Q

Prolctinoma?

A

Noncancerous tumour of the pituitary gland which secretes prolactin

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22
Q

If a pituitary tumour is secreting prolactin, what could this cause as a result?

A

Galactorrhoea
Menstrual disorders

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23
Q

Galactorrhoea?

A

Nipple discharge in someone who is not pregnant

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24
Q

What can cause pituitary hypofunction?

A

Compression by a tumour
Trauma
Infection

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25
Q

What is the function of the thyroid gland?

A

Synthesis, storage and release of thyroxine (T4) and triiodothyronine (T3)
Regulates basal metabolic rate.
Also synthesis, storage and release of calcitonin which regulates calcium homeostasis

26
Q

Which has a longer half life, T3 or T4?

A

T4

27
Q

Which more potent, T3 or T4?

A

T3

28
Q

What is the most common cause of hyperthyroidism?

A

Grave’s disease

29
Q

Who tends to be affected more by Grave’s disease?

A

Female > male
Peak 20-4oyrs
Genetic predisposition

30
Q

RECAP- what happens in Grave’s disease?

A

Autoimmune production of anti-TSH receptor antibodies

31
Q

What is the most common cause of hypothyroidism?

A

Hashimoto’s thyroiditis
->autoimmune destruction

->other causes = drugs, iodine deficiency

32
Q

What is Hashimoto’s thyroiditis?

A

Autoimmune destruction of thyroid epithelial cells

33
Q

Who is more likely to get Hashimoto’s thyroiditis?

A

Female> male
45-65yrs

34
Q

Describe follicular carcinomas.

A

Enlarged follicle epithelial cells, mirco-follciular architecture and they have a capsule.
Localised and do not invade

35
Q

What is the most common differentiated thyroid carcinoma?

A

Papillary carcinoma (75-85%)
Followed by follicular carcinoma (10%)

36
Q

How are thyroid nodules investigted?

A

TFT’s
Ultrasound
FNA cytology

->hope you know FNA is fine needle aspiration x

37
Q

What are some of the risk factors for thyroid carcinoma?

A

FH
Chronic inflammatory episodes
Radiation exposure
Obesity

38
Q

What is the only difference between a follicular adenoma and follicular carcinoma?

A

A follicular carcinoma has capsular breach and vascular invasion

-> carcinoma is malignant

39
Q

How and where does a follicular carcinoma metastasise to?

A

Via blood to bone

40
Q

Typically, how old are patients with papillary carcinoma, the most common type of thyroid carcinoma?

A

<50yrs

41
Q

What is the associated mutation to papillary carcinoma?

A

BRAF mutation
RET/PTC gene rearrangement

42
Q

What is papillary carcinoma associated with?

A

Exposure to ionising radiation

43
Q

How does a papillary carcinoma spread?

A

Via lymphatics

44
Q

What is the prognosis like for papillary carcinomas?

A

Very good

45
Q

What is a medullary carcinoma?

A

Malignant tumour of C-cells

46
Q

What does a medullary tumour produce and secrete?

A

Calcitonin

-> +/- other polypeptides

47
Q

What has an opposing inhibitory mechanism on parathyroid hormone?

A

Calcitonin

->works the other way too, each inhibit each other

48
Q

If there is parathyroid hyperfunction caused by an adenoma, how much parathyroid glands are affected?

A

1

49
Q

If there is parathyroid hyperfunction caused by hyperplasia, how much parathyroid glands are affected?

A

4

50
Q

Parathyroid hyperfunction is usually sporadic. It can be familial in which syndrome?

A

MEN-1

51
Q

Secondary hyperparathyroidism can be as a result of what?

A

Renal failure
-> decrease in calcium level because kidneys are not functioning.
Feedback so not enough calcium = overproduction of PTH

52
Q

How would someone get multiple endocrine neoplasia (MEN)?

A

Inherited disorder with underlying genetic mutation

53
Q

What is MEN-1 also known as?

A

Wermer syndrome

54
Q

What is a MEN-1 tumour caused by?

A

Tumour suppressor gene mutation meaning there is a defect in the protein involved in cell growth

55
Q

What can this MEN1 tumour suppressor gene lead to?

A

Parathyroid hyperplasia and adenomas
Pancreatic and duodenal endocrine tumours
Pituitary adenoma

-> three P’s

56
Q

If a tumour is secreting insulin, what type of symptoms will the patient have?

A

Hypoglycaemic symptoms

57
Q

What causes MEN-2?

A

Mutation in the RET gene

->this mutation drives mutations and neoplasia

58
Q

What are two clinical manifestations of MEN-2?

A

Medullary carcinoma of the thyroid
Pheochromocytoma

59
Q

MEN-2A has the same clinical manifestations (medullary carcinoma of the thyroid and pheochromocytoma) as well as one other. What is it?

A

Parathyroid hyperplasia

60
Q

MEN-2B has the same clinical manifestations as MEN2 (medullary carcinoma of the thyroid and pheochromocytoma) as well as two others. What are they?

A

Neuromas of skin and mucous membrane
Skeletal abnormalities

61
Q

Who is more likely to be affected by MEN-2B?

A

Younger patients
More aggressive

62
Q
A

Year 2- Endocrine System (27 decks)

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