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endocrine > pathology of endocrine diseases > Flashcards

pathology of endocrine diseases Flashcards

1
Q

What regulates the endocrine system

A

Feedback inhibition

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2
Q

What does the pineal gland secrete

A

Melatonin - regulates circadian rhythm

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3
Q

Describe a benign neoplasia

A

Usually circumscribed, localised and cannot invade or transform

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4
Q

Describe a malignant neoplasia

A

Cancer - invades, metastasises and is fatal if untreated

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5
Q

Where is the pituitary gland located

A

Sella turnica

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6
Q

What connects the pituitary to the hypothalamus

A

Pituitary stalk

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7
Q

What is the adenohypophyses

A

Anterior pituitary

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8
Q

What is the neurohypophyses

A

Posterior pituitary which is a down-growth of the hypothalamus

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9
Q

What does the pituitary gland secrete

A

TSH
ACTH
prolactin
FSH
GH

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10
Q

What controls release of hormones from the pituitary gland

A

Trophic hormones from the hypothalamus

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11
Q

What does the posterior pituitary secrete

A

ADH and oxytocin

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12
Q

What is the most common cause of hyperfunction of the pituitary

A

pituitary adenoma

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13
Q

What age group is pituitary adenoma common in

A

35-60 years old

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14
Q

What does a prolactinoma cause

A

Galactorrhoea and menstrual disorders

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15
Q

What does excess GH secretion cause

A

Acromegaly and gigantism

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16
Q

What does excess ACTH secretion cause

A

Cushings disease

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17
Q

What is a non functioning pituitary adenoma

A

Does not cause excess secretion of hormones

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18
Q

What is acromegaly

A

Jaw, hands and feet are enlarged

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19
Q

What happens if the pituitary adenoma is very large

A

It will cause a build up in pressure and can compress on the optic chiasm which causes visual defects

The increased intercranial pressure can cause nausea, vomiting and headaches

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20
Q

What can cause pituitary hypofunction

A

Compression by tumours
Trauma
TB and sarcoidosis

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21
Q

Describe thyroid epithelial cells

A

Arranged in follicles filled with colloid that contains thyroglobulins

C cells which secrete calcitonin

22
Q

What stimulates hypothalamus to secrete TRH

A

cold and stress

23
Q

How does hypothyroidism manifest

A

mxoedema - physical and mental sluggishness
Cretinism - retardation and failure to grow

24
Q

What is the most common cause of hyperthyroidism

A

Grave’s disease

25
Q

How does graves disease cause hyperthyroidism

A

It has autoantibodies which bind to the TSH receptor and stimulate it to secrete T3/T4 - this breaks down the negative feedback as the T3/T4 cannot inhibit the autoantibodies

26
Q

What are the symptoms of grave’s disease

A

sweating
weight loss
tachycardia
tremor
exopthalmosis

27
Q

What is the most common cause of hypothyroidism

A

Hashimotos thyroiditis

Iodine defficiency is also common

28
Q

What drugs can cause hypothyroidism

A

Lithium and methimazole

29
Q

What is hashimotos thyroiditis

A

Autoimmune destruction of the thyroid epithelial cells

30
Q

What are the symptoms of hashimotos

A

lethargy
hairloss
dry skin
muscle aches
constipation
intolerance to cold
slow speech
brittle hair and nails
bradycardia
weight gain

31
Q

What is the most common cause of multinodular goitre

A

Iodine deficiency

32
Q

How does iodine deficiency cause multinodular goitre

A

Impairs synthesis of T3/T4 causes increased TSH which causes hypertrophy and hyperplasia of the thyroid epithelium

33
Q

What investigations are done for thyroid nodules

A

TFT - thyroid function tests
US
Fine needle aspiration and then cytology

34
Q

What are the risk factors of thyroid carcinoma

A

Family history
chronic inflammatory conditions
radiation exposure
obesity

35
Q

Describe thyroid neoplasms follicular adenoma

A

Most are non functioning
Circumscribed encapsulated tumour

36
Q

What does circumscribed mean

A

within limits

37
Q

Describe follicular carcinomas

A

Rare and usually solitary but they are malignant and can breach their capsule unlike follicular adenoma

38
Q

Where do follicular carcinomas commonly metastasise to

A

blood
bones

39
Q

What gene abnormalities are associated with follicular carcinoma

A

RAS mutation
PAX8/PPARG translocation

40
Q

What gene mutations is papillary carcinoma associated with

A

RET/PTC GENE REARRANGEMENT

41
Q

What are thyroid medullary carcinomas

A

Malignant tumours of the C-cells (calcitonin producing)

42
Q

What gene abnormalities are associated with thyroid medullary carcinoma

A

MEN2A , 2B

RET

43
Q

What is the treatment options for thyroid carcinoma

A

Surgery

Radioactive iodine

external radiotherapy

chemotherapy

44
Q

When is radioactive iodine contraindicated

A

Pregnancy
Fathering a child in the 4 months after treatment
breast feeding

45
Q

What is the function of parathyroid glands

A

Produces PTH which regulates plasma calcium

46
Q

What opposes the effect of PTH

A

calcitonin

47
Q

What is the common gene mutation linked to parathyroid hyperfunction

A

MEN-1

48
Q

What is MEN1 mutation

A

MEN1 tumour supressor gene mutation so there is a defect in the protein which regulates cell growth (Menin)

49
Q

What does MEN1 cause

A

parathyroid hyperplasia and adenoma
Pancreatic and duodenal endocrine tumours
pituitary adenomas

50
Q

what is MEN2 mutation

A

Mutations to proto-oncogene

51
Q

What does MEN2 cause

A

Medullary carcinoma of thyroid

Parathyroid hyperplasia

Neuromas

52
Q
A

endocrine (30 decks)

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