pathology of endocrine diseases

Question 1

What regulates the endocrine system

Answer 1

Feedback inhibition

Question 2

What does the pineal gland secrete

Answer 2

Melatonin - regulates circadian rhythm

Question 3

Describe a benign neoplasia

Answer 3

Usually circumscribed, localised and cannot invade or transform

Question 4

Describe a malignant neoplasia

Answer 4

Cancer - invades, metastasises and is fatal if untreated

Question 5

Where is the pituitary gland located

Answer 5

Sella turnica

Question 6

What connects the pituitary to the hypothalamus

Answer 6

Pituitary stalk

Question 7

What is the adenohypophyses

Answer 7

Anterior pituitary

Question 8

What is the neurohypophyses

Answer 8

Posterior pituitary which is a down-growth of the hypothalamus

Question 9

What does the pituitary gland secrete

Answer 9

TSH
ACTH
prolactin
FSH
GH

Question 10

What controls release of hormones from the pituitary gland

Answer 10

Trophic hormones from the hypothalamus

Question 11

What does the posterior pituitary secrete

Answer 11

ADH and oxytocin

Question 12

What is the most common cause of hyperfunction of the pituitary

Answer 12

pituitary adenoma

Question 13

What age group is pituitary adenoma common in

Answer 13

35-60 years old

Question 14

What does a prolactinoma cause

Answer 14

Galactorrhoea and menstrual disorders

Question 15

What does excess GH secretion cause

Answer 15

Acromegaly and gigantism

Question 16

What does excess ACTH secretion cause

Answer 16

Cushings disease

Question 17

What is a non functioning pituitary adenoma

Answer 17

Does not cause excess secretion of hormones

Question 18

What is acromegaly

Answer 18

Jaw, hands and feet are enlarged

Question 19

What happens if the pituitary adenoma is very large

Answer 19

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

Question 20

What can cause pituitary hypofunction

Answer 20

Compression by tumours
Trauma
TB and sarcoidosis

Question 21

Describe thyroid epithelial cells

Answer 21

Arranged in follicles filled with colloid that contains thyroglobulins

C cells which secrete calcitonin

Question 22

What stimulates hypothalamus to secrete TRH

Answer 22

cold and stress

Question 23

How does hypothyroidism manifest

Answer 23

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

Question 24

What is the most common cause of hyperthyroidism

Answer 24

Grave’s disease

Question 25

How does graves disease cause hyperthyroidism

Answer 25

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

Question 26

What are the symptoms of grave's disease

Answer 26

sweating weight loss tachycardia tremor exopthalmosis

Question 27

What is the most common cause of hypothyroidism

Answer 27

Hashimotos thyroiditis Iodine defficiency is also common

Question 28

What drugs can cause hypothyroidism

Answer 28

Lithium and methimazole

Question 29

What is hashimotos thyroiditis

Answer 29

Autoimmune destruction of the thyroid epithelial cells

Question 30

What are the symptoms of hashimotos

Answer 30

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

Question 31

What is the most common cause of multinodular goitre

Answer 31

Iodine deficiency

Question 32

How does iodine deficiency cause multinodular goitre

Answer 32

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

Question 33

What investigations are done for thyroid nodules

Answer 33

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

Question 34

What are the risk factors of thyroid carcinoma

Answer 34

Family history chronic inflammatory conditions radiation exposure obesity

Question 35

Describe thyroid neoplasms follicular adenoma

Answer 35

Most are non functioning Circumscribed encapsulated tumour

Question 36

What does circumscribed mean

Answer 36

within limits

Question 37

Describe follicular carcinomas

Answer 37

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

Question 38

Where do follicular carcinomas commonly metastasise to

Answer 38

blood bones

Question 39

What gene abnormalities are associated with follicular carcinoma

Answer 39

RAS mutation PAX8/PPARG translocation

Question 40

What gene mutations is papillary carcinoma associated with

Answer 40

RET/PTC GENE REARRANGEMENT

Question 41

What are thyroid medullary carcinomas

Answer 41

Malignant tumours of the C-cells (calcitonin producing)

Question 42

What gene abnormalities are associated with thyroid medullary carcinoma

Answer 42

MEN2A , 2B RET

Question 43

What is the treatment options for thyroid carcinoma

Answer 43

Surgery Radioactive iodine external radiotherapy chemotherapy

Question 44

When is radioactive iodine contraindicated

Answer 44

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

Question 45

What is the function of parathyroid glands

Answer 45

Produces PTH which regulates plasma calcium

Question 46

What opposes the effect of PTH

Answer 46

calcitonin

Question 47

What is the common gene mutation linked to parathyroid hyperfunction

Answer 47

MEN-1

Question 48

What is MEN1 mutation

Answer 48

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

Question 49

What does MEN1 cause

Answer 49

parathyroid hyperplasia and adenoma Pancreatic and duodenal endocrine tumours pituitary adenomas

Question 50

what is MEN2 mutation

Answer 50

Mutations to proto-oncogene

Question 51

What does MEN2 cause

Answer 51

Medullary carcinoma of thyroid Parathyroid hyperplasia Neuromas