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Diabetes & Endocrinology > Pathology of the Endocrine System 1&2 > Flashcards

Pathology of the Endocrine System 1&2 Flashcards

1
Q

What are the seven components which make up the classic endocrine system?

A 
Pineal Gland
Hypothalamus
Pituitary Gland
Thyroid Gland
Adrenal Glands
Parathyroid Glands
Pancreas
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2
Q

What is hyperplasia of endocrine organs?

A

Increased number and change in activity of the secretory activity of cells

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3
Q

What is atrophy in endocrine organs?

A

Diminution of cells due to a lack of stimulation

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4
Q

What are the two types of tumour which may cause neoplasia in endocrine organs?

A

Adenoma

Carcinoma

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5
Q

Which hormones is the thyroid gland responsible for?

A

Thyroxine T4
Triiodothyronine T3
- both responsible for regulating basal metabolic rate

Calcitonin - regulates calcium homeostasis

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6
Q

Does T3 or T4 have a longer half life?

A

T4 by far and there is much more of it in the tissues

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7
Q

Which of T3 and T4 is more potent?

A

T3 - but there is less of it

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8
Q

What are found within thyroid follicular cells?

A

Colloid

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9
Q

What is the function of thyroid C-cells?

A

Secrete calcitonin

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10
Q

What two things are required to allow the epithelial cells of the thyroid to synthesise thyroglobulin?

A

Iodine and tyrosine

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11
Q

What type of epithelial cells are found surrounding the follicular cells of the thyroid?

A

Cuboidal epithelial cells

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12
Q

What external factors stimulate TRH release from the hypothalamus?

A

Cold and stress

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13
Q

What may cause thyroid enlargement excluding hyper and hypothyroidism?

A

Goitre

Isolated nodule/mass

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14
Q

Are the vast majority of thyroid diseases primary or secondary?

A

Primary

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15
Q

What is the main cause of hyperthyroidism?

A

Grave’s disease

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16
Q

Is TSH elevated in primary hyperthyroidism?

A

No

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17
Q

Which gender is more susceptible to Grave’s disease?

A

Females

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18
Q

What is the autoimmune pathology of Grave’s disease?

A

Production of anti-TSH receptor antibodies - they stimulate activity, growth and inhibit TSH from binding

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19
Q

Is there a visible increase or decrease in cell number and activity on histological visualisation of thyroid tissue in hyperthyroidism?

A

A visible increase in both

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20
Q

What is the main cause of hypothyroidism?

A

Hashimoto’s disease

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21
Q

What are some other causes of hypothyroidism?

A

Iatrogenic - surgery/drugs
Iodine deficiency
Congenital hypothyroidism

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22
Q

Which gender is more commonly affected by Hashimoto’s thyroiditis? Is this a hyper or hyposecreting condition?

A

Females -(genetic, predisposition) hyposecreting

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23
Q

What is the autoimmmune pathology of Hashimoto’s thyroiditis?

A

Autoimmune destruction of thyroid epithelial cells - cytotoxic T cells, cytosine and antibody mediated

There is a loss of tolerance and and malfunction of regulatory T cells due t o exposure to hidden antigens - cytotoxic T cells, T cell mediated cytokines and antibodies

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24
Q

What is the change that affects thyroid cells in hypothyroidism called?

A

Hurthle cell change

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25
Q

What is the most common cause of multi nodular goitre?

A

Iodine deficiency - most commonly affects the elderly

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26
Q

What is the physiological pathway of multi nodular goitre caused by iodine deficiency?

A 
Iodine deficiency
to
Impaired synthesis of T3 and T4
to 
Increased TSH synthesis
to
Hypertrophy and hyperplasia of the epithelium
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27
Q

What is the dominant nodule in a multinodular goitre known as?

A

The thyroid nodule

28
Q

What may be causing the thyroid nodule?

A

Multinodular goitre
Cyst
Follicular adenoma
Carcinoma - most commonly differentiated thyroid carcinoma

29
Q

Are the majority of thyroid follicular adenomas functioning?

A

No, the majority are non-functioning

30
Q

What is relevant about the borders of a follicular adenoma in the thyroid?

A

It is encapsulated, often by a thick margin which can prevent the cells leaking out and causing local spread, however this may eventually happen and cause local invasion and possible metastasis, commonly to the blood and bone

31
Q

What are the two gene abnormalities linked with papillary carcinoma?

A

BRAF mutation

RET/PTC rearrangement

32
Q

What is the general prognosis of papillary carcinoma?

A

Very good prognosis, 99% 1 yr survival

33
Q

What cells are affected in thyroid medullary carcinoma?

A

C-cells of the thyroid

34
Q

Are thyroid medullary carcinomas secretory? If so what do they secrete?

A

Yes, calcitonin

35
Q

What hormone is produced by parathyroid glands?

A

Parathyroid hormone (PTH)

36
Q

What is the action of PTH?

A

Regulating plasme Ca2+

37
Q

Which hormone opposes the action of PTH?

A

Calcitonin from the thyroid

38
Q

What is the main cause of hypoparathyroidism?

A

Secondary to thyroid surgery

39
Q

What is the most common cause for primary hyperthyroidism?

A

Adenoma (85-95%)

40
Q

What are some other causes of hyperparathyroidism?

A

Hyperplasia

Carcinoma

41
Q

An increase in what is commonly seen in patients with hyperparathyroidism?

A

Calcium - hypercalcaemia

And subsequent loss of phosphorus

42
Q

What is another name for the anterior pituitary?

A

Adenohypophysis

43
Q

What hormones are secreted by the anterior pituitary?

A 
ACTH
TSH
GH
Prolactin
FSH/LH
44
Q

What is another name for th posterior pituitary?

A

Neurohypophysis

45
Q

What hormones are secreted by the posterior pituitary?

A

Vasopressin/ADH

Oxytocin

46
Q

What are the three main cell types of the posterior pituitary?

A

Adicophils
Basophils
Chromophobes

47
Q

Which hormones are secreted by the acidophils of the anterior pituitary?

A

GH

Prolactin

48
Q

Which hormones are secreted by the basophils of the anterior pituitary?

A

ACTH
TSH
FSH
LH

49
Q

What is the most common cause of primary hyperfunciton of the pituitary? (hyperpituitarism)

A

Pituitary adenoma

50
Q

What is unusual about the histology of pituitary adenomas?

A

They have the same appearance as the normal gland

51
Q

What is a prolactinoma?

A

A prolactin secreting pituitary adenoma

52
Q

What hormones may a pituitary adenoma secrete?

A

Prolactin - prolactinoma
GH
ACTH = cushing’s disease

53
Q

What is the mass pressure effect associate with some pituitary adenomas?

A

If the adenoma is large enough, regardless of whether it is secreting or not, may have mass effects on the surrounding structures, and may cause visual field defects - often bitermporal hemianopia and caused raised ICP and common cranial symptoms such as headaches, nausea, vomiting

54
Q

What effect may a large pituitary adenoma exerting mass effect have on the pituitary gland?

A

It may cause compression damage which results in hypopituitarism

55
Q

What percentage of the pituitary glands mass must be lost for there to be pituitary hypofunciton?

A

75%

56
Q

What are the most common causes of pituitary hypofunction?

A

Compression damage from tumours

Trauma

Infection (rare)

57
Q

Which hormones are produced by the adrenal cortex?

A

Mineralocorticoids
Glucocorticoids
Sex steroids

58
Q

What part of the adrenal gland secretes mineralocorticoids? Which is the most significant of these hormones?

A

The bona glomerulosa of the adrenal cortex

Aldosterone

59
Q

What is the function of aldosterone?

A

To maintain plasma volume via secretion at the kidney tubules

60
Q

Which part of the adrenal gland produces glucocorticoids? Which of these hormones is the most significant?

A

The zona fasiculata of the adrenal cortex

Cortisol

61
Q

What is the function of cortisol?

A

Increasing blood glucose levels by increasing gluconeogenesis, supressing the immune system, aiding in the metabolism of fat, protein and lipolysis, as well as decreasing bone formation

62
Q

What is produced by the zona reticularis?

A

Sex steroids - oestrogen, androgens

63
Q

What is produced by the adrenal medulla?

A

Adrenaline/noradrenaline in response to stress

64
Q

What is the main cause of adrenal cortical hyperfunction? What specifically does this cause in terms of hormones?

A

Cushing’s syndrome

Hypercortisolism

65
Q

What is the main cause of hyperaldosteronsim?

A

Conn’s syndrome

Diabetes & Endocrinology (18 decks)

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