Pathology of the Endocrine System

Question 1

what hormones does the thyroid gland secrete

Answer 1

triiodothyronine (T3)
thyroxine (T4)
calcitonin

Question 2

what are the common causes of hyperthyroidism

Answer 2

Grave’s disease (diffuse toxic hyperplasia)

toxic multinodular goitre

toxic adenoma

Question 3

what is Grave’s disease

Answer 3

autoimmune production of anti-TSH receptor antibodies

Question 4

what are the changes to the thyroid gland in Grave’s disease

Answer 4

diffuse hyperplasia

hyperfunction

Question 5

what are the changes to the eye in Grave’s disease

Answer 5

ophthalmopathy (as occular fibroblasts have TSH receptor)

Question 6

what are causes of hypothyroidism

Answer 6

Hashimoto’s thyroiditis (autoimmune destruction)

iatrogenic deficiency

iodine deficiency

congenital hypothyroidism

Question 7

what is Hashimotos disease

Answer 7

autoimmune destruction of thyroid epithelial cells with circulating antibodies to thyroglobulin and thyroid peroxidase

Question 8

what are the changes to the thyroid gland in Hashimotos disease

Answer 8

diffuse enlargement

grandual failure

Question 9

what usually causes a multinodular goitre

Answer 9

iodine deficiency

Question 10

what is a multinodular goitre and what does it cause

Answer 10

multiple nodules in a thyroid gland that is bigger than normal

results in impaired synthesis of T3 and T4 (therefore an increase in TSH)

Question 11

how would you investigate a thyroid nodule

Answer 11

TFT’s
ultrasound
FNA

Question 12

what are the common neoplasms of the thyroid

Answer 12

1. follicular adenoma (benign)
2. follicular carcinoma
3. papillary carcinoma
4. thyroid medullary carcinoma (malignant tumour of C cells)

Question 13

what is usually the cause of asymptomatic hypercalcaemia

Answer 13

hyperparathyroidism

Question 14

what is usually the cause of hyperparathyroidism

Answer 14

an adenoma

Question 15

what is the most common cause of pituitary hyperfunction

Answer 15

pituitary adenoma

Question 16

what is the most common functioning pituitary adenoma

Answer 16

prolactinoma

Question 17

apart from a prolactinoma what are common pituitary adenomas

Answer 17

GH secreting adenoma (acromeagly, giantism)

ACTH secreting adenoma (Cushing’s disease)

Question 18

what are signs that suggest a pituitary mass may be present

Answer 18

visual field abnormalities
elevated ICP
headache

Question 19

what is the most common cause of pituitary hypofunction

Answer 19

a tumour pressing on the gland (Craniopharyngioma)

Question 20

what type of tissue is a Craniopharyngioma developed from

Answer 20

pituitary gland embryonic tissue

Question 21

what is Cushing’s Syndrome

Answer 21

too much cortisol production

Question 22

what is Conn’s syndrome

Answer 22

too much Aldosterone

Question 23

the causes of cushing’s syndrome can be divided into two categories what are they

Answer 23

ACTH dependent

ACTH independent

Question 24

what are the ACTH dependent causes of Cushings syndrome

Answer 24

pituitary adenoma

ectopic ACTH secretion

Question 25

what are the ACTH independent causes of Cushings

Answer 25

functioning adrenal adenoma

Question 26

what is a phaeochromocytoma

Answer 26

tumor of the adrenal medulla that secretes catelcholamines

Question 27

what is multiple endocrine neoplasia

Answer 27

when two or more endocrine tumor types, known to occur as a part of one of the defined MEN syndromes, occurs in a single patient and there is evidence for either a causative mutation or hereditary transmission

Question 28

what does MEN 1 usually causes

Answer 28

parathyroid hyperplasia and adenomas

pancreatic and duodenal endocrine tumours