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Year 2 Diabetes & Endocrinology (JK) > Pathology of the endocrine system > Flashcards

Pathology of the endocrine system Flashcards

1
Q

Hyperplasia

A

increased number and secretory activity of cells

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2
Q

Atrophy

A

Diminution of cells due to lack of stimulation

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3
Q

How do we determine the cause of disease processes in endocrine glands?

A

morphological changes

biochemical measurements

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4
Q

Briefly describe the histology of the thyroid gland

A

follicles
colloid filled with thyroglobulin
epithelial cells
c - cells - secrete calcitonin

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5
Q

3 causes of primary hyperthyroidism

A

graves disease
toxic multinodular goitre
toxic adenoma

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6
Q

Graves disease antibodies

A

anti TSH receptor antibodies

thyroid peroxidase antibodies

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7
Q

Why is there eye involvement in graves disease?

A

ocular fibroblasts have TSH receptors

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8
Q

Describe the autoimmune destruction present in Hashimoto’s disease

A

destruction of thyroid epithelium
Tc cells, cytokine, antibody mediated destruction
circulating autoantibodies to thyroglobulin and TPO

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9
Q

What happens to the thyroid gland in Hashimoto’s thyroiditis?

A

diffuse enlargement and gradual failure

Hurthle cell change infiltrate and lymphocytes

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10
Q

Explain the pathway of multinodular goitre

A

iodine deficiency, goitrogens
impaired T3 and T4 synthesis
TSH is increased
repeated stimulation of the thyroid gland
hypertrophy and hyperplasia of the epithelium

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11
Q

Follicular adenoma of thyroid gland

A

most non-functioning
circumscribed, encapsulated
small micoradenomas found incidentally

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12
Q

Medullary carcinoma of thyroid gland

A

c cells - produces calcitonin
30% MEN 2A+B
prophylactic thyroidectomy

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13
Q

3 causes of parathyroid hyperfunction

A

primary hyperparathyroidism - asymptomatic hypercalcaemia
sporadic or familial - MEN 1 - mostly adenoma
secondary - in response to renal failure

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14
Q

Anterior pituitary histology and what is secreted by each cell type

A

acidophil = prolactin, GH
basophils - ACTH, TSH, LH, FSH
chromophobes

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15
Q

Most common cause of pituitary hyperfunction

A

pituitary adenoma

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16
Q

Pituitary adenoma

A

adults, MEN 1 - 5%

immunohistochemical stains to determine what hormone is being produced

17
Q

Effect of a functioning pituitary adenoma

A

hormone excess

18
Q

Effects of a functioning prolactinoma, GH secreting, ACTH secreting pituitary adenoma

A

galactorrhoea and menstruation disorders
acromegaly/gigantism
cushing’s disease

19
Q

3 mass pressure effects of a large pituitary adenoma

A

increased ICP
visual fields
hypopituarism

20
Q

How much of the pituitary gland needs to be lost to result in hypofunction?

A

75%

21
Q

How can pituitary hypofunction result?

A

compressed by tumours eg craniopharyngioma
trauma
infection
post partum ischaemic necrosis

22
Q

Hypercorisolism result in…

A

cushings syndrome

23
Q

Hyperaldosteronism results in…

A

conns syndrome

24
Q

causes of hypercortisolism

A

exogenous eg iatrogenic steroids

endogenous eg ACTH independent and dependent

25
Q

Causes of acute and chronic adrenal insufficiency

A

acute - meningococcal septicaemia

chronic - Addison’s disease, infection, infarction, long term steroid use, atrophy, congenital

26
Q

Causes of secondary adrenal insufficiency

A

pituitary failure

27
Q

Adrenocortical adenoma

A

functioning = atrophy of adjacent cortex
non functioning
yellow-brown, circumscribed, 2-3cm, <30g

28
Q

Adrenocortical carcinoma

A

rare, functioning
haemorrhage, necrosis, cystic
mets by lymph and blood - adrenal vein
spread from breast and lung cancer

29
Q

Name an adrenomedullary tumour

A

phaeochroocytoma

30
Q

Why does a phaeochromocytoma result in hypertension?

A

secrete catecholamines eg adrenaline

31
Q

percentage association of phaechromocytoma and MEN-2?

A

30%

32
Q

What are MEN disorders?

A

inherited disorders with underlying genetic mutations

33
Q

What does MEN lead to?

A

hyperplasia/neoplasia at a younger age and multifocal

34
Q

MEN 1

A

parathyroid, pancreatic and duodenal and pituitary prolactinoma

35
Q

MEN 2

A

medullary carcinoma of thyroid

phaeochromocytoma

36
Q

MEN 2A

A

parathyroid hyperplasia

37
Q

MEN 2B

A

neuromas - aggressive, early age

Year 2 Diabetes & Endocrinology (JK) (24 decks)

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