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D&E Pathology > Pathology of the Endocrine System > Flashcards

Pathology of the Endocrine System Flashcards

1
Q

How do endocrine glands appear histologically?

A

Packets of cells
Secretory granules
Vascular
Ductless

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2
Q

Where are diffuse endocrine cells found?

A

Lung
GIT
Paraganglia

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3
Q

What does the posterior pituitary secrete?

A

Vasopressin

Oxytocin

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4
Q

What are the hormones secreted by the anterior pituitary?

A 
GH
ACTH
TSH
FSH + LH
Prolactin
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5
Q

What is endocrine hyperplasia?

A

Increased number and secretory activity of cells

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6
Q

What is endocrine atrophy?

A

Diminution of cells due to lack of stimulation

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7
Q

What are the disease processes of endocrine organs?

A 
Hyperplasia
Atrophy
Tissue damage
Neoplasia
Congenital abnormality
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8
Q

What are the neoplasms found in endocrine organs?

A

Adenoma

Carcinoma

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9
Q

How are causes determined in endocrine organs?

A

Morphological findings

Biochemical measurements

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10
Q

What does the thyroid gland secrete?

A

T3, T4

Calcitonin

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11
Q

How does the thyroid appear histologically?

A

Follicles surrounded by follicular cells

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12
Q

Follicles in the thyroid contain what?

A

Colloid (thyroglobulin)

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13
Q

What do C-cells secrete?

A

Calcitonin

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14
Q

What happens within the epithelial cells?

A

TH synthesis
Iodination
Resorption
Release

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15
Q

TRH secretion from the hypothalamus is stimulated by what?

A

Cold

Stress

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16
Q

What are the causes of hyperthyroidism?

A

Diffuse toxic hyperplasia (Graves’ disease) 70%
Toxic multinodular goitre 20%
Toxic adenoma

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17
Q

Graves’ disease is more common in who?

A

Females
20-40yrs
Genetically predisposed

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18
Q

What is graves’ disease?

A

Autoimmune production of anti-TSH receptor antibodies
Stimulate activity and inhibit TSH binding to TSH receptors
Goitre

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19
Q

How does Graves’ disease cause ophthalmopathy?

A

Ocular fibroblasts have TSH receptors

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20
Q

How does the thyroid appear histologically in Graves’ disease?

A

Cell proliferation and increased activity

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21
Q

What are the causes of Hypothyroidism?

A

Hashimoto’s thyroiditis
Iatrogenic
Iodine Deficiency
Congenital

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22
Q

Which drugs increase the risk of hypothyroidism?

A

Methimazole

Lithium

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23
Q

Hashimotos thyroiditis is more common in which group?

A

Females

45-65yrs

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24
Q

What is Hashimotos thyroiditis?

A

Autoimmune Hypothyroidism due to Cytotoxic T cell/cytokine mediated destruction of thyroid epithelial cells

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25
Q

Hashimotos thyroiditis causes circulating what?

A

Antibodies to thyroglobulin

Thyroid peroxidase

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26
Q

What causes a multinodular goitre?

A

Iodine deficiency

Goitrogens

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27
Q

How does iodine deficiency/goitrogens cause multinodular goitre?

A

Impaired synthesis of T3,T4 increases secretion of TSH

Increased TSH = hypertrophy/hyperplasia of epithelium

28
Q

What could thyroid nodules be?

A

Cyst
Follicular adenoma
Carcinoma (5%)

29
Q

How are thyroid nodules investigated?

A

TFTs
Ultrasound
FNA

30
Q

What are the main types of carcinoma of the thyroid?

A 
Differentiated:
 - Papillary (85%)
 - Follicular (10-20%)
Anaplastic
Medullary
31
Q

What is a follicular adenoma?

A

Thyroid neoplasm
Mostly non-functioning
Encapsulated tumour
Microfollicle histology

32
Q

What is a follicular carcinoma?

A

Malignant cells breach the capsule

33
Q

How do follicular carcinomas metastasise?

A

Blood

Bones

34
Q

What genetic factors can lead to follicular carcinoma of the thyroid?

A

RAS mutation

PAX8/PPARG translocation

35
Q

Papillary carcinoma is associated with what?

A

Ionising radiation

BRAF mutation

36
Q

What is a thyroid medullary carcinoma?

A

Malignant tumour of C-cells

Produces calcitonin

37
Q

thyroid medullary carcinoma is associated with what?

A

MEN 2A, 2B
Familial FMTC
RET proto-oncogene
(Prophylactic thyroidectomy)

38
Q

How does Papillary carcinoma appear histologically?

A

Papillary projections
Empty nuclei
Psammoma bodies
Cystic

39
Q

How does thyroid medullary carcinoma appear histologically?

A

Tumour cells with amyloid buildup

40
Q

What is the role of PTH?

A

Regulate Ca2+
Kidney reabsorption
Intestinal absorption
Active transport from bone

41
Q

How does primary hyperparathyroidism present?

A

Often assymptomatic

Hypercalcaemia

42
Q

Which gene is associated with parathyroid hyperfunction?

43
Q

What are the cell types of the pituitary gland? Which colour do they appear histologically?

A

Acidophils - pink
Basophils - purple
Chromophobes - pale

44
Q

What do acidophils secrete?

45
Q

What do basophils secrete?

A

ACTH
TSH
FSH
LH

46
Q

What is the most common cause of pituitary hyperfunction?

A

Pituitary adenoma

carcinoma rare

47
Q

What is the clinical presentation of prolactinoma?

A

Galactorrhoea

menstrual disorders

48
Q

What is the clinical presentation of GH secreting tumours?

A

Acromegaly

Gigantism

49
Q

What is the clinical presentation of ACTH secreting tumours?

A

Cushing’s disease

50
Q

What are the most common causes of pituitary hypofunction?

A

Craniopharyngioma
Metastatic cancer
Infection (TB, sarcoidosis)
Sheehan’s syndrome

51
Q

What is Conn’s syndrome?

A

Hyperaldosteronism

52
Q

What is Cushing’s syndrome?

A

Hypercortisolism

53
Q

What are the different types of cushing’s syndrome?

A

Exogenous
Endogenous:
- ACTH dependent
- ACTH independent

54
Q

How does gland enlargement appear differently in dependent and independent Cushing’s syndrome?

A

Dependent - pituitary adenoma - increased ACTH increasing both adrenal glands
Independent - adrenal adenoma

55
Q

What are the causes of hyperaldosteronism?

A

Bilateral idiopathic hyperplasia
Adrenal adenoma
Decreased renal perfusion

56
Q

What are the causes of Adrenogenital syndromes?

A

Functioning adrenal tumour
Pituitary tumour
Congenital adrenal hyperplasia

57
Q

What is the most common cause of acute adrenal insufficiency?

A

Waterhouse-Friderichsen syndrome (acute adrenal haemorrhage)

Meningococcal septicaemia

58
Q

What is the most common cause of chronic adrenal insufficiency?

A 
1ry - Addison's disease
Autoimmune, Infections, Replacement
Atrophy
Hypoplasia
2ry - pituitary failure
59
Q

What are the symptoms of adrenal crisis?

A 
Abdominal pain
Vomiting
Fluid loss
Collapse
Hypotension
60
Q

How does adrenal adenoma present?

A

Functioning - hyperadrenal syndromes

Nonfunctioning - incidental

61
Q

How does adrenal carcinoma present?

A

Functioning - virilising
Usually large with bleeding
Metastasises by lymphatics and blood

62
Q

What is Phaechromocytoma?

A

Adrenal medulla neuroendocrine cells - usually benign

63
Q

Phaechromocytoma secretes what?

A

Catecholamines

64
Q

Which gene is associated with Phaechromocytoma?

65
Q

What is MEN1?

A

Multiple endocrine neoplasia
Pancreatic, duodenal endocrine tumours
Pituitary adenoma

66
Q

What is MEN2A?

A

Medullary carcinoma of thyroid
Phaechromocytoma
Parathyroid hyperplasia

67
Q

What is MEN2B?

A 
Medullary carcinoma of thyroid
Phaechromocytoma
Skin neuromas
Younger patients 
Skeletal abnormalities

D&E Pathology (18 decks)

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