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Pathology > Session 6: Endocrine Pathology > Flashcards

Session 6: Endocrine Pathology Flashcards

1
Q

which gland is responsible for producing the following hormones: GRH, TRH, CRH, PRH, GHRH, Somatostatin?

A

hypothalmus

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2
Q

which gland is responsible for producing the following hormone: FSH, LH, TSH, ACTH, Prolactin?

A

Ant. Pit gland

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3
Q

What are the two hormones produced by the posterior pit gland?

A

ADH and oxytocin

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4
Q

in which ventricle will you find the hypothalamus?

A

third ventricle

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5
Q

what is the other name for the neurohyphysis?

A

posterior pit gland

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6
Q

from which gland is the posterior pit gland derived from?

A

hypothalamus

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7
Q

what is the other name for the adenonyphophysis?

A

ant pit gland

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8
Q

derived from Rathke’s pouch - anterior pit glad or posterior pit gland?

A

anterior

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9
Q

more than half of all hypopituitarism in adults is caused by what?

A

pituitary tumors, usually adenomas

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10
Q

what do symptoms of hypopituitarism often result from?

A

compression of adjacent tissue by the mass

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11
Q

what is the syndrome that is panhypopituitarism that is caused by ischemic necrosis of the pituitary gland?

A

sheehan syndrome

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12
Q

what is often the cause of sheehan syndrome?

A

severe hypotension from postpartum hemorrhage

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13
Q

what is it called when there is hemorrhage and or infarction of the pituitary gland?

A

pituitary apoplexy

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14
Q

in cases of pituitary apoplexy, half of the cases occur in association with what?

A

endcrinologically inactive adenomas

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15
Q

what are two common examples of iatrogenic hypopituitarism?

A

therapeutic radiation or neurosurgical procedures

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16
Q

what is the cause of Laron dwarfism?

A

mutation in the growth hormone releasing hormone receptor

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17
Q

this is primarily a radiologic term that describes an enlarged sella containing a thin, flattened pituitary at the base.

A

empty sella syndrome

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18
Q

in terms of the ABC’s of acromegaly - what does A-G stand for?

A

arthiris, bp elevated, calvaria thickened (thick skull cap), diabetes, enlarged organs, field defect, goiter

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19
Q

in terms of errors with ADH, what is being described: decreased ADH, decreased water reabsorption?

A

central diabetes insipdus

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20
Q

which of the following is described as being caused by a deficiency of ADH?

A

central DI

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21
Q

which of the following is described as the kidneys not responding to ADH?

A

nephrogenic DI

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22
Q

in terms of errors with ADH, what is being described: decreased water reabsorption and increased ADH

A

nephrogrenic DI

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23
Q

T or F: both CDI and NDI have intense thirst (polydipsia) and loss of diluted urine (polyuria)

A

TRUE

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24
Q

what is the only significant disease associated with he posterior pit gland?

A

central diabetes insipidous

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25
Q

T or F: 1/4 of cases of CDI are assoc with brain tumors, particularly craniopharyngioma

A

TRUE

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26
Q

what is one way to control polyuria in CDI?

A

powdered vasopressin as snuff

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27
Q

which gland is the largest endocrine organ in the body?

A

thyroid gland

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28
Q

what is defined as euthyroid (with normal or low thyroid levels) and does NOT have the pt suffering from any form of thyroiditis?

A

nontoxic goiter

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29
Q

in terms of issues regarding the thyroid gland, how is primary described?

A

when there is thyroid gland malfunction

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30
Q

in terms of issues regarding the thyroid gland, how is secondary described?

A

when there is a problem with the hypothalamic-pituitary

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31
Q

nontoxic goiters can be defined as either ___ or ____

A

nodular or diffuse

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32
Q

in which sex is nontoxic goiter more common?

A

females

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33
Q

in which two demographics is a diffuse goiter common?

A

adolescence and pregnancy

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34
Q

the multinodular type of nontoxic goiter is most common in which pt demographic?

A

pesons older than 50

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35
Q

what is the term that refers to hyperthyroidism that most commonly is due to Grave’s and is caused by inflammation or a multinodular goiter?

A

“toxic goiter”

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36
Q

which type of goiter is commonly caused by some autoimmune process, sulfonamides, lithium, etc? toxic or nontoxic

A

nontoxic goiter

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37
Q

what is the term used to describe a goiter that has spread throughout all of the thyroid?

A

diffused goiter

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38
Q

in nontoxic goiter, what is the capacity of the thyroid gland to produce thyroid hormone?

A

impaired

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39
Q

in nontoxic goiter, since there is an impairment in the ability to produce thyroid hormone, what happens to the size of the gland?

A

increases due to increased secretion of TSH which helps to maintain euthyroid state

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40
Q

what is one of the discussed causes of secondary hyperthyroid? (although rare)

A

TSH secreting tumor

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41
Q

what is the most common cause of hyperthyroidism in young adults?

A

graves disease

42
Q

what type of goiter is involved in graves disease?

A

diffuse

43
Q

what is the most prevalent autoimmune disease int he US? (esp for pple under 40 y/o)

A

graves disease

44
Q

what is known as a skin condition characterized by red, swollen skin, usually on the shins and tops of feet?

A

dermopathy

45
Q

describe what happens to the following when a pt has graves: hair, muscles, and menstruation

A

fine hair, muscle wasting, oligomenorrhea.

46
Q

True or False: graves disease will cause tremor of the hand

A

true

47
Q

what is the most common cause of goistrous hypothyroidism in the US?

A

chronic autoimmune thyroiditis (hashimoto)

48
Q

hashimotos’s thyroiditis is defined by having what kind of autoimmune Ab’s?

A

antimicrosomal Ab

49
Q

T or F: the course of Hashimoto’s is fast, infiltrate, with germinal centers.

A

True except for the fact that the course is slow

50
Q

T or F: you can use radioactive iodine therapy for Graves Disease

A

True

51
Q

what is a common cause of secondary hypopituitarism ?

A

that caused by a pituitary adenoma

52
Q

which thyroid disorder is a result of antibodies to TBG? Thyroxine Binding Globulin (TBG)

A

Hashimotos

53
Q

what are the lab values for hashimotos? (t4 and tsh

A

low t4 and high tsh

54
Q

what are the two ab present in hashimotos?

A

anti tpo ab and anti tbg ab

55
Q

defective thyroid hormone synthesis is also known as deficiency of what?

A

iodine

56
Q

what are the levels associated with iodine deficiency? TH and TSH

A

low TH and high TSH

57
Q

what is inadequate thyroid parenchyma function typically associated with?

A

thyroiditis, surgical resection of the gland or therapeutic administration of radioiodine

58
Q

what are the tsh and th levels associated with inadequate thyroid parenchyma function?

A

high tsh low th

59
Q

is inadequate secretion of tsh by the pit gland or of TRH from the hypothalamus primary or secondary hypothyroidism? what are the hormone levels associated with this?

A

secondary; low tsh and low th

60
Q

T or F: long term iodide intake can cause goitrous hypothyroidism.

A

TRUE - b/ cit prevents the thyroid from producing/synthesizing thyroid hormones itself - it should also be noted that iodine deficiency is also part of the etiology of goistrous hypothyroidism

61
Q

T or F: endemic goiters often cause hyperthyroidism

A

FALSE

62
Q

what is the procedure used to determine if the growth or nodule within the thyroid is malignant?

A

FNA (fine needle aspiration)

63
Q

the action of PTH on the kidney together with hypercalcemia does what to the phosphate levels in the blood?

A

leads to hypophoatemia

64
Q

what step (binding of some ions) is necessary for the activation of the 7 bit k dependent clotting factors with the aid of platelets ?

A

binding of calcium ions (which is why you would place chelating agent to hind the calcium so it does NOT clot in the bag)

65
Q

what level of calcium will lead to the following: spasms, tetany, increased excitability of nerve, cardiac dysfunction.

A

HYPO

66
Q

what level of calcium will lead to the following: inhibits neurons and muscle cells and may cause heart arrrhythmias

A

hyper

67
Q

what does hyperparathyroidism do to your muslces? your bones?

A

causes atrophy and will lead to osteitis fibrosa cyctica

68
Q

secondary parathyroid hyperplasia is typically seen in which patient population?

A

chronic renal failure or even those who are vit d deficiency - also be on the look for those with intestinal malabsorption and renal tubular acidosis

69
Q

this is defined as abnormal hypersecretion of PTH, producing hypercalcemia and hyperphosphatemia.

A

primary hyperparathyroidism (the primary problem is that the PTH is being hypersecreted which is then leading to an increase in calcium)

70
Q

what is the main difference between primary and secondary hyperparathyroidism?

A

in secondary there is an increase in PTH due to low calcium whereas with primary the increase in PTH is NOT caused by this - it’s independent of it.

71
Q

adrenal gland destruction leading to adrenal cortical insufficiency is called what?

A

primary adrenal cortical insufficiency

72
Q

what is defined as secondary adrenal cortical insufficiency?

A

pit or hypo dysfunction with decreased acth production

73
Q

what is the other (third) way that leads to adrenal cortical insufficiency

A

chronic corticosteriod therapy

74
Q

what is the other term for primary adrenal insufficiency?

A

Addison Disease

75
Q

symptoms of acute adrenal insufficiency are mainly due to which deficiency?

A

mineralcorticoid (as opposed to glucocorticoids - so more aldosterone and NOT cortisol)

76
Q

what is the most common cause of acute adrenal insufficiency?

A

abrupt withdrawal of corticosteriod therapy in pts with adrenal atrophy

77
Q

what is the difference between Cushing syndrome and Conn syndrome?

A

cushing is hypercortisolism while conn is hyperaldosteronism

78
Q

what is the difference between cushing disease and cushing syndrome?

A

syndrome is hypercortisolism for any reason where as disease is due specifically for excessive secretion of acth by pit tumors.

79
Q

T or F: hyperproduction of corticosteriods by adrenal tumors is more common than excess secretion of acth by pit tumors?

A

FALSE: excess secretion of acth by pit tumors is 5x more common

80
Q

what is the most common cause of cushing syndrome in the USA?

A

chronic corticosteroid administration to treat immune and inflammatory disorders

81
Q

T or F: the second most common cause of cushing syndrome in the USA is a paraneoplastic effect assoc with non pit cancers that inappropriately produce acth

A

TRUE

82
Q

what are the acth and cortisol levels for cushing’s disease?

A

increase both

83
Q

what are the cortisol levels and acth levels for adrenal hyperneoplasia?

A

high cortisol. low acth

84
Q

what accounts for most cases of acth dependent hyperadrenalism?

A

ectopic acth production by a malignant tumor (inappropriate secretion of corticotropin releasing hormone by tumors arising outside of the hypothalamus)

85
Q

what is the main cause of acth independent adrenal hyper function?

A

adrenal tumors (adenomas)

86
Q

T or F: adenomas of the adrenal cortex are uncommon

A

TRUE

87
Q

what is known as primary hyperaldosteronism?

A

conn’s

88
Q

what is it called when you have an increase in aldosterone (due to a tumor) which leads to low renin?

A

conn’s syndrome

89
Q

what are the renin and aldosterone levels associated with secondary hyperaldosteronism?

A

high aldosterone and renin (remember, secondary is basically anything that causes the kidneys to perceive low intravascular volume)

90
Q

what acid base state is the result of hyperaldosteronism?

A

metabolic alkalosis

91
Q

what is the major form of treatment for hyperaldosteronism?

A

spironolactone (K+ sparere and aldosterone inhibitor)

92
Q

what is the result of pigmentation for patients with addison’s disease?

A

hyperpigmentation

93
Q

what is the reason behind hyperpigmentation with addison’s?

A

This occurs because melanocyte-stimulating hormone (MSH) and adrenocorticotropic hormone (ACTH) share the same precursor molecule, Pro-opiomelanocortin (POMC).

94
Q

what is the most common tumor of the adrenal medulla in adults? and what is the treatment?

A

pheochromocytoma - treat with non selective alpha blockers

95
Q

pheochromocytomas are catecholmamine secreting tumors originating from which cells?

A

chromaffin cells

96
Q

if pheohromocytomas originate from an extra adrenal site, what are they called?

A

paragangliomas

97
Q

this is a prototypic paraganglioma arising at the carotid bifurcation. it tends to form a palpable mass in the neck

A

carotid body tumor

98
Q

this is an embryonal malignant tumor of neural crest origin that is composed of neoplastic neuroblast and originates int eh adrenal medulla, paravertebral sympatheic ganglia and sympathetic paraganglia?

A

neuroblastoma

99
Q

this accounts for half of all cancers diagnosed in the first month of life?

A

neuroblastoma

100
Q

what happens to osmotic BP with high blood glucose?

A

increases

101
Q

which of the types of DM has the much higher percentage associated with genetics?

A

type II

102
Q

what are the levels of beta cell mass associated with each type of DM?

A

type I is reduced type II is normal or slightly reduced

Pathology (8 decks)

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