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GERR > Pathology - Endocrine pathology and diabetes > Flashcards

Pathology - Endocrine pathology and diabetes Flashcards

1
Q

how does diabetic nephropathy appear histologically

A

glomerular lesions - diffuse sclerosis and nodular glomerulosclerosis, damage to basement membrane

vascular lesions- atherosclerosis of large vessels and small vessels, hyaline arteriosclerosis of efferent arteriole

pyelonephritis (inflam due to bacterial infection) with papillary necrosis

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2
Q

what is the most common cause of hyperpituitarism

a.adenoma of anterior pituitary
b.adenoma of posterior pituitary
c.adenoma of hypothalamus

A

a.adenoma of anterior pituitary

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3
Q

a pituitary gland tumour that is more than 1 cm big and associated with distinctive endocrine symptoms eg amenorrhea, loss of libido, infertility is classified as…

a. functional macroadenoma
b.non functional ,macro adenoma
c.functional, microadenoma
d. non functional , micro adenoma

A

a. functional macroadenoma

macro = >1cm
micro = < 1 cm

functional associated with distinctive endocrine symtoms

non functional are not

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4
Q

which type of adenomas of the anterior pituitary are associated with mass effects eg visual disturance

a.microadenomas
b.functional adenomas
c.non functional adenomas
d.macroadenomas

A

d.macroadenomas

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5
Q

which lesion is indicated by unilateral field loss of vision

a.optic nerve compression
b.chiasmal compression from pituitary tumour
c.cerebrovascular event

A

a.optic nerve compression

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6
Q

which lesion is indicated by bitemporal hemianopia ( loss of 1/2 of of each field of vision - same half eg both outer field lost or both inner ) loss of vision

a.optic nerve compression
b.chiasmal compression from pituitary tumour
c.cerebrovascular event

A

b.chiasmal compression from pituitary tumour

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7
Q

which lesion is indicated by homonymous hemianopia (loss of half of each visual field opposite half one inner one outer) loss of vision

a.optic nerve compression
b.chiasmal compression from pituitary tumour
c.cerebrovascular event

A

c.cerebrovascular event

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8
Q

what are the most common type of pituitary adenoma

a.prolactinomas
b.ACTH producing tumour
c.growth hormone producing tumour

A

a.prolactinomas

hyperprolactinaemia associated with amenorrhea, galactorrhea loss of libido and infertility

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9
Q

in which group are prolactinomas most often diagnosed in

a.young males
b.young females
c. old males
d.old females

A

b.young females

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10
Q

which type of anterior pituitary tumour produces cushings disease

a.prolactinoma
b.GH secreting tumour
c. ACTH secreting tumour

A

c. ACTH secreting tumour

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11
Q

which type of ant pituitary tumour produces acromegaly in adults

a.prolactinoma
b.GH secreting tumour
c. ACTH secreting tumour

A

b.GH secreting tumour

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12
Q

acromegaly

A

syndrome associated with excess GH produced by pituitary gland adenoma

gigantism similar but occurs prior to epiphyseal fusion

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13
Q

large hands, hyperglycaemia, hypertension, prominent suborbital ridges and jaw, enlarged head circumferences, accelerated osteoarthritis are signs of which condition

a.cushings
b.addisons
c.acromegaly

A

c.acromegaly

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14
Q

which cancer should patients with acromegaly be screened for ?

a.breast cancer
b.colon cancer
c.gastric cancer
d.osophageal cancer
e.prostate cancer

A

b.colon cancer

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15
Q

amenorrhea, infertility in women , hypothyroidism and hypoadrenalism are syndromes linked to which part of the pituitary ]

a.anterior
b.posterior

A

a.anterior

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16
Q

pituitary hypofunction is associated with which type of diabetes

a.diabetes mellitus
b.type 1 diabetes
c.type 2 diabetes
d.diabetes insipidus

A

d.diabetes insipidus

result of a lack of ADH

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17
Q

iodine deficiency is a cause of which of these anterior pituitary syndromes

a.amenorrhea
b.hypothyroidism
c.hypoadrenalinism
d.cushings

A

b.hypothyroidism

18
Q

swollen neck, loss of outer 3rd of eyebrows, deafness, psychosis, weight gain, muscle weakness and constipation are signs of

a.hyperthyroidism
b.hypothyroidism

A

b.hypothyroidism

19
Q

what cells are attacked in Hashimoto’s autoimmune disease?

a. a cells
b. B cells
c.adrenal cells
d.thyroid cells
e.pituitray cells

A

d.thyroid cells

causes hypothyroidism

20
Q

which element in drug form can cause hypothyroidism

a.iodine
b.iron
c.lithium
d.potassium

A

c.lithium

21
Q

hurthle cell change (degenerative changes in thyroid follicular epithelial cells ) and lymphocytic infiltrate with formation of reactive lymphoid follicles with germinal centres is seen in which condition

a.cushings
b.hashimotos thyroiditis
c.acromegaly
d.diabetes

A

b.hashimotos thyroiditis

22
Q

breakdown of immune tolerance to thyroid antigens resulting in progressive autoimmune destruction of thyrocytes by

-infiltrating cytotoxic t cells
-locally released cytokines
-antibodies

describes the pathophysiology of which condition

a.cushings
b.hashimotos thyroiditis
c.acromegaly
d.diabetes
e.graves disease

A

b.hashimotos thyroiditis

23
Q

goitre, hair loss, diarrhoea, and weight loss , on clinical examination shows low tsh but high t3 and t4 , tachycardia, palpatations and a tremor which condition most likely

a.cushings
b.hashimotos thyroiditis
c.acromegaly
d.diabetes
e.graves disease

A

e.graves disease

diffuse toxic hyperplasia

antibodies to tsh receptors
bind to receptor permananetly and stimulate the thyroid to release t3 and t4
would also see prescence of tsi antibodies

24
Q

toxic multinodular goitre is also known as

a.cushings
b.hashimotos thyroiditis
c.acromegaly
d.plummers disease
e.graves disease

A

d.plummers disease

enlarged thyroid gland and nodule formation that secrete increased thyroid hormone

weight loss, sweating, increased appetite, fatigue

starts from exisiting simple goitre

25
Q

how does follicular adenoma (a cause of hyperthyroidism) present histologically

a. hurthle cell change (degenerative changes in thyroid follicular epithelial cells ) and lymphocytic infiltrate with formation of reactive lymphoid follicles with germinal centres is seen in which condition

b.glomerular lesions - diffuse sclerosis and nodular glomerulosclerosis, damage to basement membrane
vascular lesions- atherosclerosis of large vessels and small vessels, hyaline arteriosclerosis of efferent arteriole
pyelonephritis (inflam due to bacterial infection) with papillary necrosis

c.solitary nodules , vast majority non functional but small proportion producing thyroxine

A

c= follicular adenoma
c.solitary nodules , vast majority non functional but small proportion producing thyroxine

a= hashimotos

b= diabteic nephropathy

26
Q

thyrotoxicosis, infiltrative opthalmopathy and pretibial myxedema are the clasical triad of which condition

a.cushings
b.hashimotos thyroiditis
c.acromegaly
d.plummers disease
e.graves disease

A

e.graves disease

27
Q

infiltrative opthalmology

A

1 part of classical triad of graves
tsh receptors also found behind eyes
antibodies bind to them permanently
eyes bulging appearance

28
Q

thyrotoxicosis

A

1 part of the classic triad of graves
thyroid producing too much thyroud hormone

29
Q

pretibial myoxedema

A

1 part of classical triad of graves
hardened patches of skin on shins

30
Q

patient with goitre due to living in an area with low iodine
which type of goitre would this be classified as

a.endemic
b.sporadic
c.dyshormonogenetic

A

a.endemic

31
Q

young female patient with goitre due to ingestion of food containing substances that interfere with thyroxine biosynthesis

a.endemic
b.sporadic
c.dyshormonogenetic

A

b.sporadic

32
Q

patient with goitre due to congenital enzyme defect affecting thyroxine biosynthesis how would this be classified

a.endemic
b.sporadic
c.dyshormonogenetic

A

c.dyshormonogenetic

33
Q

what are the 3 main cancers found in the thyroid gland

A

papillary carcinoma
follicular carcinoma
medually carcinoma

34
Q

which type of thyroid tumour is characterised by papillary architecture and distinctive nuclear features , and usually metastasises to regional lymph nodes

a.papillary carcinoma
b.follicular carcinoma
c.medulary carcinoma

A

a.papillary carcinoma

35
Q

which type of thyroid tumour is characterised by capsular and vascular invasion and usually metastasises to the bones via haematogenous spread

a.papillary carcinoma
b.follicular carcinoma
c.medulary carcinoma

A

b.follicular carcinoma

36
Q

which of these tumours is neuroendocrine and secretes calcitonin

a.papillary carcinoma
b.follicular carcinoma
c.medullary carcinoma

A

c.medullary carcinoma

37
Q

which tumour is known as the 10% tumour

a.phaeochromocytoma
b.follicular carcinoma
c. papillary carcinoma
d.medullary carcinoma

A

a.phaeochromocytoma

hypertensive crises during anaesthesia for surgery
urinary catecholamines high

38
Q

which of these is an example of an acute hypadrenalism

a.cushings
b.conns
c. graves
d.waterhouse friedrickson

A

d.waterhouse friedrickson

often associated with neissear menigitidis and disseminated intravascualr coagulation
leads to haemorrhage into the adrenal gland and associated acute adrenal dysfunction

39
Q

which of these diseases is an example of chronic adrenocortical insufficiency

a.cushings
b.conns
c. graves
d.waterhouse friedrickson
e.addisons

A

e.addisons

caused by AIDS, tb, chronic autoimmune adrenalitis

40
Q

patient with fatigue, weakness,hyperpigmntation and GI disturbance bloods show high ACTH which diagnosis most likely

a.cushings
b.conns
c. graves
d.waterhouse friedrickson
e.addisons

A

e.addisons

41
Q

which of these is an important cause of hypercalcaemia

a.hyperthyroidism
b.hyperparathyroidism
c.hypopituitarism
d.hypoadrenalism

A

b.hyperparathyroidism

90% associated with adenoma
may be secodary to chronic renal failure

GERR (53 decks)

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