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Year 5 Histopath > Endocrine > Flashcards

Endocrine Flashcards

1
Q

anterior pituitary

A

epithelial cells
blood from pituitary portal systems > hypothalamus to pituiatry

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2
Q

pituitary is ?
blood supply

A

nervous in origin
nerves supraoptic nucleus

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3
Q

hypothalamic factor

A

TRH -
dopamine
corticotrohphin
growth hormone
gonadotrophin

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4
Q

symptoms of pituitary disease
categorise?

A

hyperpituitarism - functional (benign adenoma)

hypopituitarism
deficiency of trophic hormones

local mass- expanding lesions

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5
Q

hyperpituitarism - functional (benign adenoma)

detected by?

A

immunohistochemistry

classified by basis of what hormones they contain

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6
Q

most common pituitary adenomas?

make how much of clinical attention?

A

prolactin cell

10%
4th-6th decade

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7
Q

prolactinomas clinical effects

A

amenorrhea
galactorrhea
loss of libido
infertility

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8
Q

growth hormones adenomas

A

prepuberty - gigantism

acromegaly
predisopose to DM
muscle weakness
htn
congestivce heart failure

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9
Q

corticotroph adenomas

A

cushing syndrome

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10
Q

HYPOpituitarism

caused by?

A

nonsecretory adenomas- compress and lessen function

ischaemic necrosis - sheehans syndrome (pituitary enlarges during pregnancy)

DIC, sickle cell, elevated ICP

ablation of pituitary due to surgergy or irradiation (tumout treatment)

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11
Q

hypopituitary signs

A

growth failure -
GnRH - deficient amenorrhea / infertility in women
> decreased libido

later on this can occur

TSH and ACTH
hypothyroidism
hypoadrenalism

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12
Q

posterior pituatry releases 2?

A

adh
oxytocin

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13
Q

ADH failure to secrete

A

Diabetes insipidus
siadh

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14
Q

local mass effect

A

compressed optic chiasm
bitemporal hemianopia

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15
Q

obstructive hydrocephalus

A

compression of brainstem

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16
Q

thyroid cells

A

follicle cells contain colloid
parafollucilar cells

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17
Q

thyroglobulin > T4/T3

A

TSH from anterior pituiatry actions

follicular epithelial cells use colloid in converting thyroglobulin > t4/t3

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18
Q

effect of t4/t3

A

increase basal metabolic rate

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19
Q

role of parafollicular cells?

A

synthesise calcitonin (promotes absorption of calcium by skeletal system)

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20
Q

t4
t3 distribution

A

90% inactive thyroxine T4
10% active triiodinthyronine T3

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21
Q

goitre

classification

A

enlarged thyroid

toxic

non-toxic

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22
Q

non-toxic goitre

A

little iodine
endemic in areas

derbyshire neck

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23
Q

non toxic goitre causes

A

hereditary enzymes

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24
Q

multinodular goitre

why do they develop dysphagia

A

compress structures because they get so big

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25
thyrotoxicosis
hypermetabolic state T4/T3
26
thyrotoxicosis classify
primary : Graves secondary - TSH secreting pituitary adenoma struma ovarii - ovarian teratoma w ectopic thyroid exogenous thyroid intake
27
Graves
infiltration of tissues behind eye - exophthalmos pretibial myxoedema young females
28
graves pathogenesis
antibodies to TSH receptor and thryoglobulin associated with other types of autoimmune diseases sle pernicious addisons
29
hypothyroid causes
postablative autoimmune - hashimoto's thyroidtis iodine deficiency
30
hashimotos thyroidtis histology
infiltrate of lymphoid cells germinal centres within thyroid - autoimmune epithelial cells become enlarged - hertle cells
31
neoplasms of thryoid benign
benign adenoma
32
neoplasms of thryoid
carcinoma
33
neoplastic clues
solitary nodules solid > cystic nodules in younger patients nodules in males cold nodules - no uptake of radioactive iodine
34
assessing morphology
fine needle aspiration core biopsy / remove histology
35
adenoma
well formed capsule fibrous compression of surrounding parenchyma
36
predispose to carcinoma of thryoid
multiple endocrine neoplasia ionizing radiation - atomic bomb/ chernobyl
37
papillary carcinoma nuclear features
most common neoplasm of thyroid optical clear nuclei intranuclear inclusions psammoma bodies- foci of calcification
38
presentation of papillary tumour
metastasise to lymph nodes may present w cervical lymph node 10 year survival 90%
39
follicular carcinoma
follicular morphology well demarcted with minimal invasion usually metastasise via blood stream > lungs > bone >liver
40
medullary carcinoma distinctive why?
arises from parafollicular cells which secrete calcitonin
41
medullary origin
80% spontaneous 20% familial - MEN
42
calcitonin is broken down into amyloid which cancer ? which dye detects this?
medullary congo red > polarised light gives rise to green colour
43
anaplastic
v aggressive metastases early widely most die within 1 year
44
parathyroid glands how many?
usually 4 10% only have 3/ 5
45
activiyt of parathyorid
free calcium
46
decreased calcium = increased PTh which causes
activated osteoclast increased renal absorption of calcium increased Vit d> active increased EXCRETION of urinary phosphate increased intestinal calcium absorption
47
solitary adenoma hyperparathyroidism
benign 80%
48
normal parathyroid is about 50%
fat but not adenoma
49
osteitis fibrosa cystica
primary hyperparathyroidism causes bone resorption w thinning of cortex and cyst formation = may lead to fractures = fracture
50
primary hyperparathyroidism renal effects
stones obstructive uropathy
51
primary hyperparathyroidism GI
constipation pancreatitis gallstones
52
primary hyperparathyroidism CNS effects
alterations depression lethargy and fits
53
primary hyperparathyroidism neuromuscular effects
weakness
54
primary hyperparathyroidism Uro effects
polyuria and polydipsia
55
primary hyperparathyroidism useful mnemonic for symptoms
painful bones renal stones abdominal groans psychic moans
56
secondary hyperPTH
chronic depression of serum calcium causes persistent stimulation > enlarged glands widespread bone disease renal failure is a big cause
57
hypoPTH
surgical ablation congenital absence autoimmune
58
signs of HypoPTH
neuromuscular irritibility : tingling tetany cardiac arrhythmia fits cataracts
59
adrenal gland
cortex surrounded by medulla
60
zona glomerulosa -
aldosteone
61
zona fasciculata
glucocorticoids
62
zona reticularis
androgens glucocorticoids
63
medulla
noradrenaline
64
cushing syndrome
most cases caused by exogenous steroids
65
cushing disease
primary hypothalamic pituitary disease with increased ACTH - cushing disease
66
cushing syndrome secretion of ectopic ACTH by what tumour?
most commonly small cell carcinoma of lung non-endocrine bilateral hyperplasia
67
iatrogenic cushing syndrome adrenals
atrophy
68
hyperaldosteronism
primary - Conn's syndrome bilateral hyperplasia htn and HYPOkalaemia
69
waterhouse-friderichson syndrome
a group of symptoms caused when the adrenal glands fail to function normally. This occurs as a result of bleeding into the glands
70
adrenal insufficiency split by
acute: sudden withdrawal of steroids haemorrhage (neonates) sepsis w DIC chronic > autoimmune: addison's TB HIV haemchromatosis sarcoid
71
adrenal medulla
secretes catecholamines in response to signals from the sympathetic nervous system > phaeochromocytoma >Neuroblastoma
72
phaeo rule of 10
secrete catecholamines 10% genetic syndrome MEN, von Hippel 10% bilateral 10% malignant
73
Multiple endocrine neoplasia
inherited proliferative lesions multiple endocrine organs
74
tumours in MEN
occur at a younger age than sporadic tumours arise in multiple endocrine organs multifocal in one organ preceded by hyperplasia usually more aggresive than sporadic tumours
75
parafolliculary c cells which carcinoma
medullary
76

Year 5 Histopath (11 decks)

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