Endocrine Pathalogy

Question 1

non encapsulated, pale empty nuclei, lymph node mets

Answer 1

Papillary carcinoma

Question 2

Sympathetic activation of adrenal medulla

Answer 2

ACh

Question 3

Benign adrenal lesions:

If functioning…

Answer 3

<3cm, homogenous, thin wall, lipid rich.

Urine VMA – functioning should be removed. Alpha +/- beta blockade

Question 4

Oxyphil cells normally found in

Answer 4

parathyroid glands

Question 5

Addisonian crisis

Answer 5

adrenal insufficiency - hyponatraemia, hyperkalaemia and hypoglycaemia

Question 6

Thyroid cancer recurrence

Answer 6

o Medullary carcinoma (parafollicular c cells) – calcitonin
o Follicular carcinoma – thyroglobulin antibodies

Question 7

90% of pancreatic carcinomas are

Answer 7

Ductular epithelia adenocarcinomas

Ductular epithelia - origin 90% of pancreatic carcinomas are adenocarcinomas.

Question 8

Oxyphil cells with scanty colloid

Answer 8

Hurthe Cell tumours – worst follicular prognosis

Question 9

1.5 cm insulinoma of the pancreatic head

Answer 9

Enucleation of the lesion

Question 10

hypocalcaemia – confusion + laryngospasm/stridor

Answer 10

Parathryoid gland exploration – ischaemia – hypocalcaemia – confusion + laryngospasm/stridor (if no haematoma/drain empty)

Question 11

for thyrotoxic storm

Answer 11

Beta adrenoceptor blockers and thionamides

Question 12

Post viral hyperthyroidism, painful goitre, low I131 uptake.

Answer 12

Subacute/DeQuervain thyroiditis: Post viral hyperthyroidism, painful goitre, low I131 uptake. Raised ESR.

No surgery required!

Question 13

Insulin half-life

Answer 13

<30minutes!

Question 14

MEN1

Answer 14

3Ps – Parathyroid adenoma, Pituitary/Prolactinoma, Pancreatic/ZE Syndrome

Question 15

MEN IIa –

Answer 15

Pheochromocytoma, parathyroid hyperplasia, MTC

Question 16

MEN IIb –

Answer 16

Pheochromocytoma + MTC + marfanoid +mucosal neuroma

Question 17

Triiodothyronine/T3 acts on…

Answer 17

nuclear receptor on chromatin – induce protein synthesis

Question 18

SIADH

Answer 18

Analgesics: opioids, NSAIDs / Barbiturates
o Cyclophosphamide/ Chlorpromazine/ Carbamazepine
o Diuretic (thiazides)

Question 19

Brown tumours

Answer 19

hyperparathyroidism – high bone turnover with blood supply and no matrix

Question 20

PTH half life

Answer 20

<10minutes

Question 21

Glucacon released by and when…

Answer 21

Glucacon – alpha cells release in hypoglycaemia or aminoacids

Question 22

Thyroglobulin is a…

Answer 22

Colloid

Question 23

Stimulations and Suppresses Prolactin

Answer 23

TRH stimulates prolactin secretion

Dopamine suppresses

Question 24

Catecholamines derived from

Answer 24

Catecholamines derived from tyrosine

Question 25

ECG in hypercalcaemia?

Answer 25

ECG in hypercalcaemia: 1. Increased PR interval, progressing to heart block 2. Widened QRD but Shortened QT interval (Shortened ST) 3. Flattened or inverted T waves 4. Severe J waves 5. Bradycardia

Question 26

Calcium Ranges

Answer 26

Normal serum corrected calcium = 2.1 – 2.6 mmol/L Mild hypercalcaemia = 2.7 – 2.9 mmol/L Moderate hypercalcaemia = 3.0 – 3.4 mmol/L Severe hypercalcaemia = greater than 3.4 mmol/L

Question 27

Graves description vascularity receptor type

Answer 27

commonest thyrotoxicosis, diffuse goitre, increased vascularity, P() pretibial myxodoema > exophthalmos o igG – long acting thyroid receptor (LATS)