Flashcards in Endocrine Pathology Deck (46):
What are endocrine, paracrine and autocrine glands?
Endocrine - release hormones into blood and act systemically
Paracrine - hormones released that act locally
Autocrine - hormones secreted that act of cell itself
What are the main causes for pituitary hypofunction?
Tumours - secretory adenoma or malignant
What are the most common types of pituitary tumours? What are their effects?
Adenoma - can secrete any hormone originating from thyroid
- Effects are secondary to hormone being produced (hyper functioning hormone)
-Local effects due to pressure on optic chiasma/adjacent pituitary
What is the effect of a PROLACTINOMA?
Galactorrhea (milk from breast)
What is the effect of a growth hormone secreting adenoma?
Gigantism in children
Acromegaly in adults (excessive growth - massive facial features/hands)
What is the effect of of a ACTH secreting adenoma?
- moon face etc
What is a potential complication of a thyroidectomy?
Damage to laryngeal nerve - hoarseness of voice
Where is the thyroid located?
between C5-7, anterior neck
What does ectopic mean?
Tissue somewhere where it shouldn't
What is heterotopia?
Displacement of tissue
Where can ectopic/heterotopic thyroid glands occur?
Anywhere between foramen cecum (back of tongue to suprasternal notch
Where is the most common place for ectopic/hetertopic thyroid glands to occur? Whats the effect?
Lingual thyroid - base of tongue
As this is only thyroid tissue, most patients present with hypothyroidism
Not neoplastic but can cause obstruction
What is a thyroglossal duct cyst? What can it present?
Asymptomatic mass - cyst arising from embryological remnants
What is acute thyroiditis? What are the clinical symptoms?
Inflammation of thyroid - due to virus, bacteria or fungus (generalised sepsis0
- Presents with fever, chills, malaise, pain in neck, NECK SWELLING
What is palpable thyroiditis caused by? How does it present?
Presents with thyroid nodule (granulamtous foci replace follicles)
What is Riedel thyroiditis? How does it present?
Rare, fibrosing form of chronic thyroiditis
Presents with firm goitre - dysphagia, stridor, hoarseness
- mistaken for thyroid carcinoma
What is Hashimoto's thyroiditis? How does it present?
Autoimmune chronic inflammatory disorder of thyroid
- diffuse enlargement of thyroid (non-tender)
- high TSH/low T3 and T4 cells with thyroid antibodies
What are the clinical signs of hashimoto's?
Enlarged thyroid (non-tender)
What are patients with Hashimoto's at risk of developing?
Papillary carcinoma of thyroid
What is Graves disease? How does it present?
Autoimmune chronic inflammatory condition of thyroid that causes HYPERTHYROIDISM
Elevated T3 and T4 with low TSH and high thyroid antibodies
What are the clinical features of Graves disease?
What are the complications of Graves disease?
Can develop hypothyroidism
How does mutlinodular goitre present?
Can be functional i.e. normal
Multi nodular enlargement
However, symptoms are compression of trachea/dysphagia
How to differentiate between a benign nodule and malignant carcinoma?
- Solitary nodule/Painless lump
- silent cold nodule on radioactive iodine imaging
What is the most common malignant cancer in the thyroid?
What are the three types of hyperparathyroidism? Why do they present?
Primary - excessive secretion of one/more glands (single adenoma, or diffuse chief cell) - MEN2a
Secondary - hyperplasia of glands due to vit D deficiency, renal insufficiency and malnutrition
What is the complications of primary hyperparathyroidism?
reduced renal function
What is primary chief cell hyperplasia?
Increased in parathyroid cell mass (non-neoplastic)
Hypercalcaemia - stones, bones, groans and abdominal moans
How does hyperparathyroidism present biochemically?
What is parathyroid adenoma associated with?
MEN1 and MEN2a
How does parathyroid adenoma usually present?
One enlarged gland, remaining ones suppressed and small
How do parathyroid carcinomas present?
What does the adrenal cortex produce?
Aldosterone - mineralocorticoids
Cortisol - glucocorticoids
Androgens - testosterone and DHEA
What does the adrenal medulla produce?
What is Cushings syndrome?
Excessive ACTH (pituitary adenoma) or excessive glucocorticoid secretion from adrenal cortex (cortisol) (adenoma)
What are the diagnostic features of Cushing's syndrome?
Elevated ACTH/cortisol in blood
- moon face
- central obesity
- thinning hair
- proximal muscle weakness
What is Conn's syndrome?
Excessive aldosterone release
What are the clinical features of Conn's syndrome?
Hypertension (H2O and Na retention), potassium loss (muscle weakness/muscle arrythmias)
What is addison syndrome?
Underproduction of cortisol and aldosterone
What are the causes of addison syndrome
Primary adrenal cortical insufficiency or destruction
Autoimmune or TB
How does addisons present clinically?
What is the treatment for addison's?
Steroid replacement therapy
(fatal if undiagnosed)
What is the name for a catecholamine releasing tumour arising from the adrenal gland?
What are the symptoms of pheochromocytoma?
Symptoms related to excessive catecholamines
How are pheochromocytoma diagnosed?
Raised urine catecholamines