Endocrine System Pathology Flashcards Preview

Pathology > Endocrine System Pathology > Flashcards

Flashcards in Endocrine System Pathology Deck (104)
Loading flashcards...
1

sudden onset of neurologic impairment due to a rapidly enlarging adenoma

pituitary apoplexy

2

cut off value to determine micro and macroadenomas

1cm

3

most common cause of hyperpituitarism

prolactin cell adenoma

4

second most common cause of hyperpituitarism

somatotroph adenoma

5

[diagnosis: pituitary cell type]

galactorhea, amenorrhea (in females), seuxal dysfunction, infertility

lactotroph

Hormone: prolactin

6

[diagnosis: pituitary cell type]

gigantism (children), acromegaly (adults)

Somatotroph

hormone: GH

7

[diagnosis: pituitary cell type]

cushing syndrome, presence of large, nelson syndrome

Corticotroph

hormone: ACTH

8

___ syndrome

destructive adenoma after adrenalectomy for treatment of cushing syyndrome

Nelson syndrome

9

[diagnosis: pituitary cell type]

Hyperthyroidism

Thyrotroph

Hormone: TSH

10

[diagnosis: pituitary cell type]

Hypogonadism, mass effect, hypopituitarism

Gonadotroph

Hormone: FSH, LH

11

[diagnosis: pituitary]

uniform, polygonal cells in sheets and cords, sparse reticulin network, invasion and increased mitosis: atypical adenomas

pituitary adenoma

12

[diagnosis: pituitary]

atypical adenomas + metastasis (CSF/systemic)

pituitary CA

13

hormone that is lost first following hypopituitarism

FSH and LH

14

hormone that is lost last following hypopituitarism

prolactin

15

[diagnosis: pituitary hormone deficiency]

amenorrhea, infertility, decreased libidi, impotence, loss of pubic and axillary hair

FSH, LH

16

[diagnosis: pituitary hormone deficiency]

pallor

MSH

17

[diagnosis: pituitary syndromes]

Serum Na: increased
Plasma Osm: increased
Urine Na: decreased
Urine Osm: Decreased

UO increased
CVP decreased

ADH is low

Central DI

18

[diagnosis: pituitary syndromes]

Serum Na: increased
Plasma Osm: increased
Urine Na: decreased
Urine Osm: Decreased

UO increased
CVP decreased

ADH is high

nephrogenic DI

due to unresponsiveness of renal tubules to ADH

19

[diagnosis: pituitary syndromes]

Serum Na: low
Plasma Osm: low
Urine Na: high
Urine Osm: high

UO low
CVP high

ADH is high

SIADH

20

[diagnosis]

vestifgial remnant of rathke pouch, mass effect, compress pituitary parenchyma

craniopharyngioma

21

[diagnosis: pituitary]

nest of squamous cells with peripheral palisading around a spongy reticulum

tumor nests float on wet keratin

cranipharyngioma

22

most common cause of congenital hypothyroidism world wide

iodine deficiency

23

most common cause of hypothyroidism in iodine-sufficient areas

Hashimoto Thyroiditis

24

[diagnosis]

infancy to early childhood, impaired CNS development, short stature, coarse facial features, protruding tongue, umbilical hernia

cretinism

25

[diagnosis]

late adulthood to adult, slowing of physical activity, overweight, hypercholesterolemia, non-pitting edema, coarse facial features, macroglossia, deepening of voice

myxedema

26

[diagnosis]

fibrosis of the thyroid gland + contiguous neck structures

Reidel Thyroiditis

27

[diagnosis]

hyperplastic follicles forming pseudopapillary structures, moth eaten colloid

graves ophthalmopathy

28

[diagnosis]

painless goiter, transient hyperthyroidism then hypothyroidism

autoantibodies against TG and TPO

hashimoto thyroiditis

29

[diagnosis]

painless goiter, transient hyperthyroidism then hypothyroidism

autoantibodies against TPO; usually associated with a history of autoimmune disease

Subacute Lymphocytic or postpartum

30

[Diagnosis]

painful, variable thyroid enlargement, transient hyperthyroidism then hypothyroidism then normal

antigen-mediated immune damage to follicular cells (by cytotoxic T cells)

notable history of URTI

Granulomatous

31

[diagnosis]

hurthle cell change present, present fibrosis, absent granulomas

present: lymphocyte, monocyte, plasma cell, and germinal center

Hashimoto

32

[diagnosis]

hurthle cell change absent, absent fibrosis, absent granulomas

present: lymphocyte, monocyte, plasma cell, and germinal center

Subacute Lymphocytic/postpartum

33

[diagnosis]

hurthle cell change absent, absent fibrosis, present granulomas with multinucleated giant cell

Acute phase: PMNs

Granulomatous

34

[diagnosis]

Hyperthyroidism
Ophthalmopathy
Dermopathy

Graves disease

35

Type of hypersensitivity of graves disease

Type II hypersensitivity

Autoantibodies against TSH receptor

36

[diagnosis]

low TSH
high FT3/FT4

Graves

37

[diagnosis: phase of goiter]

Trophic effects of TSH on gland, diffuse, symmetrical enlargement, colloid is less abundant

hyperplastic phase

38

[diagnosis: phase of goiter]

sufficient iodine intake/ decrease thyroid demand

brown, glassy, translucent cut surface

flattened and cuboidal follicular epithelium

abundant colloid

colloid or involution phase

39

cassava causes goiter since it contains

thiocyanate

40

____ syndrome

autonomous nodule in a long-standing TMNG, but no ophthalmopathy, no pretibial myxedema

Plummer Syndrome

41

[diagnosis]

non-functional thyroid nodule, enclosed by and intact, well-formed capsule

thyroid adenoma

42

[diagnosis]

non-functional thyroid nodule, no capsule noted

adenomatous nodule

43

[diagnosis]

non-functional thyroid nodule, capsular and vascular invasion noted

follicular CA

44

most common thyroid CA

papillary

45

second most common thyroid CA

follicular

46

thyroid CA arising from the parafollicular C cells

medullary

47

thyroid CA that is warm on scintiscan

follicular thyroid CA

48

Medullary Thyroid CA is associated with what MEN

MEN 2

49

[diagnosis]

high VIP, High ACTH, high calcitonin, hypocalcemia, MEN2

Medullary thyroid CA

50

[diagnosis: thyroid CA]

orphan annie nuclei, psammoma bodies, lymphatic invasion

papillary

51

[diagnosis: thyroid CA]

small, polygonal to spindle shape, acellular amyloid deposit, parafollicular C cell hyperplasia

medullary thyroid CA

52

[diagnosis: thyroid CA]

osteoclast-like multinucleated giant cells, spindle-shaped cells, Cytokeratin (+), Thyroglobulin (-)

Anaplastic thyroud CA

53

most common cause of secondary hyperparathyroidism

renal failure

54

most common cause of primary hyperparathyroidism

parathyroid adenoma

55

Stones, Thrones, Bones, Graons, psych overtones are clinical manifestations of?

hyperparathyroidism

56

___ disease of bone

increased osteoclast activity, peritrabecular fibrosis, cystic brown tumor

Von Recklinghausen disease

57

reliable criteria for parathyroid malignancy

metastasis and local invasion

58

[diagnosis]

calcifications of basal ganglia, frank psychosis, emotional instability, parkinsonian-like movement disorders

calcification of lens, QT prolongation

hypoparathyroidsm

59

cut off FBS value for impaired glucose tolerance

100-125 mg/dL

60

cut off FBS value for diabetes

>/126 mg/dL

61

cut off RBS value for diabetes

>/ 200 mg/dL + 3 Ps

62

Cut off HBA1c value for diabetes

>/ 6.5%

63

cut off value for 2hour 75g OGTT

>/200 mg/dL

64

Diabetic coma are due to

ketoacidosis, volume depletion

65

Type I DM is classified as ___ hypersensitivity reaction

Type IV

66

most important susceptibility gene in Type I DM is located in what chromosome

Chromosome 6

67

Triad of T2DM

genetic, environmental, proinflammatory state

68

most important environmental factor in T2DM pathogenesis

central or visceral obesity

69

[diagnosis]

hyperglycemia + ketoacidosis

DKA

70

[diagnosis]
hyperglycemia without ketoacidosis

Hyperosmotic hyperglycemic state

71

most common acute complication of DM

hypoglycemia

72

Microvascular changes in the kidneys due to T2DM

diffuse thickening of BM and leaky capillarues

73

[diagnosis]

nodular glomerulosclerosis or intercapillary glomerulosclerosis

(+) PAS
positive acellular nodules in glomerulus

Kimmelstiel-Wilson Disease

74

most common pancreatic neuroendocrine tumor

insulinomas

75

___ triad

Hypoglycemia (<50mg/dL)
Neuroglycopenic symptoms
Relief upon administration of parenteral glucose

Whipple triad

76

[diagnose]

hyperinsulinsm, whipple triad
usually benign

Histo: recapitulate normal pancreatic islet, amyloid deposition

insulinoma

77

___ syndrome

1. Pancreatic islet tumor
2. Hypersecretion of gastric acid
3. severe peptic ulceration

Zollinger-Ellison syndrome

78

[diagnose]

Hypergastrinemia
Zollinger-Ellison Syndrome

usually malignant

Histo: recapitulate normal pancreatic islet

Gastrinoma

79

[diagnose]

DM, necrolytic migratory erythema, anema

alpha cell tumor

Glucagon

Glucagonomas

80

[diagnose]

DM, cholelithiasis, steatorrhea, hypochlorydia

gamma cell tumor

Somatostatin

Somatostatinomas

81

[diagnose]
watery diarrhea, hypokalemia, achlorydia

VIPoma

82

___ syndrome

VIPoma

Verner-Morrison Syndrome

83

[diagnose]

facial flushing, diarrhea, bronchoconstriction

Pancreatic Carcinoid

Serotonin

84

Most common cause of cushing syndrome (overall)

iatrogenic (exogenous steroids)

85

most common endogenous cause of Cushing syndrome

ACTH-secreting pituitary adenoma

86

[diagnose]

abdomina striae, obesity, buffalo hump, moon facies

cushing syndrome

87

[diagnose]

crooke-hyaline change (homogenous, paler cytoplasm of ACTH-secreting cells), increased 24 hour urine free cortisol, decreased plasma ACTH

ACTH-independent

88

[diagnose]

crooke-hyaline change (homogenous, paler cytoplasm of ACTH-secreting cells),
increased 24 hour urine free cortisol,
increased plasma ACTH

ACTH-dependent

89

[diagnose]

increased plasma aldosterone,
decreased plasma renin activity

primary hyperaldosteronism

90

[diagnose]

increased plasma aldosterone,
increased plasma renin activity

secondary hyperaldosteronism

91

most common cause of primary hyperaldosteronism

bilateral idiopathic hyperaldosteronism

92

most common cause of congenital adrenal hyperplasi

21-hydroxylase deficiency

93

waterhouse-friedrichsen syndrome can be complication of a disseminated bacterial infection. The causative agent is usually

N. meningitides

94

most common cause of primary chronic adrenocortical insufficiency

autoimmune adrenalitis

95

[diagnose]

irregularly shrunken adrenals with lymphoid infiltrates, hyperpigmentation is present

ACTH stimulation test: negative

addison disease

96

[diagnose]

adrenal has a variable size, hyperpigmentation is absent

ACTH stimulation test: positive

secondary adrenocortical insufficiency

97

[diagnose: adrenocortical neoplasm]

hypercortisolism and hyperaldosteronism

grossly: yellow, lipid-rich mass
minimal atypia, no necrosis,

adenoma

98

[diagnose]

virilization

gross:hemorrhage and cystic change

anaplastic, marked mitosis, marked necrosis,

adrenal carcinoma

99

____ originates from chromaffin cells of medulla

pheochromocytoma

100

[diagnose]

nests of cell surrounded by sustentacular cells, salpt and paper chromatin, rich vascular network

pheochromocytoma

101

the only criteria for malignancy of pheochromocytoma

metastasis

102

[diagnose]

1. Prolactinoma
2. Primary hyperparathyroidism
3. Insulinoma or gastrinoma

MEN 1

Wermer Syndrome

103

[diagnose]

1. Pheochromocytoma
2. parathyroid hyperplasia

MEN 2A

Sipple syndrome

104

[diagnose]

1, pheochromocytoma
2. Neuroma
3. Ganglioneuromas
4. Marfanoid habitus

MEN 2B