Histopathology 4s - endocrine disease

Question 1

Anterior pituitary cell type, posterior pituitary cell type

Answer 1

Anterior: epithelial cells
Posterior: neural cells

Question 2

Most common type of pituitary adenoma

Answer 2

Prolactinoma

Question 3

Microadenoma size?

Answer 3

<1cm

Question 4

Growth hormone adenoma in children and adults

Answer 4

Children –> gigantism

Adults –> Acromegaly

Question 5

What are most cases of hypopituitarism caused by?

Answer 5

Non-secretory pituitary adenoma
Icshaemic necrosis (Sheehan’s)
Iatrogenic

Question 6

Main 2 cell types in thyroid gland

Answer 6

Follicular cells epithelial cells

Parafollicular/C cells

Question 7

What do the follicular epithelial cells contain?

Answer 7

Colloid

Question 8

Function of parafollicular/C cells

Answer 8

Produce calcitonin which promotes the absorption of calcium by the skeletal system

Question 9

Most common cause of non-toxic goitre

Answer 9

Iodine deficiency (Can also be normal during puberty in girls)

Question 10

Grave’s disease triad

Answer 10

Thyrotoxicosis, exophthalmos, pretibial myxoedema

Question 11

Antibody in Grave’s

Answer 11

Anti-TSHr

Question 12

Other AI diseases associated with Grave’s

Answer 12

SLE, Pernicious anaemia, T1DM, Addison’s

Question 13

Hashimoto’s antibodies

Answer 13

Anti-TPO, Anti-TG

Question 14

histology of hashimoto’s

Answer 14

Hurthle cells + lymphoid cells

Question 15

Hurthle cells

Answer 15

Epithelial thyroid cells become filled with. lots of eosinophilic cytoplasm

Question 16

Types of thyroid carcinoma

Answer 16

Papillary, follicular, medullary, anasplastic

Question 17

Histological feature of thyroid adenomas

Answer 17

Well circumscribed, well-formed capsule surrounding it

Question 18

Main risk factor for papillary carcinoma

Answer 18

Ionising radiation

Question 19

Histological features of papillary carcinoma

Answer 19

Psammoma bodies (calcifications), clear nuclei

Question 20

Site of mets in papillary carcinoma

Answer 20

Cervical LNs

Question 21

Follicular carcinoma site of mets

Answer 21

lungs, bone and liver

Question 22

medullary carcinoma which cell type?

Answer 22

C cells

Question 23

Main two causes of MTC

Answer 23

Sporadic (most common), part of MEN (2a + b)

Question 24

Characteristic feature of MTC

Answer 24

Calcitonin is broken down and deposited in to the thyroid as amyloid –> Congo red stain

Question 25

Actions of PTH

Answer 25

1a hydroxylase activation: calcidiol –> calcitriol –> gut effects
Increased renal calcium absorption
Increased osteoclast activation
Increased phosphate renal excretion

Question 26

Main cause of hyperparathyroidism

Answer 26

Solitary adenoma

Question 27

Most common cause of secondary hyperparathyroidism

Answer 27

Vitamin D deficiency e.g. renal failure

Question 28

Causes of hypoparathyroidism (3)

Answer 28

Surgical ablation
Congenital disorders (DiGeorge)
Autoimmune

Question 29

Adrenal cortex and medulla made up of which cell types respectively?

Answer 29

Cortex = epithelial cells
Medulla = neural cells

Question 30

Which cause of Cushing’s syndrome gives you adrenal atrophy?

Answer 30

Iatrogenic

Question 31

Most common cause of hyperaldoestronism

Answer 31

Bilateral adrenal hyperplasia

Question 32

Acute causes of primary adrenal insufficiency

Answer 32

Sudden withdrawal of steroids
Haemorrhage
DIC + sepsis –> haemorrhage into adrenals (Waterhouse friedrichsen syndrome)

Question 33

Main cause of Addison’s

Answer 33

Autoimmune

Question 34

What are adrenocortical carcinomas mostly associated with?

Answer 34

Virilising syndromes

Question 35

Phaeo rule of 10

Answer 35

10% malignant
10% bilateral
10% associated with syndromes (vHL, MEN, Sturge-Weber)

Question 36

MEN 1 (3Ps)

Answer 36

Pituitary adenoma
Parathyroid hyperplasia
Pancreatic tumours

Question 37

MEN2a

Answer 37

Parathyroid hyperplasia
MTC
Phaeo

Question 38

MEN2b

Answer 38

MTC
Phaeo
Mucosal neuromas
Marfanoid body habitus