Lecture 6- Endocrine pathology

Question 1

the …. is the master gland because it controls most other endocrine glands. it is located in the sella turcica, is the size of a pea and has 2 lobes

Answer 1

pituitary gland

Question 2

hormones produced by the anterior pituitary

Answer 2

GH 
TSH
PRL
ACTH
FSH
LH

Question 3

hormones of the posterior pituitary

Answer 3

oxytocin

ADH

Question 4

hyperfunction of the anterior pituitary is almost always associated with…

Answer 4

adenoma

Question 5

causes of hypopituitarism

Answer 5

nonfunctional pituitary adenoma

postpartum ischemic necrosis (need 75%)

ablation/destruction by surgery, radiation or adjacent tumor

Question 6

hypofunction in GH causes

Answer 6

dwarfism

Question 7

hypofunction in gonadotropin causes

Answer 7

amenorrhea/infertility in women

decreased libido, impotence, lack of pubic hair in men

Question 8

hypofunction of prolactin causes

Answer 8

no post-partum lactation

Question 9

hypofunction of TSH causes

Answer 9

hypothyroidism

Question 10

hypofunction of ACTH causes

Answer 10

hypoadrenalism

Question 11

… and … is caused by an adenoma in the anterior lobe of the pituitary that secretes GH

Answer 11

gigantism

acromegaly

Question 12

gigantism occurs before or after the closure of the epiphyseal plates in the long bones?

Answer 12

before

Question 13

what are the clinical features of gigantism

Answer 13

generalized increase in size of body

arms and legs are disproportionately long

Question 14

tx and prognosis for gigantism

Answer 14

surgical removal of adenoma

fair to good

Question 15

acromegaly occurs before or after the closure epiphyseal plates in the long bones?

Answer 15

after

Question 16

clinical features of acromegaly

Answer 16

enlarged bones of hand, feet and face

prognathism, diastema

HTN, CHF

Question 17

tx of acromegaly

Answer 17

surgical removal of adenoma

Question 18

prognosis for acromegaly?

Answer 18

guarded due to complications of HTN and CHF

Question 19

causes of dwarfism

Answer 19

failure of pit gland to produce GH

lack of response to GH by patients tissues

Question 20

clinical features of dwarfism

Answer 20

short stature

small jaws and teeth

Question 21

tx and prognosis of dwarfism

Answer 21

hormone replacement therapy

good

Question 22

the thyroid gland develops from an invagination of …. which arises at the base of the tongue in the region of the …

Answer 22

endoderm

foramen cecum

Question 23

most common cause of hyperthyroidism?

Answer 23

diffuse toxic hyperplasia (graves disease)

Question 24

other causes of hyperthyroidism

Answer 24

hyperfunctional multinodular goiter

hyperfunctional thyroid adenoma

TSH-ecreting pituitary adenoma (rare)

Question 25

dx of hyperthyroidism

Answer 25

elevated TH and decreased TSH

Question 26

hyperthyroidism symptoms

Answer 26

hypermobility GI hypermobility-malabsorption/diarrhea tachycardia nervousness/tremor exophthalmos (bulging eyes) excessive sweating/ heat intolerance weight loss despite increased appetitie

Question 27

... is a sudden onset of severe hyperthyroidism and is usually triggered by stress. patients usually die of cardiac arrhythmias if untreated

Answer 27

thyroid storm

Question 28

tx of hyperthyroidism ?

Answer 28

depends on cause reactive iodine can be used to destroy overactive thyroid tissue

Question 29

graves disease (diffuse toxic hyperplasia) has a ... predominance, is common and is an autoimmune disease with a significant ... component

Answer 29

female genetic

Question 30

pretibial myxedema is present in...

Answer 30

Graves disease

Question 31

causes of hypothyroidism

Answer 31

ablation by surgery or radiation therapy hashimoto thyroiditis (autoimminue) iodine deficiency

Question 32

hypothyroidism can either present as ... or ...

Answer 32

cretinism (children) myxedema (adults)

Question 33

clinical features of cretinism

Answer 33

impaired development of skeletal and CNS short stature severe mental retardation protruding tongue

Question 34

clinical features of myxedema

Answer 34

generalized apathy mental sluggishness (mimics depression) obesity cold intolerance enlarged tongue

Question 35

hashimoto thyroiditis has a ... predominance, seen in .... and has a significant

Answer 35

female older genetic

Question 36

with hypothyroidism, patients are at risk for other autoimmune diseases and ...

Answer 36

B cell non hodgkin lymphomas

Question 37

most common of thyroid cancers? (>85%) more common in women or men?

Answer 37

papillary thyroid carcinoma women

Question 38

some cases of papillary thyroid carcinoma is related to radiation exposure and many have mutations in ....

Answer 38

RET proto-oncogene

Question 39

pathology of papillary thyroid carcinoma

Answer 39

papillary projections nuclear clearing- orphan annie nuclei nuclear grooves

Question 40

papillary thyroid carcinomas are .... and have a 10 year survival rate of ...%

Answer 40

indolent 95%

Question 41

in follicular thyroid carcinoma what must you see?

Answer 41

invasion through the capsule or into the blood vessels

Question 42

2nd most common type of thyroid cancer?

Answer 42

follicular thyroid carcinoma

Question 43

follicular thyroid carcinoma may resemble

Answer 43

follicular adenoma

Question 44

T/F patients are usually older with papillary thyroid carcinoma than follicular thyroid carcinoma

Answer 44

false

Question 45

.... ... carcinoma is uncommon (5% of thyroid cancers) and is derived from parafollicular (C) cells. may be sporadic or familial (MEN syndromes)

Answer 45

medullary thyroid

Question 46

all medullary thyroid carcinomas have mutation in

Answer 46

RET proto-oncogene

Question 47

in medullary thyroid carcinoma you see increased serum...

Answer 47

calcitonin

Question 48

serum TSH in hypothyroidism

Answer 48

increased in primary due to loss of feedback inhibition *not increased in cases caused by primary hypothalamic or pituitary dz*

Question 49

T/F thyroid nodules are common

Answer 49

true

Question 50

most nodules of the thyroid are non-neoplastic. ....% are carcinomas and nodules in ... and ... patients are more likely to be neoplastic

Answer 50

1% males young

Question 51

there is an increase risk for thyroid neoplasms with radiation exposure in the first...

Answer 51

2 decades

Question 52

... accounts for 5-15% of thyroid cancers and usually patient is older than in papillary thyroid cancer. Occurs in areas with iodine deficiency and may resemble adenoma with a discrete capsule

Answer 52

follicular carcinoma