Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Endocrine System > Pathology of the Endocrine System 1 & 2 > Flashcards

Pathology of the Endocrine System 1 & 2 Flashcards

1
Q

the endocrine system:

uIntegrated network of ______ - secrete chemical messengers – hormones - directly into bloodstream

___________ act on target cells distant from site of synthesis - bind to receptors – change cell activity

___________ of metabolism, growth and development, tissue function

maintain functional balance __________

A

glands

hormones - by binding to receptors which change cell activity, differentiation, mitosis. It is instrumental in regulating metabolism, growth, development and puberty and tissue/organ function

regulation

homeostasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hormones synthesised and stored in glands, what are the features of a gland?

A

packets of cells with secretory granules

vascular

ductless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

balance of hormones is maintained by

A

feedback inhibition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what makes up the endocrine system?

A

Pineal gland - produces melatonin - regulates circadian rhythm

Hypothalamus

Pituitary gland

Thyroid gland

Parathyroid gland

Adrenal glands

Pancreas

other organs (ovary, testes, kidney)

diffuse endocrine cells (lung, GIT)

Often two - in - one (endocrine organ often does more than one thing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

example of major system pathways:

A

TRH – TSH – T3/T4

GnRH – LH/FSH – sex hormones

CRH – ACTH – cortisol

Renin – angiotensin – aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is endocrine disease?

A

Disease processes lead to changes in function and/or structure

Dysregulated hormone release -HYPERFUNCTION and HYPOFUNCTION

Effect of a MASS lesion (tumour – may secrete a hormone or have an effect of being a mass and compressing things nearby)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Disease Processes in Endocrine Organs:

what is hyperplasia?

A

increased number and secretory activity of cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Disease Processes in Endocrine Organs:

what is atrophy?

A

shrinking of an organ

diminution of cells due to lack of stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Disease Processes in Endocrine Organs:

what can cause tissue damage?

A

inflammation, autoimmune disease, compression, trauma, infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Disease Processes in Endocrine Organs:

what are examples of neoplasia (unregulated growth)

A

Adenoma – functioning or non functioning

Carcinoma – 1ry or metastatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Disease Processes in Endocrine Organs:

what is it called when something is wrong form birth

A

congenital abnormality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the properies of benign neoplasia in endocrine organs?

A

Often circumscribed, localised, cannot invade, don’t usually transform

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the properies of malignant neoplasia in endocrine organs?

A

Synonymous with cancer, invades, metastasises, if untreated, will often prove fatal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Disease in one endocrine gland may have __________ clinical effects

__________ effects may cause endocrine gland changes

Endocrine organs have high _______ capacity

A

multiorgan

feedback

reserve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what does thyroid gland secrete and what are its functions?

A

Synthesis, storage, release of thyroxine (T4), triiodothyronine (T3) - Regulates basal metabolic rate

calcitonin - Regulates calcium homeostasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

describe the histology of the thyroid gland

A

Thyroid epithelial cells are arranged in follicles filled with colloid –thyroglobulin.

Synthesis in colloid of thyroglobulin

Roles of iodine and tyrosine in T3/T4 synthesis

Involved in synthesise thyroglobulin – this requires iodine tyrosine

Cells reabsorb thyroglobulin and convert it to T3 and T4

Follicles

Colloid-contains thyroglobulin

Epithelial cells – TG synthesis, iodination, resorption & release of T4 and T3

C-cells – secrete calcitonin (not visible)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

decsribe the hypothalamus - pituitary- thyroid axis

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is a manifestation of hyperthyroidism and what causes hyperthyroidism?

A

Thyrotoxicosis

Thyroiditis, Autoimmune, Others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are manifestations of hypothyroidism and what are the causes hypothyroidism?

A

Myxoedema, Cretinism (a condition characterized by physical deformity and learning difficulties that is caused by congenital thyroid deficiency), Subclinical

Gland destruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the manifestations of thyroid enlargement and what causes thyroid enlargement?

A

Goitre, Isolated nodule/mass

Multinodular goitre

Tumours - Benign or Malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the causes of hyperthyroidism?

A

Diffuse toxic hyperplasia (Graves disease) – 70%

Toxic multinodular goitre – 20%

Toxic adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

who is graves disease common in?

A

F>M

peak 20-40 yrs

genetic predisposition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what happens in graves disease?

A

Autoimmune production of anti- TSH receptor antibodies:

stimulate activity, growth, inhibit TSH binding

ophthalmopathy immune mediated - ocular fibroblasts have TSH receptor

Thyroid - diffuse hyperplasia and hyperfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what does the histology of a thyroid gland look like in graves disease?

A

increased cell activity

increased cell numbers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what are causes of hypothyroidism?
Hashimoto’s thyroiditis (auto-immune destruction) Iatrogenic – surgery, drugs Iodine deficiency Congenital hypothyroidism
26
who is at risk of hashimotos thyroiditis
F\>M , 45-65yrs
27
how does hashimotos thyroiditis occur?
Autoimune destruction of thyroid epithelial cells Cytotoxic T cells, cytokine and antibody mediated destruction Circulating autoantibodies to thyroglobulin, thyroid peroxidase Thyroid - Diffuse enlargement gradual failure
28
what is the histology of hashimotos thyroiditis?
29
goite is
an enlarged thyroid
30
what are the causes of multinodular goitre?
Physiological - Puberty, Pregnancy Autoimmune - Graves’ disease, Hashimoto’s disease Thyroiditis - Acute (de Quervain’s ), Chronic fibrotic (Reidel’s) Iodine deficiency (endemic goitre) Dyshormogenesis Goitrogens
31
describe the process of multinodular goitre
Iodine deficiency, goitrogens ↓ Impaired synthesis of T3,T4 ↓ ↑TSH ↓ Hypertrophy and hyperplasia of thyroid epithelium Simple → → multinodular
32
describe the histology of multinodular goite
Distended colloid filled follicles Haemorrhage, fibrosis, cystic change Nodular appearance
33
what is the cause of a dominant nodule in multinodular goitre?
Follicular adenoma Carcinoma (5% of nodules) Differentiated thyroid carcinoma Papillary carcinoma 75-85% Follicular carcinoma 10-20% Anaplastic carcinoma \<5% Medullary carcinoma 5% (lymphoma)
34
how do you investigate a thyroid nodule?
TFTs Ultrasound FNA - cytology
35
how is thyroid carcinoma normally detected?
Often incidentally detected
36
what are the risk factors of a thyroid carcinoma?
Family Hx Chronic inflammatory conditions Radiation exposure Obesity
37
what is a Follicular adenoma?
a benign encapsulated tumor of the thyroid gland Most non-functioning Circumscribed, encapsulated tumour Histology often small microfollicles
38
desribe the featurrs of a follicular carcinoma
Rare, usually solitary Malignant cells breach capsule uMetastases – blood, bones
39
what are the features of a papilllary carcinoma?
Papillary carcinoma (PTC) is the most common form of well-differentiated thyroid cancer, and the most common form of thyroid cancer to result from exposure to radiation. Papillary carcinoma appears as an irregular solid or cystic mass or nodule in a normal thyroid parenchyma Usually \<50yrs BRAF mutation or RET/PTC gene rearrangement Associated with exposure to ionizing radiation Spreads via lymphatics...but Excellent prognosis - 85% survival 10 yrs (esp \<55yrs)
40
describe the histology of a papillary carcinoma
Papillary projections Empty nuclei Psammoma bodies May be cystic
41
what are the featrues of thyroid medullary carcinoma
Malignant tumour of C – cells produces calcitonin (+/- other polypeptides) 70% sporadic 30% MEN 2A, 2B, familial FMTC – mutations in RET proto-oncogene – prophylactic thyroidectomy
42
what is the treatment of thyroid carcinoma?
Surgery (no surgical option in anaplastic) Radioactive iodine - gets rid of any bits that are left External radiotherapy Chemotherapy
43
what are the parathyroid glands and their function?
4 small glands -120mg Produce PTH - regulates plasma Ca2+ thyroid Calcitonin opposes PTH (Calcitonin promotes bony absorption of calcium and prevents bone resorption)
44
if someone has got a parathyroid adenoma they will often present \_\_\_\_\_\_\_\_\_\_
hypercalcaemic
45
Primary hyperparathyroidism often asymptomatic \_\_\_\_\_\_\_\_\_\_\_\_\_
hypercalcaemia
46
what are the causes of primary hyperparathyroidism?
Sporadic or familial (MEN-1) - Adenoma (85-95%) - Hyperplasia (5-10%) - Carcinoma (rare)
47
What is secondary hyperparathyroidism due to?
Physiological response to ↓Ca2+ renal failure
48
where and what is the role of the hypothalamus and the pituitary gland?
Small gland, located in sella turcica Connected to hypothalamus by pituitary stalk Critical role in regulating other endocrine glands
49
what does the the anterior pituitary secrete, what is its blood supply and what is it controlled by? (adenohypophysis 80%)
secretes - ACTH, TSH, GH, PROLACTIN, FSH/LH blood supply from hypothalamus controlled by release factors from hypothalamus
50
where is the posterior pituitary and what does it secrete? (neurohypophysis)
downgrowth of hypothalamus Secretes ADH, OXYTOCIN
51
what is the most common cause of pituitary hyperfunction?
pituitary adenoma (not all secrete so may just cause a mass effect) (pituitary carcinomas v rare and some hypothalamic disorders)
52
what people are pituitary adenomas common in?
uusually adults, 35 to 60 yrs most sporadic; 5% inherited eg MEN1
53
pituitary adenomas are macroscopic, what do they look like?
soft, well-circumscribed lesion small microadenomas may be incidental eg at post mortem
54
what are the effects of a pituitary adenoma?
If functioning - hormone excess Prolactinoma - 20-30% - galactorrhoea, menstrual disorders GH secreting - acromegaly, gigantism ACTH secreting - Cushing’s disease Non-functioning - 25-30% of detected tumours - immunohistochemical demonstration (mostly prolactin)
55
what is the difference between cushings syndrome and cushings disease?
Cushing's syndrome refers to the condition caused by excess cortisol in the body, regardless of the cause When Cushing's syndrome is caused by a pituitary tumor, it is called Cushing's disease
56
what happens if a pituitary adenoma is large, what are some mass pressure effects?
radiographic abnormalities visual field abnormalities elevated intracranial pressure compression damage – hypopituitarism
57
how much function needs to be lost for someone to have pituitary hypofunction?
75%
58
what are the causes of pituitary hypofunction?
Compression by tumours (most common) – craniopharyngioma metastatic Trauma Infection (rare) TB Sarcoidosis Post partum ischaemic necrosis - Sheehan’s syndrome - pituitary gland is damaged during childbirth. It's caused by excess blood loss (hemorrhage) or extremely low blood pressure during or after labor. A lack of blood deprives the pituitary of the oxygen it needs to work properly
59
what is the weight of the adrenal glands
12g combined
60
what does the cortex and medulla of the adrenal gland do?
cortex - Steroid hormones medulla: Neuroendocrine (chromaffin) cells Adrenaline/noradrenaline response to stress maintain BP Extra adrenal paraganglia similar
61
what does each layer of the cortex of the adrenal gland secrete?
zona glomerulosa - mineralocorticoids - aldosterone zona fasciculata glucocorticoids - cortisol zona reticularis - sex steroids, oestrogen, androgens
62
what are different adrenal pathologies?
Hyperfunction - clinical syndromes depend on which adrenal hormones stimulated Hypofunction Mass lesion - effect late Effect on adrenal gland –hyperplasia (diffuse or nodular), atrophy, mass lesion
63
what are 3 syndromes caused by adrenal cortical hyperfunction?
Hypercortisolism (cushings syndrome) Hyperaldosteronism (Conn’s syndrome) Adrenogenital syndormes
64
what are the cuases of cushings syndrome?
Exogenous -Iatrogenic steroids Endogenous: ACTH dependent - pituitary adenoma Cushings disease – 70%, ectopic ACTH ACTH independent - functioning adrenal adenoma 10%
65
how do you diagnose cushings syndrome?
measuring cortisol, ACTH and response to ACTH suppression
66
what are the causes of conns syndrome?
Bilateral idiopathic hyperplasia Functioning adrenal adenoma (2ry hyperaldosteronism – physiological due to ↓renal perfusion ↑renin-angiotensin)
67
conns syndrome causes increased _____ retention in the nephron
sodium To much aldosterone = hypertension
68
what are the causes of adrenogenital syndromes?
Functioning adrenal tumour Pituitary tumour Cushings disease Congenital adrenal hyperplasia – steroid enzyme deficiency
69
what are the symptoms of adrenogenital syndromes?
Symptoms are variable Ambiguous genetalia, precocious puberty, failure of puberty, virilisation, infertility, undervirilisation
70
Adrenal Insufficiency - destruction of glands, can either by _____ or \_\_\_\_\_\_
acute chronic
71
what is chronic adrenal insufficiency?
1 year - addisons 2 year - pituitary failure
72
what are the causes of addisons disease?
* Autoimmune: autoimmune polyendocrine syndromes – spare medulla * Infections: TB, fungus HIV-related infections * Replacement: metastatic carcinoma amyloidosis * Atrophy: prolonged steroid therapy * Congenital hypoplasia
73
what are the effects of adrencortical tumours?
Functioning – hyperadrenal syndromes, atrophy of adjacent cortex Non functioning – often incidental - imaging/autopsy Yellow-brown circumscribed Most 2-3cm \<30g
74
describe the histology of adrenocortical tumours
Cells similar to those of normal cortex nuclei small Some pleomorphism (“endocrine atypia”). Cytoplasm eosinophilic to vacuolated, depends on lipid Mitoses inconspicuous
75
What are the features of Primary Adrenocortical Carcinoma?
rare, any age More likely functional – virilising Most large \>20cm, haemorrhage and necrosis, cystic Metastasises by lymphatics and blood – invades adrenal vein
76
are metastatic adrenal carcinoma more common? and where do they come from?
More common lung, breast
77
name an adrenal medullary tumour?
PHAEOCHROMOCYTOMA Adrenal medulla neuroendocrine cells
78
what does a phaeochromocytoma secrete?
secrete catecholamines → hypertension
79
Is a phaeochromocytoma benign or malignant? and is it inherited?
Usually benign behaviour, can be bilateral Up to 30% inherited – eg MEN 2, SDH 10% extra adrenal (paraganglioma)
80
describe the histology of a phaeochromocytoma?
Nests “Zellballen” of polygonal cells in vascular network Granular cytoplasm containing catecholamines
81
What is multiple endocrine neoplasia?
Inherited disorders with underlying genetic mutation Hyperplasia/neoplasms of endocrine organs - younger age, multifocal Several distinct syndromes
82
what is MEN 1 (Wermer syndrome)?
MEN 1 tumour suppressor gene mutation - defect in menin protein involved in regulating cell growth Parathyroid hyperplasia and adenomas Pancreatic and duodenal endocrine tumours (hypoglycaemia and ulcers) Pituitary adenoma (prolactinoma)
83
what is MEN 2?
RET proto-ongogene mutations Medullary carcinoma of thyroid Phaeochromocytoma
84
What is MEN 2A (Sipple syndrome)?
+ Parathyroid hyperplasia Extracellular domain auto dimerisation of RET receptor
85
what is MEN 2B
+ Neuromas of skin & mucous membrane, skeletal abnormalities + Younger patients, aggressive Autoactivation of tyrosine kinase pathway
86
Disease in one endocrine gland may have _________ clinical effects Disease in one endocrine gland may lead to altered activity of another __________ \_\_\_\_\_ \_\_\_\_\_\_\_\_ effects may cause changes in endocrine glands Endocrine organs have high _______ capacity nb - ectopic hormone production by other organs
Disease in one endocrine gland may have **_multiorgan_** clinical effects Disease in one endocrine gland may lead to altered activity of another **_endocrine gland_** **_Feedback_** effects may cause changes in endocrine glands Endocrine organs have high **_reserve_** capacity nb - ectopic hormone production by other organs

Endocrine System (90 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions