Quiz 3 Parts 1 & 2

Question 1

Which hormone used to be called prolactin inhibiting factor?

Answer 1

Dopamine

Question 2

TSH, PRL, ACTH, GH, FH, LH are released by

Answer 2

Anterior pituitary

Question 3

TRH, PIF, CRH, GHRH, GIH, GnRH are released by

Answer 3

hypothalamus

Question 4

Pink staining acidophils of pituitary secrete which hormones

Answer 4

GH, PRL

Question 5

Dark purple staining basophils of pituitary secrete which hormones

Answer 5

ACTH, TSH, FSH, LH

Question 6

Where are ADH and oxytocin made, and also where are they later released from?

Answer 6

Made in hypothalamus, released by posterior pituitary

Question 7

This part of the pituitary resembles neural tissue with intra-axonal neurosecretory granules

Answer 7

posterior pituitary

Question 8

Another name for ADH

Answer 8

vasopresin

Question 9

MC cause of hyperpituitarism

Answer 9

Anterior lobe adenoma

Question 10

How do we classify pituitary adenomas?

Answer 10

functional vs non-functional

Question 11

Expanding pituitary lesions can compress what nerve structure, leading to what symptom?

Answer 11

Optic chiasm - bitemporal hemianopsia

Question 12

MC pituitary tumor

Answer 12

Pituitary adenoma

Question 13

MC tumor of brain

Answer 13

Pituitary adenoma

Question 14

How do you differentiate a macro- from micro-adenoma?

Answer 14

> 10mm = macroadenoma.

Question 15

Silent and hormone negative adenomas are more likely to be macro or micro when found?

Answer 15

Macro - lack endocrine abnormalities that would alert patient

Question 16

Non-functioning tumors may also be referred to as this (relates to how it reacts to staining)

Answer 16

chromophobic

Question 17

Usually just one cell line increases in pituitary adenoma. What is the MC subset of a pit. adenoma? (it is also the MC functioning and MC cause of endocrine problems)

Answer 17

Prolactinoma

Question 18

T/F - a typical pituitary adenoma is soft, well-circumscribed and confined to the sella turcica

Answer 18

T

Question 19

Microscopy reveals small round cells with uniformly round nuclei and pink to blue cytoplasm. Cells arranged in nests or cords and with prominent vascularity

Answer 19

pituitary adenoma

Question 20

This tumor’s presenting sxs usually are limited to HA, visual field defects, cranial nerve deficits, possibly hypopituitarism

Answer 20

Non-functioning pituitary adenoma

Question 21

T/F prolactinomas tend to be weakly acidophilic or chromophobic (sparsely granulated)

Answer 21

T

Question 22

Are men more likely to have a micro or macro adenoma?

Answer 22

macro - their sx picture is nonspecific - low libido

Question 23

Pituitary adenomas are associated with which MEN syndrome?

Answer 23

MEN 1

Question 24

this MEN syndrome has parathyroid adenomas, entero-pancreatic tumors, pituitary adenomas

Answer 24

MEN1

Question 25

MEN syndrome with parathyroid adenomas, medullary thyroid carcinoma, pheochromocytoma

Answer 25

MEN2A

Question 26

MEN syndrome with medullary thyroid carcinoma, pheochromocytoma, mucosal neuromas, marfanoid body habitus

Answer 26

MEN2B

Question 27

MC initial sx of pituitary apoplexy

Answer 27

sudden HA w/ rapidly worsening visual field defect

Question 28

Name for postpartum hypopituitarism

Answer 28

Sheehan's syndrome

Question 29

What is taking up space in empty sella syndrome

Answer 29

CSF

Question 30

MC implicated lesions in hypothalamic suprasellar tumors

Answer 30

Gliomas and craniopharyngiomas

Question 31

Craniopharyngioma is derived from the vestigial remnants of _______

Answer 31

Rathke's pouch

Question 32

2nd MC functioning pituitary adenoma

Answer 32

Excess GH - acromegaly/gigantism

Question 33

Are craniopharyngiomas functioning? and are they dangerous?

Answer 33

Non-functioning, benign but can kill via space-occupying effect

Question 34

This tumor is made of epithelial cells and has palisading cells, as well as a smooth noncellular area of lamellar "wet" keratin

Answer 34

craniopharyngioma

Question 35

MC extracerebral CA's to metastasize to the pituitary

Answer 35

Breast, Lung

Question 36

Thyroid hormone receptors preferentially bind T3 or T4?

Answer 36

T3 - giving it greater biological activity than T4

Question 37

These thyroid cells secrete calcitonin

Answer 37

"C" cells (parafollicular cells) - found in the interstitial between the follicles or adjacent to the cuboidal epithelium

Question 38

MC cause of Hypothyroidism

Answer 38

Hashimoto's thyroiditis (autoimmune lymphocytic thyroiditis)

Question 39

This thyroid dz is associated with hemochromatosis, amyloidosis

Answer 39

Infiltrative thyroid dz

Question 40

When and with whom is death more common with hypothyroidism?

Answer 40

Winter, elderly

Question 41

MC cause goiters worldwide | MC cause in the USA

Answer 41

Iodine deficiency | Graves disease

Question 42

Name for accidental ingestion of excess thyroid hormone leading to hyperthyroidism

Answer 42

Thyrotoxicosis factitia

Question 43

What does toxic vs non-toxic thyroid nodule signify

Answer 43

Toxic = making more of the hormone, nontoxic = not making it

Question 44

MC cause lymphocytic AI thyroid dz

Answer 44

Hashimoto's

Question 45

Enlargement of the thyroid in Hashimotos is due to what?

Answer 45

Lymphocytic infiltration & fibrosis, but not tissue hypertrophy

Question 46

These Ab's are responsible for hashimoto's

Answer 46

TPO (thyroid peroxidase), thyroglobulin

Question 47

Grossly. the thyroid has a solid fleshy appearance with a lobular pattern. Scattered tiny nodules of darker tan colored glassy material - residual colloid.

Answer 47

Hashimoto's

Question 48

This cell appears in thyroid tissue of pt's with Hashimoto's as well as follicular thyroid CA. They stain pink with abundant eosinophilic cytoplasm as result of altered mitochondria

Answer 48

Hürthle cell

Question 49

What can cause either hyper- or hypothyroidism?

Answer 49

Subacute thyroiditis

Question 50

What viruses are associated with De Quervain's thyroiditis (a type of subacute thyroiditis)?

Answer 50

Coxsackie virus | Adenovirus

Question 51

The underlying cause of most cases of sub-acute thyroiditis

Answer 51

Viral

Question 52

Multi-nucleated giant cells within the colloid of thyroid follicles are a distinguishing feature of _____

Answer 52

de Quervain's

Question 53

MC location for a thyroglossal cyst

Answer 53

between isthmus of thyroid and hyoid bone

Question 54

MC congenital neck malformation

Answer 54

thyroglossal duct cyst

Question 55

Most thyroid CA are of what two types?

Answer 55

Well-differentiated papillary or follicular tumors. Excellent prognosis

Question 56

Follicles irregularly enlarged and surrounded with flattened epithelium, consistent with a lack of thyroid activity

Answer 56

Non-toxic multinodular goiter

Question 57

This dz has a thyroid gland with autonomously functioning thyroid nodules, resulting in hyperthyroidism

Answer 57

Toxic Nodular Goiter or Plummer's Dz

Question 58

Biopsy shows marked hypercellularity, consistent with hyperfunctioning

Answer 58

Toxic thyroid nodule/nodular goiter/plummer's

Question 59

Graves dz is caused by these autoantibodies which do what?

Answer 59

long acting thyroid autoantibodies (LATS-Ab), activate TSH receptors

Question 60

MC cause hyperthyroidism & severe hyperthyroidism

Answer 60

Grave's dz

Question 61

Hyperplastic epithelium with prominent infolding. Tall columnar epithelium line the unfolds. Clear vacuoles next to the epithelium from localized depletion of colloid.

Answer 61

Grave's dz

Question 62

Colloid cysts appear as what on a thyroid scan, helping differentiate from CA

Answer 62

cold nodules

Question 63

T/F - it is difficult to tell a follicular adenoma from a well-differentiated carcinoma

Answer 63

T

Question 64

Four main types of thyroid CA

Answer 64

Papillary Follicular Medullary Undifferentiated/Anaplastic (least common)

Question 65

T/F most thyroid CA are well responsive to tx

Answer 65

T

Question 66

MC thyroid CA

Answer 66

Papillary carcinoma

Question 67

Papillary CA is more frequently diagnosed in which age group? When is it more malignant?

Answer 67

Mostly in young, but worse if in elderly

Question 68

Thyroid CA's more common in hx of radiation

Answer 68

Papillary carcinoma, Follicular carcinoma

Question 69

Gross appearance shows multifocal neoplasm because of propensity to invade lymphatics

Answer 69

Papillary carcinoma of thyroid

Question 70

Fronds have thin fibrovascular cores and overall papillary pattern

Answer 70

Papillary Carcinoma

Question 71

T/F-All papillary neoplasms of thyroid should be considered malignant

Answer 71

T

Question 72

You may find a psamomma body in this thyroid cancer

Answer 72

Papillary carcinoma

Question 73

Follicular carcinoma is MC in which age group

Answer 73

elderly

Question 74

Gross - encapsulated and solitary and found in necrotic/hemorrhagic areas

Answer 74

Follicular carcinoma of thyroid

Question 75

Histologically, encapsulated, well-defined follicles containing colloid

Answer 75

Follicular carcinoma, but follicular adenoma looks like this too, making distinguishing them difficult

Question 76

This thyroid CA can be familial, transmitted as autosomal dominant and associated with MEN

Answer 76

Medullary carcinoma

Question 77

There is a proliferation of parafollicular cells (C cells) resulting in excess serum calcitonin

Answer 77

Medullary carcinoma

Question 78

This tumor is characterized by rapid painful enlargement of thyroid gland and most die within one year

Answer 78

Anaplastic carcinoma

Question 79

Histology shows undifferentiated malignant cells

Answer 79

Anaplastic carcinoma