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48 Cards in this Set
- Front
- Back
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How much of an endocrine gland do you have to destroy to result in hypofunction?
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A TON OF IT!
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What happens in MEN1?
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Pituitary disease
Pancreatic disease Parathyroid disease The 3 P's with MEN1 |
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What is the cellular appearance of a pituitary adenoma?
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Uniform-appearing population of endocrine cells.
No necrosis No odd nuclei Well-differentiated |
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What's the history of a pituitary adenoma?
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Slow-growing
Slow-onset endocrinopathy |
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What are some consequences of a pituitary adenoma?
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Gigantism (GH during youth)
Acromegaly (GH during old age) Cushing's diesease |
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What are some of the consequences of corticotroph adenomas?
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Just look at the following panels:
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What happens to the adrenal glands in Cushing's?
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Bilaterally hyperplastic
Yellow |
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How well does cortisol feedback work in Cushing's disease?
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Not well.
The cortisol doesn't inhibit the release of CRH |
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What is the normal size of an adrenal gland?
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4 g/gland.
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If someone has a mass in the pituitary, what do you think?
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Adnoma.
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What likely causes larger adrenal glands: ectopic ACTH or Cushing's disease? Why?
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Ectopic ACTH is more likely to cause larger glands
The ectopic tumors are less likely to respond to the negative feedback from the cortisol |
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What happens in addison's disease?
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Destruction of the adrenal gland: you have chronic adrenal insufficiency
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What are the causes of caseating necrosis?
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Less common things: Tb, fungi, etc.
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What is the abnormality in Cushing's syndrome?
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Excess of cortisol
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What is the abnormality in Conn's syndrome?
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Excess aldosterone ecretion
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What is the abnormality in adrenal virilizing syndrome?
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Excess of androgens
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What is the color of a cortical mass of the adrenal gland?
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Yellow.
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When do you start to get worried about malignancy in the adrenal gland?
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100 g and above.
In between 50 and 100, we just don't know. |
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What are the cell types in adrenal cortical adenomas?
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Lipid rich
Lipid poor NO MITOSIES, NECROSIS, INVASION! |
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What are the properties of an adrenal cortical carcinoma?
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Large
Invasive Necrotic Invades the kidney |
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What is a problem with tumors in the retroperitoneum?
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Tumors are hidden exceptionally well.
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What are the cellular characteristics of adrenal cortical carcinoma?
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Solid sheets of cells
Mitotic figures Nuclear pleomorphism |
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What are things that indicate a worse type of adrenal cortical carcinoma?
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Worse nuclear pleomorphism
Necrosis More mitotic figures |
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What color is a medullary tumor?
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RED!
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What is the difference between a pheochromocytoma and a paraganglioma?
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Pheochromocytoma: within the adrenal gland
Paraganglioma: when they occur outside the adrenal gland |
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Are pheochromocytomas generally malignant?
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It depends.
Can be either malignant or benign. |
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What's the cellular appearance of pheochromocytoma?
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Tight appearance as balls
Diffuse Low-grade appearing |
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What are some different syndromes that can cause pheochromocytomas?
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MEN2
Von Hippel-Lindau NF1 Succinate dehydroogenase problems |
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What mutation takes place in MEN2? What endocrine tumor can this cause?
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RET
Pheochromocytoma |
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What mutation takes place in Von-Hippel Lindau? What endocrine tumor can this cause?
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VHL mutation
Pheochromocytoma |
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What mutation takes place in NF1? What endocrine tumor can this cause?
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NF1 gene
Pheochromocytoma |
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Where are the genes for succinate dehydrogenase encoded?
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Mitochondria
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What are the different succinate dehydrogenase genes that are mutated?
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SDHD
SDHB SDHC |
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Where do alpha cells tend to be in the endocrine pancreas?
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Lateral.
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If you have a hyperfunctioning endocrine pancreas, what should you think?
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NEOPLASM!
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What location is best to have a pancreatic tumor? Why?
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Tail!
Less important structures around the tumor; easier to ligate vasculature |
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What's the difference between ductal adenocarcinomas of the pancreas and endocrine neoplasms?
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Ductal: much more likely to have compression symptoms
Endocrine: more likely to elicit a fibrous reaction, have a marble-like appearance. |
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What do pancreatic endocrine neoplasms look like?
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What's whipple's triad?
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Hypoglycemia
CNS symptoms Better with glucose. |
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What's a common cause of whipple's triad?
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Pancreatic endocrine tumors.
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What happens in a gastrinoma? Where does it arise?
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Ectopic production of gastrin; takes placein pancreas or duodenum, generally.
Zollinger-ellison syndrome: -PUD -Gastric hypesecretion |
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What happens in hyperplasia of the parathyroid/
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Increase in the size of ALL glands
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What happens in a parathyroid adenoma?
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Benign tumor of a single parathyroid gland
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What is the most common cause of hyperparathyroidism?
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Adnomas.
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What are the causes of hyperparathyroidism?
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Hyperpplasia
Adenoma Carcinoma |
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What happens in a parathyroid carcinoma?
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Malignant tumor of a single gland.
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What is the way that people do parathyroid operations?
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Intraoperative PTH testing
You can look at the half-life of the hormone to see if you've got the source! AWESOME! |
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What's the appearance of a parathyroid adenoma?
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Very cellular
Lack of necrosis Lack of mitotic figures |
