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44 Cards in this Set
- Front
- Back
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hyperpituitarism usually caused by
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adenoma
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non-secreting adenomas
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common
visual field defects all hormones decreased |
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40% of adenomas have this mutation
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GNAS1
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most common adenoma
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prolactinoma
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corticotroph adenomas can cause
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cushing's
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hypopituitarism + diabetes insipidus almost alway originates here
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hypothalamus
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sheehan's syndrome
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post partum pit. necrosis
all hormones decreased esp. TSH and ACTH |
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acute hemorrhage into adenoma
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pit. apoplexy
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diabetes insipidus
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decreased ADH
polyuria and polydipsia hypernatremia and dehydration |
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SIADH
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excess ADH
inability to produce dilute urine hyponatremia, cerebral edema, and dysfunction |
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SIADH often ass. with
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lung SCC
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craniopharyngiomas
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originate in rathke's pouch
growth retardation in children visual problems in ppl > 60 calcifications common |
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only way to differentiate between secondary and tertiary hypothyroidism
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TRH simulation test
2- TSH remains low 3- TSH increases |
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hyperthyroidism lab results
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low/no detectable TSH
elevated T4/3 |
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primary hypothyroidism labs
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high TSH
decreased T4/3 |
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lymphocytic infiltrates with germinal centers
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hashimoto's
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Reidel ligneous thyroiditis
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dense fibrosis
feels hard and fixes to trachea resembles carcinoma |
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subacute granulomatous thyroiditis
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giant cells/granulomas
viral etiology painful transient hyperfunction followed by hypofunction |
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papillary carcinoma
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most common thyroid CA
papillae, orphan annie nuclei, psammoma bodies mets via lymphatic system |
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RET/PTC fusion or BRAF mutation
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papillary carcinoma
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follicular carcinoma of the thyroid
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no orphan annie nuclei or psammoma bodies
hematogenous spread RAS mutation or PAX-8/PPAR-gamma fusion |
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meduallary carcinoma
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originates from parafollicular cells that produce calcitonin
amyloid stroma ass. with MEN2 RET mutation |
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anaplastic carcinoma
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giant and spindled sarcoma-like cells
p53 mutation |
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primary hyperparathyroidism
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80% adenomas
15% hyperplasia 5% carcinoma increased PTH and Ca, decreased PO4 |
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bones, stones, abdominal groans, and psychic moans
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primary hyperparathyroidism
osteitis fibrosa cystica, kidney stones, peptic ulcers, and depression & seizures |
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secondary hyperparathyroidism
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kidney failure is cause
increased PTH and phosphate, decreased calcium |
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hypoparathyroidism
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AI, congenital (diGeorge), surgical, idiopathic
no PTH, decreased Ca tetany, prolonged QT interval, depression, confusion, hallucinations |
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#1 cause of cushing's syndrome
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exogenous glucocorticoids
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Cushing's
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excess cortisol
often SCC of the lung paraneoplastic syndrome |
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primary hyperaldosteronism
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increased aldosterone
HTN, decreased K+ and renin |
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secondary hyperaldosteronism
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due to increased renin
renal ischemia renin-producing tumors |
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21 hydroxylase def.
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salt-wasting due to lack of mineralocorticoids
decreased Na+and BP increased K+ and acidosis |
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hypoadrenalism
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due to autoimmune polyendocrine syndromes
lymphoid infiltrate of and destruction of glands |
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APS 1
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candidiasis
hypoparathyroidism addison's mutation in autoimmune regulator gene (AIRE) |
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APS 2 = schmidt's syndrome
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addison's
hypothyroidism type 1 DM |
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Conn's
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adrenal adenoma causing increased aldosterone
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dexamethasone suppression test used to
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diagnose cushings
dexamethasone should suppress ACTH |
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homer-wright rosettes
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neuroblastomas
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MEN 1
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"P" lesions
parathyroid pituitary pancreatic islets peptic ulcers |
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MEN 2a
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sipple's
medullary carcinoma of the thyroid and pheo parathyroid hyperplasia RET mutations |
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MEN 2b
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medullary cacinoma of the thyroid, pheo
RET mutation NO parathyroid hyperplasia |
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Pineal tumors
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most are germinomas
Rare |
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Pineoblastomas
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primitive cells
in children |
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Pineocytomas
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more mature cells
adults |
