Pathology Final Exam

These flashcards mostly leave out anatomy-related objectives. Lessons covered: Endocrine, Skin, Reproductive systems, breast

Direct components of the endocrine system

Glands that are primary endocrine organs: pituitary, thyroid, parathyroid, adrenal

Indirect components of the endocrine system

scattered endocrine cells in organs primary to other systems: gonads, pancreas, intestines

Endocrine effect

indirect action, hormones secreted into blood stream and carried to distant sites

Paracrine effect

direct action on surrounding tissues due to hormones being secreted into neighboring tissues/cellular spaces

Growth hormone

anterior pituitary gland, bone & cartilage growth, blood glucose, body structure, and metabolism

Prolactin

anterior pituitary, lactation

adrenocorticotrophic hormone

anterior pituitary, triggers cortisol release, triggers androgen release

Gonadotrophins

anterior pituitary, luteinizing hormone, follicle stimulating hormone

Thyroid stimulating hormone

anterior pituitary, stimulates production of T3 and T4

oxytocin

posterior pituitary, labor and childbirth, lactation, bonding

antidiuretic hormone

posterior pituitary, water and sodium levels, kidney function, blood pressure

T3 and T4

follicular cells of thyroid, helps regulate metabolism

Calcitonin

C-cells of thyroid, helps with calcium regulation

Parathyroid hormone

helps with calcium and phosphate regulation, involves kidneys, bones, intestines

Aldosterone

cortex of adrenal glands, salt/water balance

Cortisol

Cortex of adrenal glands, stress management, blood sugar, metabolism

Androgens

Cortex of Adrenal glands, sex hormones

Epinephrine/Norephinephrine

Medulla of adrenal glands, adrenaline, fight or flight, sympathetic nervous system, parasympathetic nervous system, rest and digest, acetylcholine

Pituitary hyperfunction

usually due to neoplasia resulting in benign adenomas

Prolactinomas

most common pituitary neoplasm from too much prolactin

somatic adenomas

pituitary, too much growth hormone. Causes gigantism in children and acromegaly in adults.

Corticotrophic adenomas

pituitary, too much ACTH, can progress to Cushing’s disease

Other pituitary neoplasms

Gonadotrophic adenomas (excess gonadotrophins) thyrotrophic adenomas (extremely rare, excess thyroid hormone)

Malignant pituitary neoplasms

extremely rare

Pituitary hypofunction

caused by congenital defects, tumors compressing pituitary and/or affecting hypothalamus, ischemia, brain damage, trauma, intercranial surgery

pituitary hypofunction treatment

supplement the deficient hormones

Panhypopituitarism

lack of all pituitary hormones

Diabetes insipidus

Pituitary hypofunction, lack of antidiuretic hormone, only one cell type effected

Thyroid hyperfunction

excessive thyroid hormones, graves disease (autoimmune), toxic nodular goiter, thyroid adenomas

Thyroid hypofunction

deficiency in thyroid hormones, caused by developmental defects, iodine deficiency, autoimmune hashimoto’s, or post thyroidectomy.

Nodular goiter

enlargement of thyroid, often not associated with abnormal hormone levels but can cause compression syndrome

Papillary carcinoma

malignant neoplasm of thyroid follicular cells, usually cold nodules (hypofunction)

Follicular neoplasm

Malignant neoplasm of thyroid follicular cells, could be hot or cold nodules

anaplastic carcinoma

another malignant neoplasm of thyroid follicular cells. Rare and progressive form, poor prognosis.

Medullary carcinoma

malignant tumor of thyroid C-cells, produces calcitonin and may be part of multiple system tumors. (multiple endocrine neoplasia type 2)

Benign neoplasm of thyroid

adenoma

Primary parathyroid hyperfunction

excess parathyroid hormone due to gland hyperplasia and/or parathyroid adenoma

Secondary parathyroid hyperfunction

excess parathyroid hormone due to chronic renal failure or intestinal diseases/sugeries

Parathyroid hypofunction

lack of parathyroid hormone, often due to surgical removal of parathyroid glands or agenesis

adrenal hyperfunction with excess cortisol

cushing’s syndrome

adrenal hyperfunction with excess aldosterone

electrolyte imbalances, Conn’s syndrome if due to adenoma

adrenal hyperfunction with excess androgens

atypical genitalia, precocious puberty and shortened height, acne, fertility issues due to irregular menses or amenorrhea, hirsutism and deeper voice in women.

primary adrenocortical insuffieciency (hypofunction)

Addison’s disease, usually due to autoimmune diseases, resulting in damage to adrenals. Can also be caused by cancer, TB of adrenals, fungal infections, inherited disorders.

secondary adrenocortical insufficiency (hypofunction)

pituitary is not producing enough ACTH to signal adrenal glands to produce cortisol

Adrenal adenomas

benign neoplasia, usually cortical, often result in hypersecretion of hormones

adrenal neuroblastoma

malignant cancer of the nerve tissue in adrenal glands, medullary. Seen more in young children, poor prognosis because it is often diagnosed late.

pheochromocytoma

adrenal neoplasm, usually benign, found in medulla causes hypersecretion of Epi/norEpi. Causes episodic hypertension, treatable with surgical removal.

Addison’s disease (adrenal hypofunction) symptoms

Weakness, fatigue, dizziness 

Dark skin, bluish-black color around nipples, mouth, rectum, scrotum, or vagina 

Weight loss, fluid loss, lack of appetite 

Muscle aches, upset stomach, vomiting, diarrhea 

Low blood pressure, low blood sugar 

Irregular or no menstrual period in women 

adrenal neuroblastoma symptoms

Abdominal mass, bone pain, loss of appetite, tiredness, unconscious eye movements, swelling and bruising around eyes, fever, high blood pressure. 

pheochromocytoma (adrenal neoplasia) symptoms

Hypertension, heart palpitations, sweating, headache, nausea/vomiting, anxiety, flushing. 

prolactinoma (pituitary neoplasia that causes hyperfunction) symptoms

In women, prolactinomas cause amenorrhea and infertility due to interference with LH and ovulation. Causes spontaneous milk secretion. Causes impotence in men (difficulty with sex) 

panhypopituitarism symptoms

Hypofunction of the organs acted on by those hormones 

Weakness, cold intolerance, poor appetite, weight loss, hypotension, amenorrhea (women), impotence (men), childhood> pituitary dwarfism. 

diabetes insipidus (pituitary hypofunction) symptoms

Excessive urination because there isn’t enough ADH or the kidneys don’t respond to it correctly. This leads to an abnormal fluid balance. 

Excessive thirst 

Could lead to dehydration 

Hyperthyroidism: may include Grave’s disease, toxic nodular goiter, thyroid adenomas symptoms 

Unintentional weight loss, irregular and/or rapid heartbeat, increased appetite, increased sweating, muscle fatigue, changes in menstruation, nervousness/anxiety, changes in bowel patterns, enlarged thyroid, difficulty sleeping, and heat sensitivity. 

Hypothyroidism: may include Hashimoto's, iodine deficiency, post-thyroidectomy, or developmental defects symptoms

Weight gain, fatigue, slowed heart rate, muscle aches, changes in menstruation, elevated blood cholesterol, depression and impaired memory, enlarged thyroid, joint pain and stiffness, hoarseness, cold sensitivity, dry skin 

thyroid adenomas symptoms

May cause noticeable enlargement, palpable mass, occasional cold nodules seen where NM radioactive iodine uptake scan 

parathyroid adenoma that results in hyperfunction symptoms

bone pain, kidney stones

parathyroid hypofunction symptoms

muscle spasms, cardiac irregularities

Cushing’s syndrome (adrenal hypofunction) symptoms

Obesity, hypertension, metabolic disturbances 

Conn’s syndrome (adrenal hyperfunction) symptoms

Heart to control high bp in young people, weak and fatigued muscles due to low potassium, need for several drugs to control bp, drinking and urinating more 

Primary Parathyroid Hyperfunction (can be due to neoplasm) symptoms

Enlargement, increased calcium (hypercalcemia-serum and urine), decreased phosphate (serum) 

Secondary Parathyroid Hyperfunction (caused not by neoplasia, but  chronic renal failure or intestinal surgery symptoms

Low calcium, low vitamin D> parathyroids stimulated to produce more PTH. 

Parathyroid hypofunction symptoms

Results in decreased calcium which can affect muscle function (including heart)

Cushing’s syndrome symptoms

Rounded face, acne, muscle weakness, weight gain, stretch marks, irregular periods, back of neck fat, thin arms and legs, erectile dysfunction 

Hyperaldosteronism with excess sodium symptoms

hypertension, polydipsia, polyuria 

Hyperaldoerstonism with lack of potassium symptoms

weakness, tingling, muscle spasms, temporary paralysis 

Addison’s disease (adrenocortical insufficiency) symptoms

Insufficiency of cortisol and aldosterone 

May lead to abdominal pain, extreme weakness, low blood pressure, kidney failure, shock if not treated 

How do endocrine glands undergo hyperplasia?

hyperplasia in increased cellular growth that causes gland enlargement and sometimes leads to neoplasia. Neoplasia can cause mass effects, metabolic effects, and paraneoplastic syndromes. 

epidermis

outermost layer of skin contains keratinocytes, melanocytes, and basal cells.

dermis

middle layer of skin, contains nerves, CT, vessels, glands, hair follicles 

hypodermis

innermost layer of skin, primarily adipose tissue, for insulation and cushioning. 

list the functions of skin

protection, regeneration, keratinization, pigmentation

protection function of skin

Intact skin keeps underlying tissues from being exposed to pathogens and injury (mechanical, thermal, chemical). 

regeneration function of skin

the epidermis is constantly renewed from the basal layer, maintaining skin integrity. 

keratinization function of skin

produces keratin, enhancing resistance to injury and UV radiation.

pigmentation function of skin

melanocytes produce melanin, which protects against UV damage. 

hair follicles

present in various densities across the body, associated with sebaceous glands. Pores, hair, sebaceous glands. Sebum is an oily substance that lubricates and waterproofs the skin and hair 

alopecia

hair loss caused by different things: autoimmune, aging, heredity, androgen changes, chemotherapy

eccine sweat glands

temperature regulation, all over body, involved in preventing heat stroke/heat exhaustion

apocrine sweat glands

produces odor in axilla, groin, and scalp

Nails

layers of dead keratinocytes. Hard, protective plate that protects the fingertips and toes.

Onychomycosis

Fungal infection of the nail. Discoloration, thickening, separation from nail bed. More common in toenails, Age, athelete’s foot. 

Importance of intact skin

best barrier against infections from external pathogens, immune reactions, and protects inside of body from carcinogens.

How to protect non-intact skin

keep it clean, wear gloves when touching, apply barrier creams/dressing

macule

flat, colored lesion, <2cm (freckle)

patch

larger macule >2cm (measles rash)

Papule

elevated lesion <1cm (eczema) 

nodule

larger, bulging lesion 1-5cm 

vesicle

fluid-filled elevation <1cm (herpes) 

bulla

larger vesicle >1cm (burns) 

pustule

vesicle filled with pus (impetigo) 

ulcer

defect of epidermis (syphlitic chancer) 

crust

coagulated plasma or blood covering a defect

scale

flakes of keratinized skin (seborrhic dermatitis)

nevus (mole)

congenital, benign skin lesion made of melanocytes 

albinism

congenital lack of melanin production, leading to pale skin and increased cancer risk. 

bullosa

congenital, rare condition that causes fragile, blistering skin when exposed to minor injury. 

vitiligo

congenital, autoimmune disorder where loss of pigment appear anywhere on body. 

hemangioma

congenital growth of extra blood vessels (bright red or bluish) 

Mechanical Trauma

cuts, abrasions, pressure ulcers, skin tears. Varies in severity