endocrine

what hormone do lactrotrophs secrete

prolactin

what hormone do somatotrophs secrete

growth hormone

what hormone do corticotrophs secrete

ACTH

what hormone do thyrotrophs secrete

TSH

what hormone do gonadotrophs secrete

FSH, LH

what 2 hormones does the posterior pituitary secrete

oxytocin, ADH

what are 3 mass effects of the pituitary?

bitemporal hemianopsia, headache, pituitary apoplexy

what is the most common cause of hyperpituitarism

adenoma in anterior lobe

this tumor secretes prolactin with propensity to calcify creating a pituitary stone (psammoma bodies)

lactotroph pitNET

what is the most common hyper functioning pituitary tumor (Pitnet)?

lactotroph

what are some clinical features of increased prolactin in lactrotroph pit nets?

amenorrhea, galactorrhea, infertility, libido loss

this is the second most common functioning pitnet with secretion of growth hormone

somatotroph pitnet

what occurs after growth plates close causing dense bones and skin growths in somatotroph pit nets?

acromegaly

what occurs before growth plates close in somatotroph pit nets?

gigantism

this PITnet causes excess ACTH leading to hypercortisolism

corticotroph pitnet

what is it called when hypercortisolism is due to excessive production of ACTH by the pituitary

Cushing disease

what hormone do corticostrophs also cause to be released causing hyperpigmentation

MSH

when adrenal glans are removed for hypercortisolism and the patient has a corticotrophin pitnet, this causes the tumor to become large and destructive bc feedback inhibition is lost. what is this called

nelson syndrome

this is referred to as decreased pituitary hormones as a result of dz of hypothalamus or pituitary

hypopituitarism

this disease is ischemic necrosis of the pituitary during pregnancy when the anterior lobe increases size and becomes hypoxic leading to necrosis

Sheehan syndrome

this lesion is lined by ciliated cuboidal epithelium which can accumulate proteinaceous fluid and expand to compromise the normal pituitary gland

rathke cleft cyst

this syndrome occurs from a tx or condition which destroys all or part of the pituitary

empty sella syndrome

deficiency of ADH in the posterior pituitary causes a condition with polyuria which is calledq

diabetes insipidus

this syndrome is characterized by ADH in excess causing resorption of excessive water leading to hyponatremia

syndrome of inappropriate ADH

which neoplasm can cause ectopic ADH secretion causing Syndrome of inappropriate ADH secretion

small cell lung carcinoma

what are the two most common hypothalamic suprasellar tumors

gliomas and craniopharyngiomas

this craniopharyngioma consists of nests or cords of Strat sq epi embedded in a spongy reticulum with calcifications common

adamantinomatous craniopharyngioma

this craniopharyngioma contains solid sheets of cells and papillary lined by sq epic which lacks any means to calcify

papillary craniopharyngioma

these suppress t3 and t4 synthesis causes TSH to enlarge thyroid gland

goitrogens

what are two examples of goitrogens

propylthiouracil and iodide

these cells secrete calcitonin promoting ca absorption by sk system and inhibit osteoclast

parafollicular cells

what are the three most common causes of thyrotoxicosis associated with hyper function of the thyroid

diffuse hyperplasia, hyperfunctional multinodular goiter, hyperfunctional thyroid adenoma

what are some cardiac manifestations of hyperthyroidism?

hyperthyroid cardiomyopathy

this term refers to the abrupt onset of severe hyperthyroidism which is a medical emergency and common in graves disease

thyroid storm

this term refers to thyrotoxicosis in older adults who have other diseases that blunt the signs or symptoms

apathetic hyperthyroidism

what is the most useful lab finding and lab finding that confirms hyperthyroidism

TSH, free t4

what is most often the result of endemic iodine deficiency in the diet worldwide

congenital hypothyroidism

what is the most common cause of hypothyroidism in iodine sufficient areas of the world is

autoimmune hypothyroidism

deficiency in TSH or TRH is what kind of hypothyroidism

secondary

this refers to hypothyroidism that develops in infancy or early childhood in iodine deficient areas with mental and physical slowing

cretinism

this term is applied to hypothyroidism developing in older child or adults showing signs and symptoms in-between cretinism and adult with hypothyroid

myxedema

what is the most sensitive screening test for hypothyroidism

Serum TSH

This autoimmune disease is the result of thyroid gland destruction and failure from breakdown in self tolerance to thyroid autoantigens

hashimotos thyroiditis

what does the cut surface of hashimotos thyroid resemble?

lymph node

these cells in hashimotos have epithelial cells which have eosinophilic granular cytoplasm. these cells are a metaplasia as response to injury

hurthle cells

since hashimotos look like lymph node grossly, what do they have histologically

germinal centers

what neoplasm is there an increased risk of with hashimotos?

thyroid B cell lymphoma

this thyroiditis is painless with mild hypothyroidism, goiter, resembles hashi but without hurthle cells and fibrosis

chronic lymphocytic thyroiditis

this thyroiditis is triggered by viral infection with micro abscesses, yellow-white firm areas and multinucleate giant cells, granulomas!

de quervians thyroiditis

this thyroiditis is like Hashimoto but the fibrosis involves the neck and thyroid too

riedel thyroiditis

this disease is the most common cause of endogenous hyperthyroidism

graves disease

what is there autoantibodies against in graves disease

TSH receptor

this disease produces red and beefy cut surface with tall columnar follicular epi cells and scalloped colloid

graves

what are three clinical features that are unique to graves disease

diffuse hyperplasia, exophthalmos, dermopathy

this goiter causes enlargement of the entire thyroid without nodularity, it can be endemic from low iodine or goitrogens or sporadic with enzyme defects

diffuse nontoxic goiter

this goiter produces extreme thyroid enlargement and can be mistaken for neoplasm, can have cysts, calcs, fibrosis and hemorrhage

multinodular goiter

what is it called when a nodule develops in a longstanding multinodular goiter casing hyperthyroidism

Plummer disease

what must be examined to determine if a lesion is follicular adenoma or carcinoma

capsule

what are the genetic abnormalities in papillary thyroid carcinoma

BRAF and gene fusion of RET, NTRK, BRAF

what is the genetic abnormality in follicular thyroid carcinoma

GOF in RAS

this thyroid tumor is an aggressive dedifferentiated papillary or follicular tumor which accumulates more mutations

anaplastic carcinoma

what are additional mutations anaplastic thyroid carcinoma can develop

RAS or PIK3CA

what is the major risk factor predisposing to thyroid cancer

ionizing radiation

this deficiency has a higher frequency of follicular thyroid cancer

dietary iodine

what histologic feature points heavily to papillary thyroid carcinoma

psammoma bodies

what nuclear features can diagnose papillary carcinoma

ground glass or orphan Annie eye nuclei

microscopically, this thyroid carcinoma has uniform cells forming small follicles containing colloid or sheets of cells without colloid

follicular

what is the most common dissemination route of follicular thyroid carcinoma

hematogenous

these carcinomas of thyroid are neuroendocrine derived from parafollicular cells secreting calcitonin

medullary carcinoma

what thyroid carcinoma is MEN-2B associated with

medullary

what is the most common cause of primary hyperparathyroidism

adenoma

what mutations can primary hyperparathyroidism be associated with

men1

does parathyroid adenoma or primary parathyroid hyperplasia involve all the glands?

hyperplasia

what is the reliable criteria for diagnosis of parathyroid carcinoma

invasion and mets

what is the most common cause of asymptomatic hypercalcemia

primary hyperparathyroidism

what is the most common cause of symptomatic hypercalcemia in adults

parathyroid malignancy

what is the most common cause of secondary hyperparathyroidism

renal failure

tetany with hypocalcemia, Chvostek sign with CN VII, trousseau sign with spasms after bp taken, mental status change and calcs in basal ganglia, cataracts are features of what

hypoparathyroidism

what is end organ resistance to end actions of PTH presenting as hypocalcemia, hyperphosphatemia, and elevated PTH

pseudohypoparathyroidism

diabetes mellitus is a group of metabolic disorders sharing what common feature

hyperglycemia

what 3 things is diabetes mellitus a leading cause of

ESRD, adult onset blindness, non traumatic amputation

what is the major insulin responsive site for postprandial glucose utilization

skeletal muscle

what is the most important stimulus for insulin synthesis and release

glucose

what is the classic triad of diabetes

polyuria, polydipsia, polyphagia

this metabolic complication occurs when oxidation of fatty acids occurs due to glucose not being present to suppress it typically in type one diabetes

diabetic ketoacidosis

what is the most common acute metabolic complication in either type of diabetes

hypoglycemia

this disease of small, md and large vessels due to hyperglycemia can lead to MI, stroke, ischemia, retinopathy, nephropathy, neuropathy

diabetic macrovascular disease

what is the most common cause of death in diabetics due to atherosclerosis

myocardial infarction

what is the leading cause of ESRD in the united states

diabetic nephropathy

this is the most common pancreatic endocrine neoplasm which may produce enough insulin to cause hypoglycemia, deposition of amyloid is common and can be associated with maternal diabetes

insulinoma

this syndrome can be associated with insulinoma, and produces omphalocele, umbilical hernia, macroglossia and Pitts in the skin near the ears

beckwith Wiedemann syndorme

this syndrome associated pancreatic islet lesions with hypersecretion of gastric acid and peptic ulceration, also known as gastrinoma

Zollinger Ellison syndrome

what can neural crest tumors, neuroblastoma, ganglioneuroblastoma, ganglioneuromas and pheochromocytomas be associated with

VIPoma

what hormone does zone glomarulosa produce

aldosterone

what hormone does fasciculata produce

cortisol

what hormone does reticularis produce

estrogens and androgens

what hormone does the adrenal medulla produce

epinephrine

this disorder is caused by conditions elevating glucocorticoid levels, usually from exogenous but could be an ACTH pituitary adenoma causing endogenous

Cushing syndrome

what is the most common manifestation in primary hyperaldosteronism causing Na retention in kidneys

increased blood pressure

this syndrome is when there is primary hyperaldosteronism from a solitary aldosterone secreting adenoma

conn syndrome