Pathology · USMLE Step 1

USMLE Pathology: Endocrine System

Endocrine gland pathology and tumor morphology (thyroid, adrenal, pituitary, pancreatic islet), distinct from the hormone-axis focused USMLE Endocrine deck.

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What is the most common type of thyroid carcinoma?
Papillary thyroid carcinoma
What nuclear feature is characteristic of papillary thyroid carcinoma cells?
Empty-appearing nuclei with central clearing (Orphan Annie eye nuclei)
Psammoma bodies, concentric calcified structures, are a histologic feature of ____.
papillary thyroid carcinoma
What nuclear feature, besides clearing, helps identify papillary thyroid carcinoma cells?
Nuclear grooves (longitudinal folds in the nucleus)
How is follicular thyroid carcinoma distinguished from a follicular adenoma?
By capsular and/or vascular invasion seen on histology
What is the primary route of metastasis for follicular thyroid carcinoma?
Hematogenous spread
Medullary thyroid carcinoma arises from which cell type?
Parafollicular C cells
What hormone is secreted by medullary thyroid carcinoma?
Calcitonin
Medullary thyroid carcinoma is associated with which familial syndromes?
MEN2A and MEN2B
What substance forms the stroma of medullary thyroid carcinoma?
Amyloid, derived from deposited calcitonin
Which thyroid carcinoma subtype is most aggressive and typically occurs in older adults?
Anaplastic (undifferentiated) thyroid carcinoma
What cell type is characteristically seen in Hashimoto thyroiditis?
Hurthle cells (oxyphilic cells with granular eosinophilic cytoplasm)
Chronic Hashimoto thyroiditis increases the risk of developing thyroid ____.
lymphoma
What histologic finding describes the colloid in Graves disease?
Scalloped, pale colloid margins from hyperactive follicular epithelium
What type of inflammation characterizes subacute (de Quervain) thyroiditis?
Granulomatous inflammation

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