Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endo > Disorders of Ant. Pituitary (Fisher) > Flashcards

Disorders of Ant. Pituitary (Fisher) Flashcards

Delete whatever you feel is excess info

1
Q

What is monotropic hypopituitarism?

A

isolated deficiency of GH, LH/FSH, ACTH or TSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is polytropic hypopituitarism?

A

deficiency of GH, LH/FSH, ACTH and TSH in various combinations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is panhypopituitarism?

A

anterior and posterior pituitary failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the sequence of hormonal deficiencies following pituitary destruction?

A

Gonadotropic + GH → PRL + TSH → ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Loss of ___% of the pituitary results in moderate effects.

Loss of ___% of the pituitary results in severe effects.

A

65-75%

90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What 4 types of tumors cause hypopituitarism?

A
  1. Hypothalamic
  2. Pituitary
  3. Parasellar
  4. Metastatic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What do hypothalamic tumors cause?

A

secondary hypopituitarism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do parasellar tumors cause hypopituitarism?

A
  • -may directly compress median eminence or stalk

- -may invade hypothalamus or pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are 2 causes of Vascular Infarction which cause hypopituitarism?

A

Sheehan’s Syndrome

Pituitary apoplexy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Sheehan’s Syndrome?

A

Intra- or post-partum pituitary necrosis due to severe blood loss → shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is pituitary apoplexy?

A

intrapituitary hemorrhage caused by tumor compression of vessel walls + redistribution of blood flow
(this results in hypoxic injury, damage to capillary integrity + extravasation of blood from capillaries into tumor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are possible outcomes of pituitary apoplexy?

A

Tumor +/- normal tissue may be completely destroyed, which leads to autocure +/- hypopituitarism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What can occur if bleeding extends superiorly in pituitary apoplexy?

A

subarachnoid hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Sarcoidosis, tuberculosis and post-meningitic fibrosis cause destruction of:

A

median eminence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Encephalitis can (occasionally) destroy:

A

hypothalamic nuclei

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What types of infiltration may directly damage pituitary cells?

A

Amyloidosis

hemochromotosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How can head trauma cause hypopituitarism?

A

damage to median eminence or stalk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When does idiopathic hypopituitarism occur, and what causes it?

A

pre-puberty

genetic defects in transcription factors needed for differentiation of anterior pituitary cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What causes autoimmune hypopituitarism?

A

chronic inflammation causes pituitary cell destruction from lymphoid infiltrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What causes primary Empty Sella hypopituitarism?

A

defect in diaphragm sella, which allows CSF pressure to enlarge sella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What causes Secondary Empty Sella hypopituitarism?

A

mass (e.g. adenoma) which has been removed by operation, radiation or infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the hormonal effects of deficient TSH?

A

↓ T3/T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the hormonal effects of deficient ACTH?

A

↓ Cortisol

↓ androgens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the hormonal effects of deficient LH/FSH?

A

↓ T

↓estradiol/progesterone (females)

25
Q

What are the hormonal effects of deficient GH?

A

↓ somatomedin-C (IgF1)

26
Q

What is the clinical consequence of deficient TSH?

A

hypothyroidism

27
Q

What is the clinical consequence of deficient ACTH?

A

Hypoadrenalism

28
Q

What is the clinical consequence of deficient LH/FSH?

A

Hypogonadism

29
Q

What is the clinical consequence of deficient GH?

A

Growth failure

30
Q

What is the clinical consequence of deficient PRL?

A

Failed lactation

31
Q

What are 5 general causes of hypothalamic disorders?

A

i. Infiltrative Disorders
ii. Mass lesions
iii. Radiation
iv. Infection
v. Trauma

32
Q

What are the results of pituitary stalk section?

A
  • -DI

- -pituitary hormone deficiency except PL (↑ due to loss of tonic inhibition by dopamine)

33
Q

What 3 conditions result from hypothalamic lesions, and cause hyperpituitarism?

A

i. Precocious puberty
ii. Acromegaly
iii. Cushing’s Syndrome

34
Q

What conditions do prolactinomas cause?

A

amenorrhea/galactorrhea (women)

impotence/↓libido (men)

35
Q

What are the hormonal effects of prolactinomas?

A 
↓GnRH
↓LH/FSH
↓T (men)
↓estradiol/progesterone (women)
↑adrenal androgens
36
Q

What conditions do GH adenomas cause?

A

acromegaly (adults)

gigantism (children)

37
Q

What conditions do ACTH adenomas cause?

A

Cushing’s disease

Nelson’s syndrome

38
Q

What conditions do mixed GH-PRL cell adenoma cause?

A

acromegaly

hyperprolactinemia

39
Q

What conditions do gonadotropin cell adenomas cause?

A 
hypogonadism
visual impairment (when large enough due to compression of optic chiasm)
40
Q

What conditions do TSH adenomas cause?

A
  • -hyperthyroidism
  • -thyrotoxicosis
  • -acromegaly or hyperprolactinemia (1/3 of cases)
41
Q

How do TSH adenomas respond to TRH? TSH?

A 
TRH = no response
TSH = no suppression
42
Q

What suppresses TSH adenomas?

A

glucocorticoids

43
Q

What is elevated in 85% of patients with TSH adenomas?

A

alpha subunits

44
Q

What conditions does pituitary hyperplasia cause?

A

i. Cushing’s disease

ii. Hyperprolactinemia

45
Q

What types of ectopic tumors cause Cushing’s?

A
  1. ACTH-secreting lung carcinoma

2. CRH-Secreting bronchial adenoma or carcinoids

46
Q

What type of ectopic tumors causes acromegaly?

A

GHRH-secreting pancreatic islet tumor or carcinoids

due to secondary GH cell hyperplasia

47
Q

What hormone increases when GH levels increase?

A

IgF1

48
Q

What results from increased levels of IgF1?

A
  1. ↑ growth of cartilaginous bones (resulting in prognathism; splaying of teeth; large nose, nasal sinuses, hands/feet)
  2. ↑ soft tissue mass (resulting in thickened skin + subQ tissue, skin tags)
  3. sweat gland hypertrophy (↑ sweating)
49
Q

What results from increased levels of ↑GH and ↑IgF1

A
  1. Visceral enlargement (liver, spleen, kidney)

2. Insulin resistance (glu intolerance or DM)

50
Q

What results from increased levels of ↑GH and ↑PRL

A
  1. Galactorhhea
  2. Hypogonadiam (infertility)
  3. Acromegaly
51
Q

What hormones are elevated in and cause Cushing’s?

A

ACTH
Cortisol
Adrenal Androgen

52
Q

What are the effects of increased ACTH in Cushing’s?

A
  1. Bilateral adrenal hyperplasia with increased plasma cortisol and adrenal androgen
  2. Loss of diurnal rhythm of ACTH and cortisol
  3. Increased urinary cortisol
53
Q

What are the effects of increased cortisol in Cushing’s?

A 
Salt retention
Insulin resistance
↑ fat deposits
↓ skin collagen
Proximal myopathy
Cerebral effects
54
Q

What are the effects of increased adrenal androgens in Cushing’s?

A

↓LH/FSH

↑ hair growth + sebum production

↓ libido

55
Q

Signs/Symptoms of Cushing’s?

A 
obesity
HTN
glu intolerance
menstrual irregularity
hirsutism
striae
dorsal fat pad (hump)
56
Q

Most common cause of Cushing’s syndrome?

A

exogenous glucocorticoid ingestion

57
Q

How is Cushing’s diagnosed?

A

dexamethasone suppression tests, which evaluate ACTH secretion in response to potent synthetic glucocorticoid

(nml = negative feedback)

58
Q

When diagnosing Cushing’s, what can low doses of drug distinguish between?

A

Cushing’s syndrome versus normal hypothalamus/pituitary/adrenal function

59
Q

When diagnosing Cushing’s, what can high doses of drug distinguish between?

A

Cushing’s disease versus Ectopic ACTH Syndrome and adrenal tumors

Endo (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions