2: Pathology of pituitary and adrenal glands Flashcards

(53 cards)

1
Q

Pituitary pathologies are caused by what two types of abnormal function?

A

Hyperfunction

Hypofunction

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2
Q

Which recess of the middle cranial fossa is the pituitary gland found in?

A

Sella turcica

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3
Q

What membrane of dura mater covers the pituitary gland?

A

Diaphragm sellae

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4
Q

Which structure connects the pituitary to the hypothalamus?

A

Pituitary stalk

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5
Q

Which pituitary gland is

a) an extension of the neural aspect of the hypothalamus?
b) anterior?

A

a) posterior

b) anterior

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6
Q

What is the anterior pituitary also known as?

A

Adenohypophysis

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7
Q

Which hormones does the anterior pituitary secrete?

A

Trophic: TSH, ACTH, LH and FSH

Non-trophic: GH and PRL

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8
Q

Which hormones does the posterior pituitary secrete?

A

ADH

Oxytocin

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9
Q

What is the posterior pituitary also known as?

A

Neurohypophysis

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10
Q

On histology of the pituitary gland, all the cells look different - why is this?

A

Loads of different cells which produce different hormones

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11
Q

What causes anterior pituitary hyperfunction?

A

Pituitary tumours

Adenomas and carcinomas

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12
Q

What causes anterior pituitary hypofunction?

A

Surgery, radiation

Haemorrhage into gland

Tumours

Inflammatory conditions

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13
Q

What is Sheehan syndrome?

What kind of abnormal pituitary function does it cause?

A

Ischaemic necrosis of pituitary gland following childbirth

Pituitary hypofunction

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14
Q

What are two notable conditions associated with the posterior pituitary?

A

Diabetes insipidus

SIADH

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15
Q

What is a benign tumour of the anterior pituitary known as?

A

Pituitary adenoma

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16
Q

What genetic syndrome are numerous pituitary adenomas a presentation of?

A

MEN1

multiple endocrine neoplasia

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17
Q

Pituitary adenomas are classified by the type of ___ they produce.

A

hormone

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18
Q

Can pituitary adenomas produce more than one hormone?

A

Yes

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19
Q

Do pituitary adenomas have to produce hormone?

A

No, similarly to thyroid, some are non-functional

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20
Q

Why may large pituitary adenomas cause visual field defects?

A

Compression of optic chiasm

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21
Q

What disease involves multiple hormone deficiencies of the pituitary gland?

A

Panhypopituitarism

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22
Q

Why may large pituitary adenomas cause hypopituitarism?

A

(Infarction due to) compression

23
Q

What are three types of pituitary adenoma and which diseases will they cause?

A

Prolactinoma - hyperprolactinaemia (galactorrhoea, infertility, loss of libido, amenorrhoea)

GHoma - acromegaly

ACTHoma - Cushing’s disease

24
Q

What are three causes of panhypopituitarism?

A

Tumours (primary or metastatic)

Granulomatous disease e.g sarcoidosis

Sheehan syndrome

25
The anterior pituitary gland is a remnant of which embryological structure?
**Rafke's pouch**
26
Which rare, benign tumour is most commonly seen in children and arises from Rafke's pouch during development?
**Craniopharyngioma**
27
What are two important posterior pituitary syndromes?
**Diabetes insipidus** **SIADH**
28
Production of **ectopic** hormone e.g ADH, ACTH may be caused by what?
**Functioning tumours elsewhere e.g small cell carcinomas of the lung** "Paraneoplastic syndrome"
29
What are the two parts of the adrenal gland?
**Cortex** **Medulla**
30
The adrenal medulla is an extension of the ___ nervous system.
**sympathetic**
31
What hormones do the adrenal a) cortex b) medulla produce?
**Adrenal cortex** - cortisol (glucocorticoids), aldosterone (mineralocorticoids), androgens (sex hormone) **Adrenal medulla** - adrenaline and noradrenaline (catecholamines)
32
Again, what two types of abnormal adrenal function are there?
**Hyperfunction** **Hypofunction**
33
Adrenal disease can be caused by which other endocrine gland?
**Pituitary gland**
34
What are three causes of **adrenal cortex hyperfunction**?
**Hyperplasia** (too much ACTH stimulation) ## Footnote **Adenoma, carcinoma**
35
What are diseases causing **acute** and **chronic** **adrenal cortex hypofunction?**
**Acutely -** Waterhouse-Friederichsen disease **Chronic** - Addison's disease (the important one)
36
What is Waterhouse-Friderichson syndrome?
**Adrenal hypofunction** caused by bleeding secondary to infection usually Neisseria meningitidis
37
What causes adrenal cortex hyperplasia?
**Overstimulation by ACTH**
38
**Which diseases are associated with overproduction of ACTH?** **Which adrenal pathology is associated with this?**
**Cushing's DISEASE** **2ndary hyperaldosteronism** **Ectopic ACTH production** e.g small cell carcinoma of lungs **Androgen excess** ADRENAL HYPERPLASIA
39
Why are adrenal cortex adenomas yellow?
**Lipid content**
40
How do adrenocortical carcinomas tend to spread?
**Locally** - to retroperitoneum, kidneys **Haematogenously** - to liver, lungs and bone
41
What syndromes do overproduction of a) aldosterone b) cortisol by the adrenal cortex tumours produce?
**a) Conn's syndrome** **b) Cushing's syndrome** mind that pituitary ACTH excess causing symptoms would be Cushing's **disease** and **secondary hyperaldosteronism**
42
Problems with which axis can cause secondary adrenocortical hypofunction?
**Hypothalamic-pituitary-adrenal axis**
43
Which type of drug **suppresses** the adrenal cortex?
**Steroids**
44
What is the name given to chronic adrenocortical insufficiency?
**Addison's disease**
45
Addison's disease is a type of **(primary / secondary)** adrenocortical insufficiency.
**primary adrenocortical insufficiency**
46
Which part of the nervous system innervates the adrenal medulla?
**Sympathetic**
47
Which cells in the adrenal medulla secrete catecholamines?
**Neuroendocrine / Chromaffin cells**
48
What are two types of tumour found in the adrenal medulla?
**Phaeochromocytoma** **Neuroblastoma**
49
Which type of endocrine tumour is common in infancy?
**Neuroblastoma** **Craniopharyngioma**
50
What is a neoplasm of neuroendocrine cells called?
**Phaeochromocytoma**
51
What cardiovascular disease does phaeochromocytoma cause?
**Hypertension** | (secondary)
52
What is a lab sign of phaeochromocytoma?
**Urinary excretion of catecholamines** makes sense cuz you're overproducing them
53
Phaeochromocytoma is known as the \_\_% tumour.
10% tumour ## Footnote **10% extra-adrenal** **10% bilateral** **10% malignant** **10% familial (think MEN2A)** **10% DON'T cause hypertension**