Disorders of the Pituitary Gland Flashcards Preview

X Clin Med II Exam 4 > Disorders of the Pituitary Gland > Flashcards

Flashcards in Disorders of the Pituitary Gland Deck (74)
Loading flashcards...
1

What does the anterior pituitary do?

Synthesize and secrete hormones in response to negative feedback from adrenals, thyroid and gonads

2

What are the anterior pituitary hormones?

Adrenocorticotropic hormone
Thyroid stimulating hormone
Luteinizing hormone
Follicle stimulating hormone
Growth hormone
Prolactin

3

What does ACTH do?

Increase production and release of cortisol by the adrenal cortex (cortisol negatively feedbacks on it)

4

What does TSH do?

Stimulate thyroid gland to produce T4 and T3 to stimulate the metabolism of many tissues

5

What does LH do?

Trigger ovulation and development of corpus luteum and stimulate production of testosterone

6

What does FSH do?

Stimulates growth of ovarian follicles (F) or stimulates formation of secondary spermatocytes (M)

7

What does GH do?

Stimulate growth, cell reproduction, cell regeneration and gluconeogenesis

8

What does prolactin do?

Stimulates milk production (F) or works with LH and testosterone to increase reproductive function (M)

9

What is different about the posterior pituitary?

It does not synthesize hormones, it just stores ADH and oxytocin which are made in the hypothalamus

10

What does ADH do?

Released in response to hypertonicity and causes kidneys to reabsorb water (concentrated urine and reduce urine vol)

11

What does oxytocin do?

Increase uterine contractions and promote stretching of cervix and uterus during labor

12

What does the intermediate pituitary do?

Synthesize and secrete melanocyte-stimulating hormone to control skin pigmentation

13

Presentation of a sellar mass

Neuro sxs (vision changes, HA)
Incidental MRI finding
Hormonal abnormalities

14

Most common visual complaint of sellar masses

Bitemporal hemianopsia (suprasellar extension of adenoma leading to compression of optic chiasm)

15

Etiologies of sellar masses

Benign: pituitary adenomas, craniopharyngioma, meningioma
Cysts, abscesses, AV fistula of cavernous sinus
Malignant tumors: primary like germ cell tumor, chordoma, lymphoma or mets from breast or lung cancer

16

Most common primary pituitary tumor

Prolactinoma

17

Micro vs macroadenoma

Micro <1 and macro >1

18

Features of pituitary adenoma due to gonadotrophs

Non-functioning meaning no hormonal related role

19

Features of pituitary adenoma due to thyrotrophs

Increased TSH secretion

20

Features of pituitary adenoma due to corticotrophs

Increased cortisol causes Cushing's (these make ACTH)

21

Features of pituitary adenoma due to lactotrophs

Increased prolactin causes hyperprolactinemia (and therefore hypogonadism)

22

Features of pituitary adenoma due to somatotrophs

Increased GH causes acromegaly

23

How to diagnose a sellar mass

MRI of the brain
Hormonal hypersecretion tests (serum prolactin and IGF-1, 24 hr urine cortisol, T3/T4/TSH)

24

Prolactinoma in premenopausal women

Infertility, oligomenorrhea/amenorrhea, galactorrhea
Serum prolactin >30 ng/mL

25

Prolactinoma in postmenopausal women

HA, impaired vision, galactorrhea (rare)
Later findings and bigger mass b/c don't see things like amenorrhea
Serum prolactin >20ng/mL

26

Prolactinoma in men

Decreased libido, impotence, infertility, gynecomastia, galactorrhea (rare)
Serum prolactin >20 ng/mL

27

Causes of hyperprolactinemia

Pregnancy, stress, lactation, exercise, drugs (phenothiazine, haloperidol, benzos), pathologic (micro and macro, hypothyroidism)

28

Medical tx for prolactinoma

Bromocriptine or Cabergoline (dopa agonist to stop action of prolactin)

29

Surgical tx of prolactinoma

Transsphenoidal resection (if small) or radiotherapy

30

Most common etiology of growth hormone excess

Benign pituitary adenoma >1 cm (can be ectopic tumors, MEN type 1, NF)