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D&T3 Exam 1 > Endocrine-graffeo > Flashcards

Endocrine-graffeo Flashcards

(115 cards)

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1
Q

Pituitary Adenoma

Can get effects due to…

A

Mass effect

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2
Q

Empty sella syndrome

And hypopituitarism

A

Rarely causes

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3
Q

Pituitary

Basophil

A

ACTH

FSH/LH

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4
Q

Empty sella syndrome

Primary empty sella

A

Defect in the diaphragma sella allows CSF to enter and compress the pituitary gland

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5
Q

Adenomas

Morphology

A

Well circumscribed and soft

Larger ones expand SUPERIORLY

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6
Q

Prolactinoma

Characteristics

A

Weakly acidophilic

Can calcify and form psammoma bodies and pituitary stone

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7
Q

Pituitary adenocarcinoma

A

Rare

Only criteria of malignancy is distant mets

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8
Q

Genetic Alterations in Pituitary Tumors

Loss of function

Menin

A

GH, PRL, ACTH adenomas

Familial predisposition to pituitary adenomas

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9
Q

Genetic Alterations in Pituitary Tumors

Loss of function

CDKN1B(p27/KIP1)

A

ACTH adenomas

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10
Q

Corticotroph Adenomas

Hypercortisolism

Leads to

A

Cushing Disease

Cushing syndrome

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11
Q

Pituitary Adenoma

Classification

A

Classified by hormone produced (usually only ONE)

May be functional or silent

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12
Q

Hypopituitarism

Causes

Ischemic necrosis

Ass with

A

Sheehan syndrome: postpartum hemorrhage

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13
Q

Mild elevation in prolactin in pt with adenoma

A

Does NOT necessarily indicate a prolactin-secreting tumor

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14
Q

Serum hyper prolactinemia

Stalk effect

A

MASS in suprsellar compartment

Interferes with normal inhibition by hypothalamus to release dopamine to inhibit PRL secretion

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15
Q

Pituitary

Chromophobe

A

FSH

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16
Q

SIADH

Due to

A

Xs ADH

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17
Q

Infiltration disorders

Lymphocytic hypophysitis

A

Postpartum or pregnant females

Autoimmune?

Mild hyperprolactinemia and isolated ACTH deficiency

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18
Q

MC hyperfunctioning pituitary adenoma

A

Prolactinoma

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19
Q

Pituitary Adenoma

Ass

A

MEN I

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20
Q

Pituitary Adenoma

Sx

A

Benign

Visual symptoms

Endocrine sx

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21
Q

Hypopituitarism

Ischemic necrosis

Caused by

A

DIC

Sickle cell anemia

Shock

Elevated ICP

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22
Q

Craniopharyngioma

Origin

A

Derived from vestigial remnant of Rathke pouch

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23
Q

Corticotroph Adenomas

Nelson syndrome

Hormone result

A

Growth of pituitary corticotroph adenoma results in inc ACTH but no inc in cortisol (no adrenals)

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24
Q

Hypopituitarism

Define

A

Loss of 75% or more of pituitary

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25
Pituitary Apoplexy Define
Rapid enlargement
26
Adenomas Size
Macroadenoma: >1cm Microadenoma: <1cm
27
Inc risk of GI cancers?
GH Adenoma
28
Genetic Alterations in Pituitary Tumors Loss of function Rb
Aggressive adenoma
29
Empty sella syndrome Secondary
Resected mass
30
Adenomas Histology Chromophobic
TSH/non Functional
31
Pituitary Acidophil
GH PRL
32
Corticotroph Adenoma Nelson syndrome Cause
Adrenals removed for Cushing syndrome Pituitary has no negative feedback
33
Hypopituitarism Genetic defects
Mutation in pituitary specific homeobox gen POU1F1 Deficiency of transcription factors
34
Hyperchorisolism ass with
Corticotroph adenomas
35
Genetic Alterations in Pituitary Tumors Gain of function GH adenoma
Gs alpha
36
Prolactinoma Rx:
Dopamine agonists Bromocriptine- 1st line of therapy
37
Pituitary Posterior Pituitary
Derived from nervous system tissue, secretes neurohormones (oxytocin and ADH) produced in HT
38
GH Adenoma Ass with...
INC RISK OF GI CANCERS
39
Hyperpituitarism MC due to
Adenoma
40
Serum hyper prolactinemia Drugs (causes)
Anything that dec dopamine (phenothizaines, haloperidol)
41
Hypothalamic Suprasellar tumor
Craniopharyngioma
42
GH Adenoma Sx
Pre-pubertal children: gigantism Adults: acromegaly
43
Posteriory pituitary Abnormal ADH
Diabetes insipidus (lack) Syndrome of inappropriate ADH (SIADH: xs)
44
Pituitary Adenoma Mass effect shows..
Radio graphic changes of sella turcica Sellar expansion Bony erosion Disruption of the diaphrgma sella
45
Adenomas Histology Eosinophilic
PRL and GH
46
Pituitary adenocarcinoma Ass
Activating mutations in HRAS
47
Posterior pituitary Abnormal oxytocin
No significant clinical abnormalities
48
Genetic Alterations in Pituitary Tumors Gain of function GH and Prolactin adenomas
Protein kinase A
49
Granulomatous hypophysitis
Idiopathic Rare 1/10,000,000 Visual symptoms, N/V, HA
50
GH Adenoma Other signs and sx
ABN glucose tolerance DM Generalized mm weakness Hypertension Arthritis/osteoporosis CHF
51
Serum hyper prolactinemia Other causes
Estrogen Renal failure Hypothyroidism
52
Diabetes insipidus Caused by
Lack of ADH
53
Pituitary Anterior Pituitary
Derived from Rathke's Pouch (of epithelial origin), produces numerous hormones
54
Pituitary Apoplexy Ass with
Pan-hypopituitarism
55
Serum hyper prolactinemia Physiologic causes
Pregnancy, nursing Stress Damage to pituitary stalk or hypothalamus (head trauma) Stalk effect
56
Prolactinoma Rx Surgery
Transphenoidal surgery (through nose)
57
Corticotroph Adenomas S&sx
Silent OR HYPERCORTISOLISM
58
Rathke cleft cyst Can cause
DI
59
Read table in pics
Just do it
60
Pituitary Adenoma Mass Effect Sx
Visual field abnormalities Elevated intracranial pressure Hypopituitarism
61
Craniopharyngioma Caused by
Abnormal WNT signaling, activating B-catenin mutations
62
Prolactinoma Signs and sx
Amenorrhea, galactorrhea, infertility Loss of libido (men)
63
Genetic Alterations in Pituitary Tumors Gain of function Gs alpha
GH adenoma
64
Corticotroph Adenomas Nelson Syndrome Common sign
Hyperpigmentation Due to POMC peptides Pituitary apoplexy possible
65
Prolactinoma Early dx in...
Premenopausal women
66
Pineal Gland
Minute pine cone shaped organ Sup colliculi at base of brain Photosensory neuroendocrine organ
67
Hypopituitarism S&sx
Hypofunction of adrenal cortex, thyroid and gonads Pallor (dec MSH) Atrophy of gonads and genitalia (amenorrhea, impotence, loss of libido) Loss of axillary and pubic hair
68
Diabetes insipidus Lack of ADH causes
Polyuria, dilute urine, inc serum osmolality, inc serum na, polydipsia (inc serum na) Life threatening dehydration may occur!!!!!!!!
69
Posterior pituitary Secretes
ADH and oxytocin
70
Rathke cleft cyst Mechanism of DI
Compression of surrounding structures (loss of ADH-vasopressin storage and release)
71
GH Adenoma Characteristics
ACIDOPHILIC (or chromophobic) May have PRL Granules
72
Corticotroph Adenomas Characteristics
Microadenoma BASOPHILIC (could also be chromophobic)
73
Pituitary Adenoma Mass Effect Hypopituitarism
Compression of normal pituitary tissue Compression of stalk
74
Craniopharyngioma Common pt
Childhood or adolescence
75
SIADH MC cause
Malignant neoplasms Small Cell CA of Lung
76
Pituitary Adenoma Clinical Presentation
30-60s 10% of intracranial lesion
77
Pineal Gland Secretes
Melatonin
78
Cushing disease caused by
Pituitary Adenoma
79
Pituitary Apoplexy Rapid enlargement caused by
Acute hemorrhage Infarction and swelling Neurosurgical/medical emergency
80
Craniopharyngioma Sx
Children: endocrine deficiencies (growth retardation) Adults: visual disturbances (papillary)
81
Empty sella syndrome Caused by
Due to chronic herniation of the subarachnoid space into the sella turcica
82
Invasive Adenoma Morphology
Non-encapsulated Infiltrates Surrounding Tissue
83
Empty sella syndrome Define
Enlarged, empty sella turcica
84
Nelson Syndrome ass with
Corticotroph adenoma
85
Cushing Syndrome caused by
Iatrogenic Primary adrenal cortex Ectopic ACTH
86
Pineal Gland Neoplasms
Germinoma/seminoma Pinealomas
87
Other pituitary tumors Gonadotroph (FSH/LH)
Middle aged men and women Loss of libido or no symptoms in men
88
Hypopituitarism Causes
Nonsecretory Pituitary Adenoma Ischemic Necrosis Ablation (Sx or Radiation) Trauma and subarachnoid hemorrhage
89
Atypical adenomas Characteristics
Inc mitotic figures Inc KI67 Nuclear Immunoreactivity for p53 protein
90
Rathke cleft cyst Origin and histology
Pars intermedia Ciliated cuboidal/columnar epithelium Squamous metaplasia
91
Hypopituitarism When do you get diabetes insipidus (lack of ADH)?
If due to hypothalamic cause
92
Pituitary Adenoma Mass Effect Visual field abnormalities
Bitemporal hemianopsia=loss of lateral vision Optic chiasm compression
93
Craniopharyngioma Dx
Seen on X-ray (3/4 have enough Ca)
94
Other pituitary tumors Null cell
No hormones Mass effect Compress remaining pituitary causing hypopituitarism
95
Pituitary Adenoma Mass Effect Elevated ICP
Headache N/V
96
2nd most common adenoma
GH adenoma
97
Empty sella syndrome Common pt
Obese pts with multiple pregnancies
98
Adenoma Histology
Monomorphic cells: eosinophilic, basophilic, chromophobic (no stain) No reticulin network (seen in normal)
99
Pituitary Hypothalamus pituitary interaction
Hypothalamus. Pituitary TRH. +. TSH PIF (dopamine). - PRL CRH. +. ACTH GHRH. +. GH GIH(somatostatin). - GH GnRH. +. FSH/LH
100
Adenomas Histology Basophilic
ACTH
101
Pineal Gland Histology
Neuroglial stroma and epithelial pineocytes Sequestered embryonic germ cells
102
Pituitary Apoplexy Sx
Sudden onset of excruciating headache, diploid, panhypopit, cardiovascular collapse, LOC----death
103
Pituitary apoplexy Caused by
Usually undiagnosed adenoma
104
Genetic Alterations in Pituitary Tumors Loss of function Aggressive adenoma
Rb
105
Craniopharyngioma Pediatric histology
Adamantinomatous histology
106
SIADH Xs ADH causes
Inc resorption of water Dec serum no NO PERIPHERAL EDEMA (na not retained)
107
Pituitary Hypofunction Can cause
``` Growth failure (primary dwarfism) Amenorrhea/infertility Dec libido/ED Hypothyroidism Hypoadrenalism Pallor due to loss of MSH ```
108
Genetic Alterations in Pituitary Tumors Loss of function Aryl hydrocarbon receptor interacting protein (AIP1)
GH adenomas
109
Genetic Alterations in Pituitary Tumors Gain of function Protein kinase A
GH and Prolactin adenomas
110
Craniopharyngioma Age distribution
Bimodal 5-15 and 50-60
111
Pituitary Sella Turcica
Bony box in which pituitary sits, depression in sphenoid bone
112
Diabetes insipidus ADH function
Cause reabsorption of free water by the renal collecting tubules Retain water dilutes the blood
113
Hyperpituitarism Less common causes
Hyperplasia Carcinoma Non pituitary tumors Disorders of hypothalamus
114
Empty sella syndrome Rarely causes...
Hypopituitarism
115
Hypopituitarism If due to hypothalamic cause
Also get diabetes insipidus (lack of ADH)

D&T3 Exam 1 (19 decks)

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