Path 5 Endocrine Intro, Pituitary Flashcards Preview

Test 9 > Path 5 Endocrine Intro, Pituitary > Flashcards

Flashcards in Path 5 Endocrine Intro, Pituitary Deck (61):
1

Anterior lobe & posterior lobe of pituitary names

Adenohypophysis
Neurohypophysis

2

Anterior v Posterior function

Anterior produces via hypothalamus, Posterior secretes via neurons

3

Larger lobe of the pituitary

Anterior

4

5 anterior cells & hormones

1. Somatotrophs - Growth Hormone
2. Corticotrophs - POMC (ACTH, B-MSH)
3. Thyrotrophs -TSH
4. Gonadotrophs - FSH, LH
5. Lactotrophs - Prolactin

5

Somatotroph

GH -> Somatomedins (liver) ->

6

Somatotroph regulation

Hypothalamus:
1. ++ GHRH
2. -- Somatostatin (GIH)

7

Corticotroph

POMC (pro-opiomelanocortin) split into
a. ACTH -> adrenal -> cortisol and androgen
b. B-lipotropin -> B-MSH and B-endorphins

8

Corticotroph regulation

++ Hypothalamic CRH (corticotropin releasing hormone)

9

Thyrotroph

TSH (Thyroid Stimulating Hormone) -> Thyroid follicle growth

10

Thyrotroph regulation

++ Hypothalamic TRH (Thyrotropin releasing hormone)

11

Lactotroph/mammotroph

Prolactin -> lactation

12

Lactotroph regulation

-- Prolactin inhibiting factor (Dopamine)

13

Gonadotroph

FSH -> follicle formation
LH -> ovulation and corpus luteum formation

14

Gonadotroph regulation

++ Hypothalamic GnRH

15

Posterior pituitary anatomy

Pituicytes (glial cells from hypothalamus) travel through stalk into neuro hypophysis

16

2 posterior cells & hormones

Pituicytes
1. Oxytocin
2. ADH (vasopressin)

17

Oxytocin function, regulation

Stimulates uterine contraction and milk ejection
-Regulated by cervical dilation and nipple stimulation

18

ADH function, regulation

Water retention in collecting ducts
-Controlled by baro and osmoreceptors

19

Most common cause of hyperpituitarism

Pituitary adenoma

20

Nonfunctioning adenoma clinical presentation

Temporal hemianopsia
Hypopituitarism
Headaches

21

Pituitary adenoma histo

Cellular monotony
Loss of normal reticulin network

22

2 Familial pituitary adenoma syndromes

-MEN1 mutation
-Carney's complex

23

Carney's complex

Endocrine adenomas, cardiac myxomas, pigmented skin lesions

24

MEN1 mutation

Hyperplasia of pituitary, thyroid, parathyroid, adrenal cortex, pancreas

25

Mutation found in all pituitary adenomas

G-protein

26

Lactotroph adenoma

Prolactin -> Galactorrhea and amenorrhea, sexual dysfunction, infertility

27

Somatotroph adenoma

GH -> Gigantism (children), Acromegaly (adults)

28

Corticotroph mutation

ACTH -> Cushing syndrome, Nelson syndrome

29

Mammosomatotroph adenoma

Prolactin/GH -> combined features

30

Thyrotroph

TSH -> Hyperthyroidism

31

Prolactinoma clinical

Amenorrhea, Galactorrhea (female)
Loss of libido, headaches (male)

32

Prolactinoma Tx

DA agonist (bromocriptine)

33

Prolactinoma secondary causes

Hypothalamic malfunction
DA antagonists (methyldopa, reserpine)

34

Somatotrophic adenoma clinical

-Diabetes Mellitus
-Gigantism (children)
-Acromegaly (adults), problems with thyroid, heart, liver, adrenals

35

Somatotrophic Adenoma Tx

-Somatostatin analog
-GH-R antagonis

36

Somatotrophic Adenoma Dx

-lack of GH suppression by oral glucose
-elevated GH and IGF-1 levels

37

Somatotrophic Adenoma diabetes mechanism

GH induces hepatic gluconeogenesis

38

Corticotrophic Adenoma

Cushing disease (not syndrome)

39

Gonadotrophic Adenoma

LH, FSH production rare
-Commonly mass effect and hypogonadism

40

Thyrotrophic Adenoma

Rare and often subclinical

41

Non-functioning adenoma Dx

Immunohistochemical staining for lineage

42

Non-functioning adenoma clinical

-Hypopituitarism
-Bitemporal hemianopsia
-Headache
-Pituitary apoplexy (acute hemorrhage)

43

Posterior pituitary dysfunction

Suspect hypothalamic condition

44

Sheehan syndrome

Ischemic necrosis of pituitary gland in postpartum women
-Enlarged pituitary with reduced blood pressure during partuition

45

Sheehan syndrome presentation

-Impaired lactation (no prolactin)
-Loss of pubic hair (no gonadotrophs)
-Fatigue (no TSH)

46

Rathke cleft cyst

Rathke pouch (ant. pituitary) remnant becomes cystic
-Lined by ciliated cuboidal epithelium

47

Empty sella syndrome

Malformed sella fills with CSF, pituitary gland is compressed

48

Hypothalamic lesion

Diminish anterior as well as posterior function

49

Non-cancerous causes of hypopituitarism

Sarcoidosis
Tuberculous meningitis

50

Genetic hypopituitarism

Pituitary-specific homeobox gene POU1F1 deficiency

51

Diabetes Insipidus

Low ADH secondary to p.pituitary dysfunction

52

Types of Diabetes Insipidus (3)

-Central DI: ADH deficiency
-Nephrogenic DI: Renal tubule unresponsiveness to ADH
-Iatrogenic DI: Lithium, demeclocycline

53

Diabetes Insipidus clinical

-Polyuria/polydipsia
-Inappropriately low urine osmolarity/gravity
-Increased serum sodium and osmolarity

54

Diabetes Insipidus Dx

Water deprivation test (no increase in urine osmolarity)

55

Diabetes Insipidus Tx

Desmopressin (ADH analog)

56

Syndrome of Inappropriate ADH causes (3)

-Small cell lung carcinoma
-Cyclophosphamide
-CNS disorders

57

SIADH clinical

-Hyponatremia, low serum osmolarity
-Cerebral edema, CNS dysfunction/seizures

58

SIADH Tx

-Demeclocycline
-Water retention

59

Craniopharyngioma

Derived from Rathke pouch remnants
-peaks at 10 and 65 years
-pituitary (GH) hypofunction in children
-headaches and visual disturbance in adults

60

Craniopharyngioma types

-Adamantinomatous craniopharyngioma (children)
-Papillary craniopharyngioma (adults)

61

Pituitary carcinoma

Rare malignant form (<1%)