What are the hormones secreted by the anterior pituitary gland ?
- TSH, ACTH, FSH, LH
- GH and Prolactin
What are the hormones secreted by the posterior pituitary gland?
ADH and oxytocin
What are some of the pathologies affecting the anterior pituitary gland ?
- Sudden Haemorrhage into gland
- Ischaemic necrosis - Sheehan Syndrome
- Tumours extending into sella
- Inflammatory conditions (Sarcoidosis)
What are some of the pathologies affecting the posterior pituitary gland ?
- Lack of ADH secretion
- Can lead to life threatening dehydration
Syndrome of Inappropriate ADH secretion (SIADH):
- Ectopic secretion of ADH by tumours
- Primary disorder in the pituitary
Describe the characteristics of pituitary adenomas
- Most common lesions of anterior pituitary
- Small pituitary adenomas usually go unnoticed and are found post-mortem
- If large enough may push on optic chiasm and produce visual distrubances, headache also common
- Can cause excessive secretion of anterior pituitary hormones
How do pituitary adenomas arise ?
Either sporadic or may be due to MEN1 syndrome
How are pituitary adenomas classified ?
By cell type and hormone secreted
- Prolactin (20-30%)
- ACTH (10-15%)
- FSH/LH (10-15%)
- GH (5%)
- Can produce more than one
- Can be hypo / non-functional (25-30%)
- hormone production may be at subclinical levels
What can prolactinomas (prolactin secreting pituitary adenoma) cause ?
Infertility, lack of libido, amenorrhea
What condition is GH secreting pituitary adenomas associated with ?
Gigantism or acromegaly
What is ACTH secreting pituitary adenomas associated with ?
What are some of the causes of panhypopituitarism ?
- Granulomatous inflammation – sarcoidosis
- Infarction – Sheehan’s syndrome
- Primary or metastatic tumours
What are some of the types of diabetes insipidus ?
- ADH deficiency
- Trauma (including surgery), tumours and inflammatory disorders of hypothalamus and pituitary
- Renal resistance to ADH effects
What is SIADH?
Ectopic production of ADH
Where are the adrenal glands located ?
Bilateral glands which sit superior and medial to upper pole of kidneys
What is the adrenal gland composed of ?
An outer cortex and inner medulla
What are some of the pathologies affecting the adrenal glands ?
- Acute -Waterhouse-Friderichsen
- Chronic - Addison’s disease
What are the features of adrenocortical adenomas ?
Well circumcised, yellow/brown in appearance
Composed of cells resembling adrenocortical cells