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Endo II > Pathology of the Pituitary > Flashcards

Pathology of the Pituitary Flashcards

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1
Q

location of pituitary

A

sella turcica

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2
Q

80% of pituitary

A

adenohypophysis

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3
Q

ADH and oxytocin production

A

neurohypophysis of pituitary gland

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4
Q

secreted by anterior pituitary

A 
TSH
PRL
ACTH
GH
FSH
LH
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5
Q

control of GH release

A

somatostatin - inhibitory

GHRH - stimulatory

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6
Q

cells of anterior pituitary

A 
somatotrophs
mammosomatotrophs
lactotrophs
corticotrophs
thyrotrophs
gonadotrophs
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7
Q

cells secreting GH

A

somatotrophs

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8
Q

cells secreting GH and PRL

A

mammosomatotrophs

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9
Q

cells secreting PRL

A

lactotrophs

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10
Q

cells secreting ACTH, POMC, and MSH

A

corticotrophs

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11
Q

cells secreting TSH

A

thyrotrophs

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12
Q

cells secreting FSH and LH

A

gonadotrophs

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13
Q

vasopressin

A

ADH

from posterior pituitary

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14
Q

ACTH and POMC

A

same analog

hypopituitary - loss of pigmentation

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15
Q

acidophil

A

cells of pituitary

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16
Q

loss of lateral visual fields

A

bitemporal hemianopsia

local mass effect with pituitary gland size increase

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17
Q

N/V, headaches, papilledema

A

cerebral edema

pituitary growth leading to brain swelling

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18
Q

milky discharge

A

galactorrhea

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19
Q

bilateral galactorrhea, onset of HAs, elevated PRL

A

pituitary adenoma - prolactinoma

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20
Q

combined features of GH and PRL excess

A

mammosomatotroph pituitary adenoma

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21
Q

types of pituitary adenomas

A 
lactotroph - most common
somatotroph
mammosomatotroph
corticotroph
thyrotroph
gonadotroph
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22
Q

gigantism and acromegaly

A

somatotroph pituitary adenoma

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23
Q

HRAS

A

pituitary carcinoma

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24
Q

GNAS

A

GH adenomas

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25
PRKAR1A
GH and PRL adenomas
26
MEN1
GH, PRL, ACTH adenomas
27
larger pituitary adenomas
tend to be nonfunctional - more local mass effects
28
bleeding into pituitary adenoma
pituitary apoplexy
29
amenorrhea, galactorrhea, loss of libido, infertility
prolictinemia typically female age 20-40
30
1/4 amenorrhea cases
lactotroph adenoma
31
men and older women with lactotroph adenoma
hormone manifestations may be subtle | -so not detected until large size - macroadenoma
32
dense core granules
think endocrine source
33
gigantism
children - before epiphyseal plates close
34
acromegaly
adults - after epiphyseal plates close
35
IGF-1
from liver -stimulated by GH causes many of the clinical manifestations of somatotroph adenomas (acromegaly and gigantism)
36
acromegaly growth
skin, soft tissue, thyroid, heart, liver, adrenal, bones of face, hands, and feet
37
increased body size with long arms and legs
gigantism
38
increased bone density
hyperostosis seen in somatotroph adenomas
39
protrusion of jaw
prognathism seen in somatotroph adenoma
40
sausage hands
acromegaly
41
GH excess associations
``` gonadal dysfunction DM muscle weakness HTN arthritis CHF GI cancer risk increase ```
42
diagnosis of GH excess
elevated serum and IGF-1
43
sensitive test for acromegaly
failure to suppress GH production in response to oral load of glucose**
44
cushings disease vs. syndrome
syndrome - elevated cortisol disease - elevated cortisol due to corticotroph adenoma in pituitary
45
predominant hormone in gonadotroph adenoma
FSH
46
hyperthyroidism
can be due to thyrotroph adenoma rare**
47
nonfunctioning pituitary adenomas
25-30% of all pituitary tumors aka silent variant or null-cell adenomas typically present with mass effects can lead to hypopituitarism
48
middle aged men and women, impaired vision, HA, diplopia, pituitary apoplexy
gonadotroph adenoma mass effects also impaired secretion of LH - decrased energy and libido in men and amenorrhea in premenopausal women
49
most common cause of hyperpituitarism
anterior lobe pituitary adenoma
50
macroadenoma
greater than 1cm in diameter
51
corticotroph adenoma
secrete ACTH - cushing syndrome - hyperpigmentation
52
25yo M IED explosion with multiple medical problems, hypopigmentation, loss of libido, impotence, loss of pubic and axillary hair FSH and LH decrease TSH increase ACTH decreased
hypothyroid wound to neck - loss of thyroid
53
most common causes of pituitary hypofuction
traumatic brain injury | subarachnoid hemorrhage
54
rathke cleft cyst
differential for hypopituitarism
55
pituitary growth failure
in children hypopituitary
56
amenorrhea and infertility
gonadotropin deficiency
57
MSH
synthesized in anterior pituitary hypopituitarism - can lead to pallor due do loss of MSH stimulation on melanocytes
58
ADH deficiency
diabetes insipidus with polyuria
59
ADH excess
SIADH | -hyponatremia - because of excess free water absorption
60
52yo male smoker, confusion, HA, hyponatremia small cell carcinoma of lung
SIADH
61
23yo M head trauma in MVA, confused hypernatremia subdural hematoma
possible diabetes insipidus loss of ADH from pituitary
62
diagnosis of diabetes insipidus
neurogenic (central) and nephrogenic
63
large volume dilute urine, lower specific gravity, hypernatremia, hyperosmolar, thirst, polydipsia
diabetes insipidus
64
craniopharyngioma
compact lamellar wet keratin and cords of squamous epitheilum 3-4cm children - adamantinomatous adult - papillary
65
motor oil like with tumor aspiration
adamantinomatous craniopharyngiomas also see calcification
66
prognosis of craniopharyngiomas
less than 5cm excellent -recurrent free larger lesions - mre invasive malignant transformation is rare

Endo II (12 decks)

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