Pituitary Gland (path)

Question 1

Makeup of posterior pituitary

Answer 1

neuroendocrine

Question 2

makeup of anterior pituitary

Answer 2

vascular glandular

Question 3

color of anterior pituitary

Answer 3

red

Question 4

overall function of pituitary

Answer 4

role in regulation of most other endocrine glands

Question 5

Connection of hypothalamus to posterior pituitary

Answer 5

neuroendocrine direct stimulation by neurons

Question 6

connection of hypothalamus to anterior pituitary

Answer 6

vascular/endocrine through hypothalamic-hypophysial portal vessels

Question 7

GRH stimulates & where

Answer 7

ACTH secretion, anterior pituitary

Question 8

GnRH stimulates & where

Answer 8

LH/FSH secrection, anterior pituitary

Question 9

GHRC stimulates & where

Answer 9

GH secretion, anterior pituitary

Question 10

TRH stimulates & where

Answer 10

TSH and PRL secretion, anterior pituitary

Question 11

SRIF stimulates & where

Answer 11

inhibition of GH, anterior pituitary

Question 12

VIP stimulates & where

Answer 12

stimulation of PRL secretion, anterior pituitary

Question 13

Dopamine stimulates & where

Answer 13

inhibition of PRL secretion , anterior pituitary

Question 14

most cells in pituitary make what

Answer 14

GH (40-50%)

Question 15

% of cells that make PRL

Answer 15

15-25%

Question 16

arrangement of cells in anterior pituitary

Answer 16

vascular
arrangement in clusters (hard to see)
basophilic & acidophilic cells (hard to see)

Question 17

adenohypophysis

Answer 17

anterior pituitary

Question 18

neurohypophysis

Answer 18

posterior pituitary

Question 19

hypopituitarism common causes (8)

Answer 19

postsurgical
postirradiation
cysts
tumors
ischemia/hemorrhage
inflammation
empty sella syndrome
gene defect

Question 20

Infarct usual location

Answer 20

usually anterior lobe

Question 21

% of lobe that must be lost in infarct before symptomatic

Answer 21

75%

Question 22

causes of infarct (6)

Answer 22

DM
CVA
^ICP
hypoperfusion (trauma, etc)
sheehan's syndrome
pituitary apoplexy

Question 23

sheehan’s syndrome

Answer 23

post-partum necrosis/infarct of pituitary

from edema & blood loss
no prolactin –> lack of lactation. Take’s a minute to be symptomatic when not nursing

Question 24

ddx for granulomatous histology of pituitary (4)

Answer 24

TB, fungal, sarcoid, idiopathic giant cell

Question 25

hyperpituitarism (4 causes)

Answer 25

hyperplasia pituitary adenoma ectopic secretion by nonpituitary tumor hypothalamic disorder

Question 26

pituitary hyperplasia common? 2 types 2 patterns example

Answer 26

uncommon primary & secondary nodular & diffuse ACTH hyperplasia in Addison's disease

Question 27

Pituitary adenoma - common?

Answer 27

very - 10% of intracranial neoplasms

Question 28

pituitary adenoma ages associated condition usually found earlier when functional or nonfunctional?

Answer 28

30-50 yo MEN functional

Question 29

pituitary carcinoma - freq?

Answer 29

vanishingly rare

Question 30

common symptom of pituitary enlargement

Answer 30

optic defects - chasm is very close

Question 31

most common type of pituitary adenoma

Answer 31

prolactin cell adenoma (disproportionately high at 20-30%)

Question 32

sex pref for pituitary adenoma

Answer 32

equal M/F

Question 33

gross morphology of pituitary adenomas

Answer 33

fragemented (resection artifact) well circumscribed macro or micro (1cm division) larger lesions may extend to suprasellar region

Question 34

histopathlogy of pituitary adenomas

Answer 34

sheet-like monomorphic loss of reticulin fiber network fx status not predicted from std histo appearance immunohistochemical staining confirmatory

Question 35

can fx status be predicted from std histo appearance in pituitary adenoma?

Answer 35

no. need immunohistochemical stains

Question 36

diabetes insipidus

Answer 36

ADH deficiency --> excretion of large V dilute urine. hypernatremia, increased osM. after trauma, tumors, inflammatory disorder, postsurg

Question 37

SIADH

Answer 37

ADH excess --> ectopic secretion of tumor (small cell lung cancer, often). hyponatremia, cerebral edema, neuro dysfunction.