Pituitary Pathology Flashcards Preview

HRM - Pathology > Pituitary Pathology > Flashcards

Flashcards in Pituitary Pathology Deck (43):
1

What six hormones are produced by the anterior pituitary?

GH
ACTH
TSH
LH
FSH
Prolactin

2

Which anterior pituitary hormone is under inhibitory control? What inhibits it?

Prolactin
Dopamine

3

Which hormones are produced by acidophils? Basophils?

Acidophils: GH, PL
Basophils: FSH, LH, ACTH, TSH (BFLAT)

4

What hormones are released by the posterior pituitary?

Oxytocin, ADH

5

What is the role of Oxytocin?

Labor, milk let-down
(Cuddling, monogamy, trust)

6

What are five causes of hyperpituitarism? Which is the most common?

Pituitary adenoma (MOST COMMON)
Destruction of end organs
Hypothalmic disorders
Hyperplasia of anterior lobe
Carcinoma of anterior lobe

7

What are considered "Mass effects" of pituitary adenomas?

Visual deficits, increased ICP, HYPOpituitarism

8

What genetic endocrine disorder oftentimes sees pituitary adenoma?

MEN I

9

Who most often gets pituitary adenomas?

Adults

10

When is a pituitary adenoma a neurosurgical emergency?

When it bleeds

11

What do pituitary adenomas look like on microscopy?

Sheets/cords
Uniform cells of one type
May be pleomorphic
May have mitoses

12

What is the most common hormone produced by a pituitary adenoma? Least common?

Most common: Prolactin
Least common: TSH

13

What proteins are often mutated in pituitary adenomas?

GNAS1
MEN1
RAS/cMYC

14

What type of protein does GNAS code?

G3 protein, leads to increased cAMP

15

How do men present with a prolactinoma? Women?

Men: Decreased libido and headache
Women: Amenorrhea, galactorea

16

How do you treat prolactinomas?

Dopamine receptor agonists:
Bromocryptine
Cabergoline

17

What do people who present with a GH adenoma before adulthood look like? After?

Before: Zach Fredman
After: Andre the Giant

18

Other than being huge, what can GH adenoma manifest as?

Diabetes
Hypertension
Arthritis
GI carcinoma

19

What are common lab findings for a GH adenoma?

Increased GH
Increased IGF-1
GH unresponsive to glucose

20

How do you treat a GH adenoma?

Octreotide
GH receptor antagonists
Surgery

21

What disease does an ACTH adenoma result in?

Cushing Disease

22

What is Nelson Syndrome?

Take away adrenal glands' negative feedback (remove cortisol)
Leads to super growth of pituitary adenoma

23

What are two causes of adrenal Cushing syndrome?

Tumor
Nodular hyperplasia

24

What is paraneoplastic Cushing Syndrome?

ACTH producing nonendocrine cancer (SCC of Lung)

25

What is iatrogenic Cushing syndrome?

Cushing syndrome from long term use of corticosteroids

26

What are causes of Hypopituitarism?

Pituitary destruction
Ischemic necrosis
Empty sella syndrome
Pituitary apoplexy
Hypothalmic lesions

27

How can the pituitary be destroyed?

Big pituitary adenoma
Surgery or radiation

28

What are the events leading up to ischemic necrosis of the pituitary?

Pituitary gets BIG (Pregnancy, e.g.)
Hemorrhage (delivery) causes hypotension
Pituitary becomes necrotic

29

What syndrome is Pituitary Ischemic Necrosis after pregnancy known as?

Sheehan syndrome

30

How does Sheehan syndrome present?

Poor lactition
Loss of pubic hair
Fatigue

31

What events lead to Empty Sella Syndrome?

Arachnoid or CSF herniation
Pituitary compression

32

What is Pituitary Apoplexy and what are the symptoms?

Sudden infarction of adenoma
Meningeal symptoms

33

What hormone is affected first in hypopituitarism?

GH
then FSH/LH, TSH, ACTH

34

What are signs of decreased GH?

Pituitary dwarfism, muscle weakness

35

What are signs of decreased FSH/LH?

Loss of libido
Menstrual abnormalities

36

What are signs of decreased PL?

Inability to lactate

37

What are signs of decreased TSH?

Hypothyroidism

38

What are signs of decreased ACTH?

Adrenal insufficiency

39

What hormone is decreased in central Diabetes Insipidus?

ADH

40

What happens to serum osmolality as a result of DI?

Serum osmolality increases

41

What happens to serum osmolality in SIADH?

Serum osmolality decreases

42

What are some causes of SIADH?

SCC of Lung
CNS trauma
Pulmonary infection
Drugs (Cyclophosphamide)

43

How do you treat SIADH?

Demeclocycline