Flashcards in Pituitary Pathology Deck (43):
What six hormones are produced by the anterior pituitary?
Which anterior pituitary hormone is under inhibitory control? What inhibits it?
Which hormones are produced by acidophils? Basophils?
Acidophils: GH, PL
Basophils: FSH, LH, ACTH, TSH (BFLAT)
What hormones are released by the posterior pituitary?
What is the role of Oxytocin?
Labor, milk let-down
(Cuddling, monogamy, trust)
What are five causes of hyperpituitarism? Which is the most common?
Pituitary adenoma (MOST COMMON)
Destruction of end organs
Hyperplasia of anterior lobe
Carcinoma of anterior lobe
What are considered "Mass effects" of pituitary adenomas?
Visual deficits, increased ICP, HYPOpituitarism
What genetic endocrine disorder oftentimes sees pituitary adenoma?
Who most often gets pituitary adenomas?
When is a pituitary adenoma a neurosurgical emergency?
When it bleeds
What do pituitary adenomas look like on microscopy?
Uniform cells of one type
May be pleomorphic
May have mitoses
What is the most common hormone produced by a pituitary adenoma? Least common?
Most common: Prolactin
Least common: TSH
What proteins are often mutated in pituitary adenomas?
What type of protein does GNAS code?
G3 protein, leads to increased cAMP
How do men present with a prolactinoma? Women?
Men: Decreased libido and headache
Women: Amenorrhea, galactorea
How do you treat prolactinomas?
Dopamine receptor agonists:
What do people who present with a GH adenoma before adulthood look like? After?
Before: Zach Fredman
After: Andre the Giant
Other than being huge, what can GH adenoma manifest as?
What are common lab findings for a GH adenoma?
GH unresponsive to glucose
How do you treat a GH adenoma?
GH receptor antagonists
What disease does an ACTH adenoma result in?
What is Nelson Syndrome?
Take away adrenal glands' negative feedback (remove cortisol)
Leads to super growth of pituitary adenoma
What are two causes of adrenal Cushing syndrome?
What is paraneoplastic Cushing Syndrome?
ACTH producing nonendocrine cancer (SCC of Lung)
What is iatrogenic Cushing syndrome?
Cushing syndrome from long term use of corticosteroids
What are causes of Hypopituitarism?
Empty sella syndrome
How can the pituitary be destroyed?
Big pituitary adenoma
Surgery or radiation
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
What syndrome is Pituitary Ischemic Necrosis after pregnancy known as?
How does Sheehan syndrome present?
Loss of pubic hair
What events lead to Empty Sella Syndrome?
Arachnoid or CSF herniation
What is Pituitary Apoplexy and what are the symptoms?
Sudden infarction of adenoma
What hormone is affected first in hypopituitarism?
then FSH/LH, TSH, ACTH
What are signs of decreased GH?
Pituitary dwarfism, muscle weakness
What are signs of decreased FSH/LH?
Loss of libido
What are signs of decreased PL?
Inability to lactate
What are signs of decreased TSH?
What are signs of decreased ACTH?
What hormone is decreased in central Diabetes Insipidus?
What happens to serum osmolality as a result of DI?
Serum osmolality increases
What happens to serum osmolality in SIADH?
Serum osmolality decreases
What are some causes of SIADH?
SCC of Lung