Pituitary Pathophysiology Flashcards Preview

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Flashcards in Pituitary Pathophysiology Deck (38):
1

Benign tumors of pituitary/hypothalamus

adenomas of AP and tumors of cell rests like craniopharyngiomas and Rathke's cleft cysts

2

Infiltrative disease of pituitary

hemochromatosis

3

Infiltrative disease of hypothalamus

sarcoidosis, Langerhans cell histiocytosis

4

only _____ can hypersecrete pituitary hormones or fragments thereof

pituitary adenomas

5

T/F any disease of pituitary or hypothalamus can cause deficiency of any AP hormone

T

6

T/F any disease of pituitary or hypothalamus can cause a deficiency of vasopressin and thereby cause diabetes insipidus

F --> only a disease of the hypothalamus or infundibulum

7

Replacement hormone for: GH

Somatropin --> short stature due to gh deficiency/turners/renal failure, GH deficiency in adults

8

Replacement hormone for: prolactin

none

9

Replacement hormone for: ACTH

hydrocortisone

10

Replacement hormone for: TSH

thyroxine

11

Replacement hormone for: LH/FSH

FSH and hCG

12

Secretory products of the associated adenoma: somatotroph

GH

13

Secretory products of the associated adenoma: lactotroph

prolactin

14

Secretory products of the associated adenoma: corticotroph

acth

15

Secretory products of the associated adenoma: gonadotroph

FSH (LH rarely)

16

Secretory products of the associated adenoma: thyrotorph

TSH, alpha subunit

17

T/F Peptide adenomas are recognizable early in clinical course

T --> somatotroph, lactotroph, corticotroph tend to be efficient in production of secretory products--> make you look "funny" early on

18

Somatotroph adenomas cause clinical syndromes ____ and ____

gigantism if before epiphyseal closure, acromegaly after epiphyseal closure

19

Acromegaly

growth of bones after epiphyseal closure --> jaw, nose, frontal bones, hands, feet

20

Chemical profile of somatotroph adenoma

IGF1 elevation, lack of suppression of GH to an oral glucose load --> histologic apeparance of pituitary adenoma, immunostaining of GH

21

Consequences of somatotroph adenoma

OA, cancer of colon, CVD, diabetes mellitus, neuropathy/carpal tunnel syndrome, sleep apnea

22

T/F Acromegaly is associated with higher mortality

T

23

Tx for somatotroph adenoma

surgical, radiation, pharmacological: dopamine agonist (cabergoline), somatostatin analog (octreotide, lantreotide), GH receptor antagonists (pegvisomant)

24

GH receptor antagonist

pegvisomant

25

Dopamine agonist

cabergoline, bromocriptine

26

Somatostatin analog

octreotide, lantreotide

27

In premenopausal women, lactotroph adenomas cause ____

amenorrhea/oligomenorrhea, galactorrhea

28

In postmenopausal women, lactotroph adenomas cause ____

neurologic symptoms

29

In men, lactotroph adenomas cause ____

hypogonadism: decreased libido, fertility, potency

30

Physiologic causes of hyperprolactinemia

pregnancy, nursing, exercise, physical/psychological stress

31

Pathologic causes of hyperprolactinemia

adenoma, dopamine receptor antagonists, catecholamine inhibitors, h2 antagonists, estrogens, opiates

32

T/F serum prolactin levels >200 are usually adenomas (pregancy up to 400) and <200 are due to other causes

T

33

Tx of lactotroph adenoma

dopamine agonist

34

Clinical syndromes of corticotroph adenomas

Cushing's (common), neurological symptoms (uncommon)

35

Do thyrotroph adenomas cause hyperthyroidism?

not usually but sometimes

36

Tx of thyrotroph adenoma mediated hyperthyroidism

somatostatin analog

37

Gonadotroph adenomas cause _____

neurological symptoms (common) --> visual field impairement, headache ; hormonal abnormality (uncommon) --> premature puberty in boys, ovarian hyperstimulation in premenopausal women

38

Most common hormonal finding in gonadotroph adenoma

elevated intact FSH, rarely intact LH, elevated subunits of FSH/LH