Pituitary Pathophysiology Flashcards Preview

Endocrine > Pituitary Pathophysiology > Flashcards

Flashcards in Pituitary Pathophysiology Deck (38)
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1
Q

Benign tumors of pituitary/hypothalamus

A

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

2
Q

Infiltrative disease of pituitary

A

hemochromatosis

3
Q

Infiltrative disease of hypothalamus

A

sarcoidosis, Langerhans cell histiocytosis

4
Q

only _____ can hypersecrete pituitary hormones or fragments thereof

A

pituitary adenomas

5
Q

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

A

T

6
Q

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

A

F –> only a disease of the hypothalamus or infundibulum

7
Q

Replacement hormone for: GH

A

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

8
Q

Replacement hormone for: prolactin

A

none

9
Q

Replacement hormone for: ACTH

A

hydrocortisone

10
Q

Replacement hormone for: TSH

A

thyroxine

11
Q

Replacement hormone for: LH/FSH

A

FSH and hCG

12
Q

Secretory products of the associated adenoma: somatotroph

A

GH

13
Q

Secretory products of the associated adenoma: lactotroph

A

prolactin

14
Q

Secretory products of the associated adenoma: corticotroph

A

acth

15
Q

Secretory products of the associated adenoma: gonadotroph

A

FSH (LH rarely)

16
Q

Secretory products of the associated adenoma: thyrotorph

A

TSH, alpha subunit

17
Q

T/F Peptide adenomas are recognizable early in clinical course

A

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

18
Q

Somatotroph adenomas cause clinical syndromes ____ and ____

A

gigantism if before epiphyseal closure, acromegaly after epiphyseal closure

19
Q

Acromegaly

A

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

20
Q

Chemical profile of somatotroph adenoma

A

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

21
Q

Consequences of somatotroph adenoma

A

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

22
Q

T/F Acromegaly is associated with higher mortality

A

T

23
Q

Tx for somatotroph adenoma

A

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

24
Q

GH receptor antagonist

A

pegvisomant

25
Q

Dopamine agonist

A

cabergoline, bromocriptine

26
Q

Somatostatin analog

A

octreotide, lantreotide

27
Q

In premenopausal women, lactotroph adenomas cause ____

A

amenorrhea/oligomenorrhea, galactorrhea

28
Q

In postmenopausal women, lactotroph adenomas cause ____

A

neurologic symptoms

29
Q

In men, lactotroph adenomas cause ____

A

hypogonadism: decreased libido, fertility, potency

30
Q

Physiologic causes of hyperprolactinemia

A

pregnancy, nursing, exercise, physical/psychological stress

31
Q

Pathologic causes of hyperprolactinemia

A

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

32
Q

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

A

T

33
Q

Tx of lactotroph adenoma

A

dopamine agonist

34
Q

Clinical syndromes of corticotroph adenomas

A

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

35
Q

Do thyrotroph adenomas cause hyperthyroidism?

A

not usually but sometimes

36
Q

Tx of thyrotroph adenoma mediated hyperthyroidism

A

somatostatin analog

37
Q

Gonadotroph adenomas cause _____

A

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

38
Q

Most common hormonal finding in gonadotroph adenoma

A

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