Quiz 3 Flashcards
(61 cards)
what are the 5 hormones released by the anterior pituitary?
TSH - thyroid stimulating hormone PRL - prolactin ACTH - adrenocorticotropic hormone GH - growth hormone FSH - follicle stimulating hormone LH - luteinizing hormone
what are the inhibitory hypothalamic influences?
dopamine (prolactin inhibitory factor)
somatostatin (growth hormone inhibitory factor)
what is another term for antidiuretic hormone
vasopressin
the most important function of ADH is to conserve water by restricting diuresis during periods of dehydration and hypovolemia
what is the hallmark symptom of a mass in the optic chiasm?
blocks peripheral vision
what is the most common cause of hyperpituitarism? what is most commonly secreted?
pituitary adenoma (generally anterior lobe) - GH and prolactin are the most commonly secreted and the most common combination of hormones secreted (if 2)
hyperplasia
carcinoma
what is the difference between functioning and non-functioning adenoma?
functional - associated with hormonal excess, symptoms expressed as expected
non-functional - hormonal activity non-detectable - tend to present with mass effects - HA, VFD, CN defects
what are defects in the lateral visual fields called and what’s common etiology?
bitemporal hemianopsia
- local mass effects, i.e expanding pituitary lesions (seller expansion, bony erosion and disruption of sella)
what is seen typically for pituitary adenoma (describe the lesion and histology)
soft, well-circumscribed lesion that may be confined to the sella turcica
histo - composed of relatively uniform, polygonal cells arrayed in sheets or cords
what is the most frequent type of functioning pituitary adenoma?
prolactinoma
underlies almost a quarter of cases of amenorrhea
microscopically - weakly acidophilic or chromophoric cells are seen with which condition?
prolactinoma
adenomas of the anterior pituitary gland are a major clinical feature of..
multiple endocrine neoplasia type I (MEN1)
25% develop pituitary adenomas
what is the term for rapid enlargement of a lesion - this is associated with?
pituitary apoplexy
-usually occurs in the presence of a pre-existing adenoma (generally not previously dx’d)
associated with acute hemorrhage into an adenoma
what condition presents with the most common symptom of a sudden headache with rapid worsening of visual field defects
pituitary apoplexy
which condition is caused by necrosis of the pituitary gland due to blood loss and hypovolemic shock during/after childbirth
Sheehan’s syndrome
-presents with agalactorrhea most common initial sx
what is the classic triad for empty sella syndrome?
woman multiparity
overweight
hypertensive
amyloid deposits may be seen in pituitary adenomas when?
in the absence of amyloidosis
the most commonly implicated lesions of hypothalamic suprasellar tumors are?
gliomas
craniopharyngiomas
the craniopharyngioma is thought to be derived from vestigial remnants of Rathke’s pouch
what are the two distinct histological variants of craniopharyngiomas?
adamantinomatous - CHILDHOOD - calcifications seen on X-ray
papillary - ADULT - calcifies rarely
craniopharyngiomas, benign, but locally invasive tumors originate from what?
remnant of Rathke’s pouch
MOST COMMON SELLAR TUMOR IN CHILDREN
which tumor usually contains a thick, oil-like fluid resembling “black sludge*
craniopharyngiomas
these difficult to eradicate tumors demonstate a characteristic compact, lamellar “wet” keratin with cords of squamous epithelium
craniopharyngiomas
-adamantinomatous craniopharyngiomas appear this way, containing a cholesterol-rich, thick brownish-yellow fluid
which condition generally presents, initially, as a pituitary adenoma?
pituitary carcinoma
Where are the most common sites of metastasis when discussing pituitary carcinoma?
subarachnoid space, brain parenchyma, cervical lymph nodes, bone, liver, lungs
what are the two most common sources of cancer that metastasize to the pituitary gland?
breast
lung
