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ENR Biweekly 2 > Roveda- pathology of pituitary > Flashcards

Roveda- pathology of pituitary Flashcards

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1
Q

sits in sella turcica that is posterior from sphenoid sinus

A

pituitary gland

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2
Q

normal size of pituitary gland

A

1 cm

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3
Q

L
R

A

L: posterior pituitary
R: anterior pituitary

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4
Q

anterior pituitary is derived from ____

A

oral surface ectoderm

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5
Q

posterior pituitary is derived from _____

A

neuroectoderm

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6
Q

hormones of the anterior pituitary are produced where

A

anterior pituitary

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7
Q

hormones of posterior pituitary are produced where

A

hypothalamus

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8
Q
A

anterior pituitary cells

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9
Q

acidophils from anterior pituitary

A

somatotropes (GH)
lactotropes (PRL)

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10
Q

basophils of anterior pituitary

A

corticotropes (ACTH)
gonadotropes (FSH, LH)
thyrotropes (TSH)

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11
Q
A

posterior pituitary

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12
Q

Excess hormones
Usually limited to 1 anterior hormone

A

hyperpituitarism

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13
Q

Deficiency hormones
Usually involves all anterior hormones

A

hypopituitarism

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14
Q

Bitemporal hemianopsia due to compression of the optic chiasm (if they have an enlargement of pituitary gland)

A

tunnel vision (peripheral vision messed up)

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15
Q

sx’s of elevated intracranial pressure due to pituitary disease

A

N/V, HA

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16
Q

manifestation of pituitary disease with sudden hemorrhage and necrosis into pituitary gland—-acute onset of sx’s

A

pituitary apoplexy

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17
Q

main 2 causes of hyperpituitarism

A

pituitary adenoma
ectopic hormone production by extra pituitary tumors

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18
Q

can be functional or silent
invasive/non-invasive
micro or macro

A

pituitary adenomas

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19
Q

size of microadenoma

A

<1 cm

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20
Q

size of macroadenoma

A

> 1 cm

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21
Q

to diagnose pituitary adenoma

A

IHC stain
labs
radiography

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22
Q

L
R

A

L: pituitary adenoma
R: bone marrow b/t bone spicules

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23
Q

monotonous population of cytologically uniform cells

A

pituitary adenoma

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24
Q

pituitary ___adenoma compressing optic chiasm

A

macroadenoma

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25
pituitary microadenoma
26
pituitary adenomas
27
4 most common pituitary adenomas
prolactin cell adenoma GH cell adenoma ACTH cell adenoma mixed GH-PRL adenoma
28
pituitary adenoma
29
Excess hormone Hypopituitarism (non-functioning adenomas)(if the adenoma is compressing normal pituitary tissue) Mass effect resulting in visual field defects
pituitary adenoma
30
most common functioning pituitary tumor
prolactinomas
31
elevated ____ causes amenorrhea and galactorrhea, loss of libido and infertility in women
increased PRL
32
elevated _____causes impotence and gynecomastia in males
PRL
33
elevated _____-levels inhibit secretion of GnRH which leads to decreased FSH and LH, which leads to decreased progesterone, estrogen and testosterone which leads to amenorrhea and loss of libido
PRL
34
pregnancy lactation hypothyroidism renal failure interference with dopamine inhibition
other causes of elevated prolactin
35
in hypothyroidism, elevated ____ upregulates prolactin
TRH
36
can cause what
elevated prolactin
37
treatment for prolactinoma
transphenoidal surgery dopamine receptor agonists
38
increase in _____ increases IGF-1 these act in conjunction to cause overgrowth of bones and muscle
GH
39
can cause gigantism in children before epiphyses closure
GH adenoma
40
can cause acromegaly in adults (after epiphyses closure) also can be due to brain injury
GH adenoma
41
____ and ____ can cause visceral growth and bone growth
acromegaly and gigantism
42
hyperostosis spine prognathism (protrusion of jaw) cardiomyopathy
acromegaly and gigantism
43
to diagnose GH adenoma
elevated serum IGF-1 Imaging
44
to treat GH adenoma
transphenoidal surgery Octreotide
45
Leads to adrenal hypersecretion of cortisol resulting in Cushing disease / syndrome
ACTH cell adenoma
46
pituitary adenoma is producing ACTH and acting on adrenal glands and increase in cortisol which results in cushings syndrome
Cushing disease
47
cushing ___ can be caused by other factors not just pituitary adenoma
syndrome
48
___ and ___ are formed from the cleavage of POMC (proopiomelanocortin)
ACTH and MSH
49
patients with ____ often have hyperpigmented skin
Cushing syndrome
50
Truncal obesity and thin extremities and buffalo hump; abdominal striae
Cushing disease/syndrome
51
Cushing syndrome
52
other adenomas may come to clinical attention due to mass effect and/or ______ (compression of normal pituitary tissue)
hypopituitarism
53
decrease secretion of anterior pituitary hormones
hypopituitarism
54
associated w/ posterior pituitary deficiencies
hypopituitarism originating in hypothalamus
55
tumors/lesions brain injury surgery pituitary apoplexy sheehan syndrome empty sella syndrome
can all cause hypopituitarism
56
postpartum hemorrhage resulting in hypovolemic shock and ischemic necrosis of the pituitary
Sheehan syndrome
57
____ can grow so large it can compress normal functioning pituitary tissue
tumors/lesions
58
(defect in sella turcica); arachnoid tissue going into where pituitary sits and compression
empty sella syndrome
59
treat pituitary deficiencies
surgery or replace target gland hormone
60
most life threatening pituitary deficiency is ______
ACTH deficiency
61
pituitary apoplexy
62
red and dead
pituitary apoplexy
63
postpartum necrosis of anterior pituitary gland usually associated w/ obstetric hemorrhage/shock
Sheehan syndrome
64
failure to lactate, CV collapse, hypothyroidism
Sheehan syndrome
65
enlarged and empty sella turcica CSF and arachnoid can herniate into sella
empty sella syndrome
66
2 main posterior pituitary syndromes
diabetes insipidus SIADH
67
promotes uterine contraction stimulates myoepithelial cells breast-milk letdown released in response to suckling and cervix dilation
oxytocin
68
Released in response to increased plasma osmotic pressure, left atrial distention, exercise and certain emotional states. Results in water resorption in the collecting tubules of the kidney
ADH (vasopressin)
69
due to ineffective ADH axis inappropriately dilute urine
diabetes insipidus
70
Excessive urination (polyuria) due to an inability of the kidney to resorb water properly from the urine
Diabetes insipidus
70
increase water intake psychiatric patients (differential for diabetes insipidus)
primary polydipsia
70
functions to concentrate urine and conserve water
ADH
71
Absence/insufficient ADH
Central Diabetes Insipidus
72
Renal resistance to ADH Normal ADH secretion (kidney just unresponsive to ADH)
Nephrogenic Diabetes Insipidus
73
excessive urination and thirst low urine osmolality increased serum osmolality hypernatremia
Diabetes Insipidus
74
in _____DI, kidneys are functioning so they will have increase in urine osmolality when given ADH injection
central DI
75
in ____DI, kidneys wont respond to ADH
nephrogenic DI
76
to treat central DI
Desmopressin (ADH analog)
77
to treat nephrogenic DI
thiazides (look this up) indomethacin (also treats PDA)
78
Excess ADH Results in resorption of excessive amounts of free water
SIADH
79
hyponatremia (Acute onset: cerebral edema leading to lethargy, weakness, seizures, coma, etc)
SIADH
80
SCLC TB, pneumonia head trauma drugs
causes of SIADH
81
decreased serum Na+ and Posm increase Uosm plasma Cr normal
SIADH
82
to treat SIADH
fluid restriction V2 receptor antagonists treat cause

ENR Biweekly 2 (11 decks)

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