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D&T 4 exam 1 > The Endocrine System: pituitary - Graffeo > Flashcards

The Endocrine System: pituitary - Graffeo Flashcards

1
Q

name hormones secreted by anterior pituitary

A
  • GH
  • ACTH
  • TSH
  • FH
  • LH
  • PRL
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2
Q

name hormones secreted by posterior pituitary

A

ADH

OT ( oxytocin)

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3
Q

from what embryology does ant. pituitary come from

A
  • oral ectoderm

- Rathke’s pouch Stem cell

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4
Q

which part of the pituitary has the infundibular stalk

A

posterior pituitary

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5
Q

which pituitary has a venous/portal system

A

anterior pituitary

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6
Q

pituitary sits in what bone structe

A

sella turcica

- depression in sphenoid bone

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7
Q

what is the post. pituitary derived from

A

nervous system tissue

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8
Q

what are 3 types of cells found in normal anterior pituitary and what do they secrete

A

Acidophil: GH, PRL
Basophil: ACTH, LH, FSH
Chromophobe: TSH

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9
Q

the hypothalamus produces 2 hormones that have a negative impact on what pituitary hormones

A

dopamine –> prolactin

GIH somatostatin –> GH

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10
Q

majority of cases of hyperpituitarism is due to what

A

adenomas

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11
Q

How is pituitary adenoma classified

A

hormone produced, usually one, can be multiple

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12
Q

who can get pituitary adenoma

A

all adults

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13
Q

pituitary ademona is associated with what neoplasm

A

multiple endocrine neoplasia MEN-1

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14
Q

What can cause pituitary adenoma?

A

mass effect of Sella turcica

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15
Q

what are 3 effects of pituitary adenoma

A
  • visual field abnormalities - bitemporal hemianopsia
  • ICP
  • hypopituitarism
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16
Q

what can be seen in histo for pituitary adenoma

A
  • red or blue or no stain

- no reticulin network

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17
Q

atypical adenomas have increased what

A
  • mitotic figures

- increased KI67

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18
Q

what is the most common hyper functioning pituitary adenoma

A

prolactinoma

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19
Q

what do prolactinoma form

A
  • calcify and from psammoma bodies

- pituitary stone

20
Q

signs and symptoms for prolactinoma

A
  • amenorrhea, galactorrhea, infertility

- loss of libido (men)

21
Q

what are physiologic causes of serum hyper-prolactinemia

A

pregnancy
nursing
stress

22
Q

how does stalk effect create a serum hyper-prolactinemia

A
  • mass in suprasellar compartment

- interferes with normal inhibition by hypothalamus to release dopamine to inhibit PRL secretion

23
Q

name 2 drugs that decrease serum prolactinemia

A

phenothizines

haloperidol

24
Q

does a mild elevation in prolactin in patient with adenoma mean prolactin-secreting tumor

A

no

25
Q

how is prolactinoma treated? first line?

A
  • dopamine agonists
  • Bromocriptine - first line
  • Transphenoidal surgery
26
Q

what is the second most common adenoma

A

growth hormone

27
Q

is GH adenoma acidophilic or chromophobic

A

acidophilic

28
Q

signs and symptoms for GH adenoma

A

Pre-pubertal children: gigantism

adults: acromegaly

29
Q

GH adenoma patients have increased risk for what

A

GI cancers

30
Q

are corticotroph adenomas basophilic or chromophobic

A

basophilic

31
Q

what causes corticotroph adenomas

A

hypercortisolism

32
Q

what are 2 diseases that cause hypercortisolism

A

cushing disease: pituitary adenoma

cushing syndrome

33
Q

what is Nelson syndrome

A

adrenals removed for cushing syndrome

  • no negative feedback for pituitary
  • increase ACTH
  • no increase cortisol
34
Q

clinical feature of Nelson syndrome

A

hyperpigmentation due to POMC peptides

35
Q

what is pituitary apoplexy

A

rapid enlargement of pituitary

36
Q

symptoms of pituitary apoplexy

A

sudden onset of excruciating headache

  • diplopia
  • panhypopit
  • cardiovascular collapse
  • loss of consciousness
  • death
37
Q

what causes Null cell? what did this result in

A
  • mass effect

- hypopituitarism

38
Q

men have what symptoms for gonadotroph

A

loss of libido or no symptoms

39
Q

Hypopituitarism can cause what

A

diabetes insipdus (lack of ADH)

40
Q

what are signs and symptoms of hypopituitarism

A

hypofunction: adrenal cortex, thyroid, gonads
Amenorrhea, Impotence, loss of libido
loss of axillary and pubic hair

41
Q

what are causes of hypopituitarism

A 
Sheehan syndrome : postpartum hemorrhage 
DIC
Sickle Cell Anemia
Shock 
increased ICP
42
Q

hypopituitarism is a genetic or acquired?

A

both

genetic , POU1F1

43
Q

what causes empty sella syndrome

A
  • chronic herniation of subarachnoid space into sella turcica
44
Q

who usually gets empty sella syndrome

A

obese patients with multiple pregnancies

45
Q

what is wrong in primary empty sella syndrome

A

defect in diaphragma sella

  • allows CSF to enter
  • compresses pituitary gland
46
Q

clinical symptoms of abnormal oxytocin levels

A

no clinical abnormalities

47
Q

what are 2 problems that ADH can cause

A
  • diabetes insipidus (lack)

- syndrome of inappropriate ADH ( excess) SIADH

D&T 4 exam 1 (17 decks)

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