373 - Pituitary Tumor syndromes

Question 1

The mass effect includes: (5)

Answer 1

1. Headache
2. Vision impairment
3. Prolactin elevation, decrease in the other pituitary hormones
4. Cranial nerves paralysis (III, IV, IV)
5. CSF leakage in aggressive tumors

Question 2

The pituitary gland is about ___ mm. During pregnancy it grows up to ___ mm. Small microadenomas should be followed __ a year. Macroadenomas should be ___, because they usually continue growing

Answer 2

8
12
once
Removed

Question 3

The loss of ___ color is an early sign for pressure inflicted on the ___

Answer 3

Red
Optic nerve (II)

Question 4

The approach for pituitary tumors is ____ surgeries, beside in tumors with substantial ___ penetration

Answer 4

Transsphenoidal

Suprasellar

Question 5

What are the S/E of transsphenoidal surgeries? (3)

Answer 5

1. Death (1%)
2. DI
3. Visual impairment (10%)

Question 6

Radiation is usually used for ____ therapy. >___ develop long term hormonal deficiencies due to ___ injury. two rare complications include: ___ and ___

Answer 6

Post surgery
Hypothalamus
Visual impairment (2%)
CVA

Question 7

Pharmaceutical therapy for prolactinomas include: ____

Answer 7

Dopamine agonist

Question 8

Pharmaceutical therapy for TSH and GH secreting hormones include: ____ and ____

Answer 8

Dopamine agonist

Octreotide (somatostatin)

Question 9

Tumors secreting ____ do not usually respond to pharmaceutical therapy

Answer 9

ACTH

Question 10

Clinical symptoms of hypothalamus tumors may include different metabolic signs such as: (5)

Answer 10

1. Temperature regulation
2. Tachycardia
3. Paradoxical vasoconstriction
4. Hunger+ obesity
5. Mood disorders

Question 11

What is craniopharyngioma tumor?

Answer 11

Cystic growth above the hypophysis (pituitary)

Question 12

Craniopharyngioma tumor progresses and lead to hypophysis injury and ___. Treatment is usually with ___ and ___.

Answer 12

DI
Surgical
Radiation

Question 13

Rathke’s cyst is a development malformation in closing the ____ leading to multiple small cysts. The pressure may lead to ___, ___ and in rare cases also ___/
Diagnosis is with ____

Answer 13

Rathke's pouch
DI
Hyperprolactinemia
Hydrocephalus
MRI

Question 14

What is Rathke’s pouch?

Answer 14

An evagination at the roof of the developing mouth in front of the buccopharyngeal membrane. It gives rise to the anterior pituitary (adenohypophysis).

Question 15

Hypophysis tumors are the common cause for ____. Compose ___ of brain tumors

Answer 15

Hypophysis problems

15%

Question 16

MEN1 is an ____ ____ with predisposition to develop___ of the ___, pancreatic tumors, and ___.

Answer 16

AD
Familial syndrome 
hyperplasia
Parathyroid 
Hypophysial tumors

Question 17

In MEN1 there’s a mutation on chromosome ___ in the ___ gene. ___ of patients will develop ____. Other common effects include ___ and ___

Answer 17

11
MENIN
50%
Prolactinoma
Acromegaly
Cushing

Question 18

MEN4 is defined by ____ and ___. It is caused by a mutation on chromosome __ in the ___ gene

Answer 18

Hyperparathyroidism
Hypophysial adenomas
12
CDKNIB

Question 19

Carney syndrome is characterized by ____, ___, and ___ including in the hypophysis testis and adrenal. The common expression is with ___

Answer 19

Spotted skin
Myxomas
Endocrine tumors
Acromegaly

Question 20

McCaune Albright syndrome is characterized by multiple ___, ___ on the skin, and endocrine disease (___ and ____).

Answer 20

Bone dysplasia
Pigmentation
GH releasing tumors
Adrenal adenomas

Question 21

Familial pituitary adenomas is a rare disease in which family members develop ___ or ____. It is caused by a dysfunction in ___ gene on the __ chromosme

Answer 21

Acromegaly
Gigantism
AIP
11

Question 22

Hyperprolactinemia in women can lead to the following symptoms: (4)

Answer 22

1. Amenorrhea
2. Galactorrhea
3. Infertility
4. Decrease in bone density

Question 23

Hyperprolactinemia in men can lead to the following symptoms: (4)

Answer 23

1. Decreased libido
2. Vision impairment
3. Decreased testosterone-> impotence
4. Osteopenia

Question 24

How would you treat hyperprolactinemia?

Answer 24

Dopamine agonists (bromocriptine, cabergoline)

Question 25

Missing acromegaly

Answer 25

Missing acromegaly