Endocrine 1

Question 1

Are pituitary diseases common or uncommon?

Answer 1

•Uncommon

Question 2

How do pituitary diseases usually present (2 ways)?

Answer 2

1. hyperfunction or hypofunction of the pituitary
2. a localized mass lesion causing compression of the optic chiasm or basal portion of the brain.

Question 3

In pituitary hyperfunction, why is the pituitary enlarged?

Answer 3

•The pituitary is enlarged due to these functioning Adenomas, which are composed of a single cell type or several cell types.

Question 4

T/F: pituitary hyperfunction can present in several forms depending on which one of the five cells is hyperfunctioning.

Answer 4

true

Question 5

Pituitary hyperfunction-

which is the most common tumor and what type of cells is it composed of?

Answer 5

Prolactinoma

composed of lactotrophic cells

Question 6

What are 2 less common pituitary hyperfunction adenomas?

Answer 6

Somatotropic and Corticotropic Adenomas

Question 7

Which tumor?

•Are usually small, benign tumors composed of prolactin-secreting cells.

Answer 7

Prolactinomas

Question 8

What are the typical symptoms of prolactinomas (3)?

Answer 8

typical symptoms of hyperprolactinemia :

1. Amenorrhea
2. Galactorrhea (spontaneous milk secretion unrelated to pregnancy)
3. infertility

Question 9

In prolactinomas, hyperprolactinemia inhibits what?

Answer 9

hyperprolactinemia inhibits the pulsatile secretion of LH, which is essential for normal ovulation to occur.

Question 10

In men, what are the sxs of prolactinomas?

Answer 10

• sx’s are vague, may include:
  
  1. impotence
  2. loss of libido

Question 11

What medication can be given to patients with Prolactinomas and how does it work?

Answer 11

1. The function of prolactinomas can be inhibited with Bromocriptine
   
   • this is an inhibitor of prolactin secretion

Question 12

How do you treat larger prolactinomas?

Answer 12

transnasal sx to the Sella Tursica

Question 13

Which hyperfunctioning pituitary tumor is composed of cells synthesizing growth hormone

Answer 13

Somatotropic Adenomas

Question 14

How are somatotropic adenomas different from prolactinomas?

Answer 14

• Prolactinomas are microscopic, 75% of Somatotropic Adenomas are clearly visible with the naked eye or CT scan
• because of this, Somatotropic Adenomas are classified as macroadenomas

Question 15

Somatotropic Adenomas:

T/F: the clinical signs and symptoms of GH hyper secretion is the same no matter the age of the patient.

Answer 15

FALSE

The clinical signs and symptoms of GH hypersecretion depends on the age of the patient

Question 16

What do Somatotropic Adenomas cause in prepubertal patients before the closure of epiphyseal plates of the long bones?

Answer 16

these tumors stimulate longitudinal skeletal growth, resulting in Gigantism, individuals more than eight feet tall.

Question 17

Which adenoma causes Gigantism?

Answer 17

Somatotropic adenomas

(in prepubertal patients)

Question 18

What do Somatotropic Adenomas cause in postpubertal patients?

Answer 18

Acromegaly

Question 19

How does Somatotropic Adenomas in postpubertal patients present (3 things) and what is this called?

Answer 19

Acromegaly

Presents as:

1. enlargement of the acral parts of the extremities (fingers, hands and toes), tongue, jaw and nose
2. internal organs enlarged (ex: heart, liver, etc)
3. Metabolic disturbances- hyperglycemia and hypercalcemia

Question 20

What type of cell are Corticotropic Adenomas composed of?

Answer 20

ACTH-secreting cells

Question 21

What is the tx of choice for acromegaly?

Answer 21

Surgical remover of the tumor

Question 22

Are Corticotropic Adenomas micro or macroadenomas?

Answer 22

Most tumors are microadenomas

Question 23

Corticotropic Adenomas are clinically recognized by the typical signs and symtpoms of what disease?

What are these 3 signs/symptoms?

Answer 23

Cushings disease

Signs/sxs:

1. Fatigue
2. Weakness
3. Mental instability

Question 24

True of false, removal of the corticotropic adenoma results in NO improvement of clinical symptoms

Answer 24

FALSE

removal results in an IMPROVEMENT of clinical sxs