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D&T3 Exam 1 > Endocrine-graffeo > Flashcards

Endocrine-graffeo Flashcards

1
Q

Pituitary Adenoma

Can get effects due to…

A

Mass effect

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2
Q

Empty sella syndrome

And hypopituitarism

A

Rarely causes

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3
Q

Pituitary

Basophil

A

ACTH

FSH/LH

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4
Q

Empty sella syndrome

Primary empty sella

A

Defect in the diaphragma sella allows CSF to enter and compress the pituitary gland

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5
Q

Adenomas

Morphology

A

Well circumscribed and soft

Larger ones expand SUPERIORLY

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6
Q

Prolactinoma

Characteristics

A

Weakly acidophilic

Can calcify and form psammoma bodies and pituitary stone

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7
Q

Pituitary adenocarcinoma

A

Rare

Only criteria of malignancy is distant mets

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8
Q

Genetic Alterations in Pituitary Tumors

Loss of function

Menin

A

GH, PRL, ACTH adenomas

Familial predisposition to pituitary adenomas

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9
Q

Genetic Alterations in Pituitary Tumors

Loss of function

CDKN1B(p27/KIP1)

A

ACTH adenomas

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10
Q

Corticotroph Adenomas

Hypercortisolism

Leads to

A

Cushing Disease

Cushing syndrome

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11
Q

Pituitary Adenoma

Classification

A

Classified by hormone produced (usually only ONE)

May be functional or silent

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12
Q

Hypopituitarism

Causes

Ischemic necrosis

Ass with

A

Sheehan syndrome: postpartum hemorrhage

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13
Q

Mild elevation in prolactin in pt with adenoma

A

Does NOT necessarily indicate a prolactin-secreting tumor

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14
Q

Serum hyper prolactinemia

Stalk effect

A

MASS in suprsellar compartment

Interferes with normal inhibition by hypothalamus to release dopamine to inhibit PRL secretion

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15
Q

Pituitary

Chromophobe

A

FSH

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16
Q

SIADH

Due to

A

Xs ADH

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17
Q

Infiltration disorders

Lymphocytic hypophysitis

A

Postpartum or pregnant females

Autoimmune?

Mild hyperprolactinemia and isolated ACTH deficiency

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18
Q

MC hyperfunctioning pituitary adenoma

A

Prolactinoma

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19
Q

Pituitary Adenoma

Ass

A

MEN I

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20
Q

Pituitary Adenoma

Sx

A

Benign

Visual symptoms

Endocrine sx

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21
Q

Hypopituitarism

Ischemic necrosis

Caused by

A

DIC

Sickle cell anemia

Shock

Elevated ICP

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22
Q

Craniopharyngioma

Origin

A

Derived from vestigial remnant of Rathke pouch

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23
Q

Corticotroph Adenomas

Nelson syndrome

Hormone result

A

Growth of pituitary corticotroph adenoma results in inc ACTH but no inc in cortisol (no adrenals)

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24
Q

Hypopituitarism

Define

A

Loss of 75% or more of pituitary

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25
Q

Pituitary Apoplexy

Define

A

Rapid enlargement

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26
Q

Adenomas

Size

A

Macroadenoma: >1cm

Microadenoma: <1cm

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27
Q

Inc risk of GI cancers?

A

GH Adenoma

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28
Q

Genetic Alterations in Pituitary Tumors

Loss of function

Rb

A

Aggressive adenoma

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29
Q

Empty sella syndrome

Secondary

A

Resected mass

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30
Q

Adenomas

Histology

Chromophobic

A

TSH/non Functional

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31
Q

Pituitary

Acidophil

A

GH

PRL

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32
Q

Corticotroph Adenoma

Nelson syndrome

Cause

A

Adrenals removed for Cushing syndrome

Pituitary has no negative feedback

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33
Q

Hypopituitarism

Genetic defects

A

Mutation in pituitary specific homeobox gen POU1F1

Deficiency of transcription factors

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34
Q

Hyperchorisolism ass with

A

Corticotroph adenomas

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35
Q

Genetic Alterations in Pituitary Tumors

Gain of function

GH adenoma

A

Gs alpha

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36
Q

Prolactinoma

Rx:

A

Dopamine agonists

Bromocriptine- 1st line of therapy

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37
Q

Pituitary

Posterior Pituitary

A

Derived from nervous system tissue, secretes neurohormones (oxytocin and ADH) produced in HT

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38
Q

GH Adenoma

Ass with…

A

INC RISK OF GI CANCERS

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39
Q

Hyperpituitarism

MC due to

A

Adenoma

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40
Q

Serum hyper prolactinemia

Drugs (causes)

A

Anything that dec dopamine (phenothizaines, haloperidol)

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41
Q

Hypothalamic Suprasellar tumor

A

Craniopharyngioma

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42
Q

GH Adenoma

Sx

A

Pre-pubertal children: gigantism

Adults: acromegaly

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43
Q

Posteriory pituitary

Abnormal ADH

A

Diabetes insipidus (lack)

Syndrome of inappropriate ADH (SIADH: xs)

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44
Q

Pituitary Adenoma

Mass effect shows..

A

Radio graphic changes of sella turcica

Sellar expansion

Bony erosion

Disruption of the diaphrgma sella

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45
Q

Adenomas

Histology

Eosinophilic

A

PRL and GH

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46
Q

Pituitary adenocarcinoma

Ass

A

Activating mutations in HRAS

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47
Q

Posterior pituitary

Abnormal oxytocin

A

No significant clinical abnormalities

48
Q

Genetic Alterations in Pituitary Tumors

Gain of function

GH and Prolactin adenomas

A

Protein kinase A

49
Q

Granulomatous hypophysitis

A

Idiopathic

Rare 1/10,000,000

Visual symptoms, N/V, HA

50
Q

GH Adenoma

Other signs and sx

A

ABN glucose tolerance

DM

Generalized mm weakness

Hypertension

Arthritis/osteoporosis

CHF

51
Q

Serum hyper prolactinemia

Other causes

A

Estrogen

Renal failure

Hypothyroidism

52
Q

Diabetes insipidus

Caused by

A

Lack of ADH

53
Q

Pituitary

Anterior Pituitary

A

Derived from Rathke’s Pouch (of epithelial origin), produces numerous hormones

54
Q

Pituitary Apoplexy

Ass with

A

Pan-hypopituitarism

55
Q

Serum hyper prolactinemia

Physiologic causes

A

Pregnancy, nursing

Stress

Damage to pituitary stalk or hypothalamus (head trauma)

Stalk effect

56
Q

Prolactinoma

Rx

Surgery

A

Transphenoidal surgery (through nose)

57
Q

Corticotroph Adenomas

S&sx

A

Silent

OR

HYPERCORTISOLISM

58
Q

Rathke cleft cyst

Can cause

A

DI

59
Q

Read table in pics

A

Just do it

60
Q

Pituitary Adenoma

Mass Effect

Sx

A

Visual field abnormalities

Elevated intracranial pressure

Hypopituitarism

61
Q

Craniopharyngioma

Caused by

A

Abnormal WNT signaling, activating B-catenin mutations

62
Q

Prolactinoma

Signs and sx

A

Amenorrhea, galactorrhea, infertility

Loss of libido (men)

63
Q

Genetic Alterations in Pituitary Tumors

Gain of function

Gs alpha

A

GH adenoma

64
Q

Corticotroph Adenomas

Nelson Syndrome

Common sign

A

Hyperpigmentation

Due to POMC peptides
Pituitary apoplexy possible

65
Q

Prolactinoma

Early dx in…

A

Premenopausal women

66
Q

Pineal Gland

A

Minute pine cone shaped organ

Sup colliculi at base of brain

Photosensory neuroendocrine organ

67
Q

Hypopituitarism

S&sx

A

Hypofunction of adrenal cortex, thyroid and gonads

Pallor (dec MSH)

Atrophy of gonads and genitalia (amenorrhea, impotence, loss of libido)

Loss of axillary and pubic hair

68
Q

Diabetes insipidus

Lack of ADH causes

A

Polyuria, dilute urine, inc serum osmolality, inc serum na, polydipsia (inc serum na)

Life threatening dehydration may occur!!!!!!!!

69
Q

Posterior pituitary

Secretes

A

ADH and oxytocin

70
Q

Rathke cleft cyst

Mechanism of DI

A

Compression of surrounding structures (loss of ADH-vasopressin storage and release)

71
Q

GH Adenoma

Characteristics

A

ACIDOPHILIC (or chromophobic)

May have PRL Granules

72
Q

Corticotroph Adenomas

Characteristics

A

Microadenoma

BASOPHILIC (could also be chromophobic)

73
Q

Pituitary Adenoma

Mass Effect

Hypopituitarism

A

Compression of normal pituitary tissue

Compression of stalk

74
Q

Craniopharyngioma

Common pt

A

Childhood or adolescence

75
Q

SIADH

MC cause

A

Malignant neoplasms

Small Cell CA of Lung

76
Q

Pituitary Adenoma

Clinical

Presentation

A

30-60s

10% of intracranial lesion

77
Q

Pineal Gland

Secretes

A

Melatonin

78
Q

Cushing disease caused by

A

Pituitary Adenoma

79
Q

Pituitary Apoplexy

Rapid enlargement caused by

A

Acute hemorrhage

Infarction and swelling

Neurosurgical/medical emergency

80
Q

Craniopharyngioma

Sx

A

Children: endocrine deficiencies (growth retardation)

Adults: visual disturbances (papillary)

81
Q

Empty sella syndrome

Caused by

A

Due to chronic herniation of the subarachnoid space into the sella turcica

82
Q

Invasive Adenoma

Morphology

A

Non-encapsulated

Infiltrates Surrounding Tissue

83
Q

Empty sella syndrome

Define

A

Enlarged, empty sella turcica

84
Q

Nelson Syndrome ass with

A

Corticotroph adenoma

85
Q

Cushing Syndrome caused by

A

Iatrogenic

Primary adrenal cortex

Ectopic ACTH

86
Q

Pineal Gland

Neoplasms

A

Germinoma/seminoma

Pinealomas

87
Q

Other pituitary tumors

Gonadotroph (FSH/LH)

A

Middle aged men and women

Loss of libido or no symptoms in men

88
Q

Hypopituitarism

Causes

A

Nonsecretory Pituitary Adenoma

Ischemic Necrosis

Ablation (Sx or Radiation)

Trauma and subarachnoid hemorrhage

89
Q

Atypical adenomas

Characteristics

A

Inc mitotic figures

Inc KI67

Nuclear Immunoreactivity for p53 protein

90
Q

Rathke cleft cyst

Origin and histology

A

Pars intermedia

Ciliated cuboidal/columnar epithelium

Squamous metaplasia

91
Q

Hypopituitarism

When do you get diabetes insipidus (lack of ADH)?

A

If due to hypothalamic cause

92
Q

Pituitary Adenoma

Mass Effect

Visual field abnormalities

A

Bitemporal hemianopsia=loss of lateral vision

Optic chiasm compression

93
Q

Craniopharyngioma

Dx

A

Seen on X-ray (3/4 have enough Ca)

94
Q

Other pituitary tumors

Null cell

A

No hormones

Mass effect

Compress remaining pituitary causing hypopituitarism

95
Q

Pituitary Adenoma

Mass Effect

Elevated ICP

A

Headache

N/V

96
Q

2nd most common adenoma

A

GH adenoma

97
Q

Empty sella syndrome

Common pt

A

Obese pts with multiple pregnancies

98
Q

Adenoma

Histology

A

Monomorphic cells: eosinophilic, basophilic, chromophobic (no stain)

No reticulin network (seen in normal)

99
Q

Pituitary

Hypothalamus pituitary interaction

A

Hypothalamus. Pituitary
TRH. +. TSH
PIF (dopamine). - PRL
CRH. +. ACTH
GHRH. +. GH
GIH(somatostatin). - GH
GnRH. +. FSH/LH

100
Q

Adenomas

Histology

Basophilic

A

ACTH

101
Q

Pineal Gland

Histology

A

Neuroglial stroma and epithelial pineocytes

Sequestered embryonic germ cells

102
Q

Pituitary Apoplexy

Sx

A

Sudden onset of excruciating headache, diploid, panhypopit, cardiovascular collapse, LOC—-death

103
Q

Pituitary apoplexy

Caused by

A

Usually undiagnosed adenoma

104
Q

Genetic Alterations in Pituitary Tumors

Loss of function

Aggressive adenoma

A

Rb

105
Q

Craniopharyngioma

Pediatric histology

A

Adamantinomatous histology

106
Q

SIADH

Xs ADH causes

A

Inc resorption of water

Dec serum no

NO PERIPHERAL EDEMA (na not retained)

107
Q

Pituitary Hypofunction

Can cause

A 
Growth failure (primary dwarfism)
Amenorrhea/infertility
Dec libido/ED
Hypothyroidism
Hypoadrenalism
Pallor due to loss of MSH
108
Q

Genetic Alterations in Pituitary Tumors

Loss of function

Aryl hydrocarbon receptor interacting protein (AIP1)

A

GH adenomas

109
Q

Genetic Alterations in Pituitary Tumors

Gain of function

Protein kinase A

A

GH and Prolactin adenomas

110
Q

Craniopharyngioma

Age distribution

A

Bimodal

5-15 and 50-60

111
Q

Pituitary

Sella Turcica

A

Bony box in which pituitary sits, depression in sphenoid bone

112
Q

Diabetes insipidus

ADH function

A

Cause reabsorption of free water by the renal collecting tubules

Retain water dilutes the blood

113
Q

Hyperpituitarism

Less common causes

A

Hyperplasia

Carcinoma

Non pituitary tumors

Disorders of hypothalamus

114
Q

Empty sella syndrome

Rarely causes…

A

Hypopituitarism

115
Q

Hypopituitarism

If due to hypothalamic cause

A

Also get diabetes insipidus (lack of ADH)

D&T3 Exam 1 (19 decks)

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