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Block 2 Pathophysiology > Endocrine- pituitary > Flashcards

Endocrine- pituitary Flashcards

1
Q

Endocrine System Consists of tissues that orchestrate ______ (homeostasis)

A

metabolic equilibrium

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2
Q

Means of communication mediated by secreted molecules (______) released by endocrine tissue (gland) and carried through the blood to a distant tissue (target cell/tissue)

A

hormones

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3
Q

Target tissue often secretes factors that down-regulate the activity of the gland (______)

A

feedback inhibition

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4
Q

Pathology occurs when there is:

A

Underproduction or overproduction of hormones

Mass lesions of hyperplastic glandular tissue

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5
Q

Lesions may be _____ (don’t produce hormones)

A

nonfunctional

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6
Q

Lesions may be _____ (produce hormones)

A

functional

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7
Q

Mass lesions of hyperplastic glandular tissue

may be __________ and can ________.

A

Benign or malignant

compress other tissues (e.g., vasculature, nerves)

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8
Q 
Anterior lobe (adenohypophysis) 
is what percent of pituitary gland
A

80%

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9
Q

Hypothalamus releasing factors (positive) are carried to the anterior pituitary by the______.

A

portal vascular system

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10
Q

Hypothalamus releasing factors (positive) are carried to the anterior pituitary by the portal vascular system, Except for _____.

A

Prolactin secretion inhibited by hypothalamic dopamine (not stimulated)

Growth hormone secretion stimulated by GHRH and inhibited by somatostatin (both from the hypothalamus)

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11
Q

Prolactin secretion inhibited by hypothalamic ______(not stimulated)

A

dopamine

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12
Q

Growth hormone secretion stimulated by ___ and inhibited by somatostatin (both from the hypothalamus)

A

GHRH

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13
Q

Growth hormone secretion stimulated by GHRH and inhibited by______ (both from the hypothalamus)

A

somatostatin

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14
Q

in posterior pituitary, Modified glial cells and axonal processes from the hypothalamus, pass through the _____ to the posterior lobe (axon terminals)

A

pituitary stalk

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15
Q

Pre-formed hormones produced in the _____, stored in the axon terminals in the posterior pituitary, released directly into the systemic circulation

A

hypothalamus

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16
Q

Posterior pituitary hormones

A 
Oxytocin
 Antidiuretic hormone (ADH or vasopressin)
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17
Q

what causes release of oxytocin or ADH

A

Direct CNS stimulation causes release

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18
Q

Dilatation of the cervix (pregnancy) and nipple stimulation (suckling) results in ____ release (also “happy” times!)

A

oxytocin

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19
Q

Decreased blood pressure (cardiac atria and carotid baroreceptors), increase in plasma osmotic pressure detected by CNS osmoreceptors stimulates ____ release (opposite effects inhibit)

A

ADH

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20
Q

Diseases of the posterior pituitary often noticed quickly because of increased or decreased secretion of ___

A

ADH

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21
Q

what is Hyperpituitarism

A

Excess secretion of pituitary hormones

22
Q

causes of hyperpituitarism

A

Functional pituitary adenoma
Hyperplasia or carcinoma of the anterior pituitary
Ectopic secretion of hormones by non-pituitary tumors
Over-secretion of hypothalamic releasing factors

23
Q

causes of Hypopituitarism

A

Pituitary or hypothalamic injury

  • Ischemic injury (including compression injury, thrombolic / embolic injury)
  • Surgery or radiation
  • Inflammatory reactions

Nonfunctional pituitary adenomas (replaces functional tissue)

24
Q

what is Hypopituitarism

A

Under-secretion of pituitary hormones

25
Q

examples of Pituitary or hypothalamic injury

A
  • Ischemic injury (including compression injury, thrombolic / embolic injury)
  • Surgery or radiation
  • Inflammatory reactions
26
Q

Sellar expansion, bony erosion, and

disruption of the diaphragma sella can cause pituitary _____.

A

Local mass effects

27
Q

Expanding pituitary lesions often compress the _____(visual field abnormalities, classically bitemporal hemianopsia)

A

optic chiasm

28
Q

pituitary mass effects May produce signs and symptoms of elevated ____(headache, nausea, and vomiting)

A

intracranial pressure

29
Q

Acute hemorrhage into an adenoma causes rapid enlargement of the lesion, called pituitary ____ (i.e., pituitary stroke, a neurosurgical emergency)

A

apoplexy

30
Q

Most common cause of hyperpituitarism is an ______.

A

anterior lobe adenoma

31
Q

anterior lobe adenoma Can be _____(hormone excess and clinical manifestations) or _____(without clinical symptoms of hormone excess, present late)

A

functional

non functioning

32
Q

Less common causes of _____include pituitary carcinomas and some hypothalamic disorders (unregulated secretion of releasing factors)

A

hyperpituitarism

33
Q

anterior lobe adenomas are

Usually found in adults ___ years

A

35 to 60

34
Q

Pituitary adenomas are well-circumscribed lesions usually confined to the _____(may extend superiorly through the diaphragm sella into the suprasellar region, where they may compress the optic chiasm and cranial nerves.

A

sella turcica

35
Q

_______ tend to be more invasive and contain areas of hemorrhage and necrosis.

A

Macroadenomas

36
Q

headaches occur when there is inflammation/irritation to the ____.

A

dura

37
Q

if there is disruption of bony sella, CSF can be released and pt will have ___.

A

rhinorrea

38
Q

most common pituitary adenoma

A

prolactinoma

39
Q

associated symptoms with ACTH

A 
Cushing syndrome (hypercortisolism)
Nelson syndrome (reactive adenoma after adrenalectomy)
40
Q

associated symptoms with GH (IGF-1)

A

Gigantism (children)

Acromegaly (adults)

41
Q

associated symptoms with Prolactin

A

Galactorrhea and amenorrhea (in females)
Reduced libido, infertility
Most common manifestation

42
Q

associated symptoms with Prolactin, GH

A

Combined features of GH and prolactin excess

43
Q

associated symptoms with TSH

A

hyperthyroidism

44
Q

______ refers to the loss of one or more pituitary hormones

A

Hypopituitarism

45
Q

______ results from complete loss of all pituitary hormone secretion

A

Panhypopituitarism

46
Q

Causes

of Panhypopituitarism

A

Ischemic necrosis (head injury, vascular, postpartum)
Sella turcica neoplasms (nonfunctioning adenoma)
Intrasellar cysts
Chronic inflammatory lesions (TB, syphillis, sarcoidosis)
Infiltrative disorders (amyloidosis, hemochromatosis)
Genetic mutations

47
Q

A syndrome of polyuria resulting from the inability to concentrate urine and to conserve water due to inadequate ADH

A

Diabetes Insipidus

48
Q

diabetes insipidus causes

A

Reduced pituitary production of ADH (central diabetes insipidus)

Reduced renal response to ADH (nephrogenic diabetes insipidus)

Pregnancy increases metabolic clearance of ADH (so it lasts longer), decrease water reabsorption

49
Q

____ is Due to secretion of more ADH than is appropriate for the blood sodium concentration or volume

A

SIADH

50
Q

Associated with dilutional hyponatremia without edema

A

SIADH

51
Q

SIADH- About 30% cases are _________ (hyperpituitarism), remainder are other CNS disorders, neoplastic, pulmonary, drug effects

A

posterior pituitary oversecretion

52
Q

Neurologic consequences of _____include confusion, lethargy and weakness, myoclonus, asterixis, generalized seizures, and coma

A

hyponatremia

Block 2 Pathophysiology (8 decks)

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