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Test 9 > Path 5 Endocrine Intro, Pituitary > Flashcards

Path 5 Endocrine Intro, Pituitary Flashcards

1
Q

Anterior lobe & posterior lobe of pituitary names

A

Adenohypophysis

Neurohypophysis

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2
Q

Anterior v Posterior function

A

Anterior produces via hypothalamus, Posterior secretes via neurons

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3
Q

Larger lobe of the pituitary

A

Anterior

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4
Q

5 anterior cells & hormones

A
  1. Somatotrophs - Growth Hormone
  2. Corticotrophs - POMC (ACTH, B-MSH)
  3. Thyrotrophs -TSH
  4. Gonadotrophs - FSH, LH
  5. Lactotrophs - Prolactin
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5
Q

Somatotroph

A

GH -> Somatomedins (liver) ->

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6
Q

Somatotroph regulation

A

Hypothalamus:

  1. ++ GHRH
  2. – Somatostatin (GIH)
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7
Q

Corticotroph

A

POMC (pro-opiomelanocortin) split into

a. ACTH -> adrenal -> cortisol and androgen
b. B-lipotropin -> B-MSH and B-endorphins

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8
Q

Corticotroph regulation

A

++ Hypothalamic CRH (corticotropin releasing hormone)

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9
Q

Thyrotroph

A

TSH (Thyroid Stimulating Hormone) -> Thyroid follicle growth

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10
Q

Thyrotroph regulation

A

++ Hypothalamic TRH (Thyrotropin releasing hormone)

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11
Q

Lactotroph/mammotroph

A

Prolactin -> lactation

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12
Q

Lactotroph regulation

A

– Prolactin inhibiting factor (Dopamine)

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13
Q

Gonadotroph

A

FSH -> follicle formation

LH -> ovulation and corpus luteum formation

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14
Q

Gonadotroph regulation

A

++ Hypothalamic GnRH

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15
Q

Posterior pituitary anatomy

A

Pituicytes (glial cells from hypothalamus) travel through stalk into neuro hypophysis

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16
Q

2 posterior cells & hormones

A

Pituicytes

  1. Oxytocin
  2. ADH (vasopressin)
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17
Q

Oxytocin function, regulation

A

Stimulates uterine contraction and milk ejection

-Regulated by cervical dilation and nipple stimulation

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18
Q

ADH function, regulation

A

Water retention in collecting ducts

-Controlled by baro and osmoreceptors

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19
Q

Most common cause of hyperpituitarism

A

Pituitary adenoma

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20
Q

Nonfunctioning adenoma clinical presentation

A

Temporal hemianopsia
Hypopituitarism
Headaches

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21
Q

Pituitary adenoma histo

A

Cellular monotony

Loss of normal reticulin network

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22
Q

2 Familial pituitary adenoma syndromes

A
  • MEN1 mutation

- Carney’s complex

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23
Q

Carney’s complex

A

Endocrine adenomas, cardiac myxomas, pigmented skin lesions

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24
Q

MEN1 mutation

A

Hyperplasia of pituitary, thyroid, parathyroid, adrenal cortex, pancreas

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25
Mutation found in all pituitary adenomas
G-protein
26
Lactotroph adenoma
Prolactin -> Galactorrhea and amenorrhea, sexual dysfunction, infertility
27
Somatotroph adenoma
GH -> Gigantism (children), Acromegaly (adults)
28
Corticotroph mutation
ACTH -> Cushing syndrome, Nelson syndrome
29
Mammosomatotroph adenoma
Prolactin/GH -> combined features
30
Thyrotroph
TSH -> Hyperthyroidism
31
Prolactinoma clinical
Amenorrhea, Galactorrhea (female) | Loss of libido, headaches (male)
32
Prolactinoma Tx
DA agonist (bromocriptine)
33
Prolactinoma secondary causes
``` Hypothalamic malfunction DA antagonists (methyldopa, reserpine) ```
34
Somatotrophic adenoma clinical
- Diabetes Mellitus - Gigantism (children) - Acromegaly (adults), problems with thyroid, heart, liver, adrenals
35
Somatotrophic Adenoma Tx
- Somatostatin analog | - GH-R antagonis
36
Somatotrophic Adenoma Dx
- lack of GH suppression by oral glucose | - elevated GH and IGF-1 levels
37
Somatotrophic Adenoma diabetes mechanism
GH induces hepatic gluconeogenesis
38
Corticotrophic Adenoma
Cushing disease (not syndrome)
39
Gonadotrophic Adenoma
LH, FSH production rare | -Commonly mass effect and hypogonadism
40
Thyrotrophic Adenoma
Rare and often subclinical
41
Non-functioning adenoma Dx
Immunohistochemical staining for lineage
42
Non-functioning adenoma clinical
- Hypopituitarism - Bitemporal hemianopsia - Headache - Pituitary apoplexy (acute hemorrhage)
43
Posterior pituitary dysfunction
Suspect hypothalamic condition
44
Sheehan syndrome
Ischemic necrosis of pituitary gland in postpartum women | -Enlarged pituitary with reduced blood pressure during partuition
45
Sheehan syndrome presentation
- Impaired lactation (no prolactin) - Loss of pubic hair (no gonadotrophs) - Fatigue (no TSH)
46
Rathke cleft cyst
``` Rathke pouch (ant. pituitary) remnant becomes cystic -Lined by ciliated cuboidal epithelium ```
47
Empty sella syndrome
Malformed sella fills with CSF, pituitary gland is compressed
48
Hypothalamic lesion
Diminish anterior as well as posterior function
49
Non-cancerous causes of hypopituitarism
Sarcoidosis | Tuberculous meningitis
50
Genetic hypopituitarism
Pituitary-specific homeobox gene POU1F1 deficiency
51
Diabetes Insipidus
Low ADH secondary to p.pituitary dysfunction
52
Types of Diabetes Insipidus (3)
- Central DI: ADH deficiency - Nephrogenic DI: Renal tubule unresponsiveness to ADH - Iatrogenic DI: Lithium, demeclocycline
53
Diabetes Insipidus clinical
- Polyuria/polydipsia - Inappropriately low urine osmolarity/gravity - Increased serum sodium and osmolarity
54
Diabetes Insipidus Dx
Water deprivation test (no increase in urine osmolarity)
55
Diabetes Insipidus Tx
Desmopressin (ADH analog)
56
Syndrome of Inappropriate ADH causes (3)
- Small cell lung carcinoma - Cyclophosphamide - CNS disorders
57
SIADH clinical
- Hyponatremia, low serum osmolarity | - Cerebral edema, CNS dysfunction/seizures
58
SIADH Tx
- Demeclocycline | - Water retention
59
Craniopharyngioma
Derived from Rathke pouch remnants - peaks at 10 and 65 years - pituitary (GH) hypofunction in children - headaches and visual disturbance in adults
60
Craniopharyngioma types
- Adamantinomatous craniopharyngioma (children) | - Papillary craniopharyngioma (adults)
61
Pituitary carcinoma
Rare malignant form (<1%)

Test 9 (17 decks)

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