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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
Q

Mutation found in all pituitary adenomas

26
Q

Lactotroph adenoma

A

Prolactin -> Galactorrhea and amenorrhea, sexual dysfunction, infertility

27
Q

Somatotroph adenoma

A

GH -> Gigantism (children), Acromegaly (adults)

28
Q

Corticotroph mutation

A

ACTH -> Cushing syndrome, Nelson syndrome

29
Q

Mammosomatotroph adenoma

A

Prolactin/GH -> combined features

30
Q

Thyrotroph

A

TSH -> Hyperthyroidism

31
Q

Prolactinoma clinical

A

Amenorrhea, Galactorrhea (female)

Loss of libido, headaches (male)

32
Q

Prolactinoma Tx

A

DA agonist (bromocriptine)

33
Q

Prolactinoma secondary causes

A 
Hypothalamic malfunction
DA antagonists (methyldopa, reserpine)
34
Q

Somatotrophic adenoma clinical

A
  • Diabetes Mellitus
  • Gigantism (children)
  • Acromegaly (adults), problems with thyroid, heart, liver, adrenals
35
Q

Somatotrophic Adenoma Tx

A
  • Somatostatin analog

- GH-R antagonis

36
Q

Somatotrophic Adenoma Dx

A
  • lack of GH suppression by oral glucose

- elevated GH and IGF-1 levels

37
Q

Somatotrophic Adenoma diabetes mechanism

A

GH induces hepatic gluconeogenesis

38
Q

Corticotrophic Adenoma

A

Cushing disease (not syndrome)

39
Q

Gonadotrophic Adenoma

A

LH, FSH production rare

-Commonly mass effect and hypogonadism

40
Q

Thyrotrophic Adenoma

A

Rare and often subclinical

41
Q

Non-functioning adenoma Dx

A

Immunohistochemical staining for lineage

42
Q

Non-functioning adenoma clinical

A
  • Hypopituitarism
  • Bitemporal hemianopsia
  • Headache
  • Pituitary apoplexy (acute hemorrhage)
43
Q

Posterior pituitary dysfunction

A

Suspect hypothalamic condition

44
Q

Sheehan syndrome

A

Ischemic necrosis of pituitary gland in postpartum women

-Enlarged pituitary with reduced blood pressure during partuition

45
Q

Sheehan syndrome presentation

A
  • Impaired lactation (no prolactin)
  • Loss of pubic hair (no gonadotrophs)
  • Fatigue (no TSH)
46
Q

Rathke cleft cyst

A 
Rathke pouch (ant. pituitary) remnant becomes cystic
-Lined by ciliated cuboidal epithelium
47
Q

Empty sella syndrome

A

Malformed sella fills with CSF, pituitary gland is compressed

48
Q

Hypothalamic lesion

A

Diminish anterior as well as posterior function

49
Q

Non-cancerous causes of hypopituitarism

A

Sarcoidosis

Tuberculous meningitis

50
Q

Genetic hypopituitarism

A

Pituitary-specific homeobox gene POU1F1 deficiency

51
Q

Diabetes Insipidus

A

Low ADH secondary to p.pituitary dysfunction

52
Q

Types of Diabetes Insipidus (3)

A
  • Central DI: ADH deficiency
  • Nephrogenic DI: Renal tubule unresponsiveness to ADH
  • Iatrogenic DI: Lithium, demeclocycline
53
Q

Diabetes Insipidus clinical

A
  • Polyuria/polydipsia
  • Inappropriately low urine osmolarity/gravity
  • Increased serum sodium and osmolarity
54
Q

Diabetes Insipidus Dx

A

Water deprivation test (no increase in urine osmolarity)

55
Q

Diabetes Insipidus Tx

A

Desmopressin (ADH analog)

56
Q

Syndrome of Inappropriate ADH causes (3)

A
  • Small cell lung carcinoma
  • Cyclophosphamide
  • CNS disorders
57
Q

SIADH clinical

A
  • Hyponatremia, low serum osmolarity

- Cerebral edema, CNS dysfunction/seizures

58
Q

SIADH Tx

A
  • Demeclocycline

- Water retention

59
Q

Craniopharyngioma

A

Derived from Rathke pouch remnants

  • peaks at 10 and 65 years
  • pituitary (GH) hypofunction in children
  • headaches and visual disturbance in adults
60
Q

Craniopharyngioma types

A
  • Adamantinomatous craniopharyngioma (children)

- Papillary craniopharyngioma (adults)

61
Q

Pituitary carcinoma

A

Rare malignant form (<1%)

Test 9 (17 decks)

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