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D&T test 6 - endocrine, dermatology, MSK > Path: Pituitary > Flashcards

Path: Pituitary Flashcards

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Dermatology Board Prep flashcards
1
Q

3 cells types of the APit and their colors

A 
Acidophils = pink
Basophils = Blue
Chromophobes = gray
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2
Q

What is Apit derived from (be specific)

A

Dervied from Rathke’s pouch (oral ectoderm)

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3
Q

Difference in vascularity of APit and Ppit? Implications

A

Apit- has only single vascular supply

  • Ppit has dual vascular supply
    implication: Apit is more susceptible to ischemic damage
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4
Q

What 2 cell types are the acidophils and what do they secrete

A

Somatotrophs (GH)

Lactotrophs (Prolactin)

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5
Q

What 3 cell types are the basophils and what do they secrete

A

Corticotrophs (ACTH)
Thryotrophs (TSH)
Gonadotrophs (FSH, LH)

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6
Q

destructive process usually –> what derangement of pituitary output?

A

hypopituitarianism

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7
Q

hyperpituitarianism is usually cuased by what?

A

Adenomas

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8
Q

pituitary adenomas are assc with what MEN syndrome

A

MEN I

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9
Q

pituitary adenomas are the MC cause of?

A

MC cause of excess hormone production

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10
Q

In Functional adenomas- how many homos are produced

A

just one hormone overproduced

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11
Q

Most Pit adenomas are sporadic but the genetic ones are dt Mutations in gene encoding what protein?

A

Mutations in gene encoding α-subunit of Gs

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12
Q

Microadenomas are distinguished by:

  • What size
  • What micro change?
A

size: < 1cm
Micro: ONE cell type with Decreased reticulin network (support tissue around acini)

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13
Q

What is the only change that signifies malignancy in pit adenomas

A

metastasis only

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14
Q

What is the MC functional pituitary tumor

A

prolactinoma

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15
Q

What is CP (4) of prolactinoma and why

A

Amenorrhea (by far the most common sign), galactorrhea, loss of libido, infertility
PRL inhibits GnRH release–> low LH, FSH –> CP

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16
Q

Tx for prolactinoma (3)

A
  • Bromocriptine (DA analog)—- also carbergoline (not for class but in pathoma)
  • surgery
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17
Q

What mutation causes GH adenoma

A

mutant GTPase dt deficient α-subunit of Gs

18
Q

What mediates tissue growth in GH adenoma

A

IGF-1 produced by liver

19
Q

Gigantism and Acromegaly occur in what age groups with enlargement of what?

A

Gigantism: kids, increased linear bone growth
Acromegaly: Adults, enlarged head, hands, feet, jaw tongue, soft tissues

20
Q

If an oral glucose challenge fails to suppress GH, what is the dx

A

Acromegaly

21
Q

GH effect on Glc levels and condition it gives rise to

A

GH –> GNG by liver –> hyperglycemia –> Secondary DM

22
Q

ACTH secreting tumor in Apit is called

A

Cushings disease

23
Q

treatment for GH adenoma (and MOA)

A

octreotide- a somatostatin analog that inhibits GH release from Apit

24
Q

Nelson Syndrome: Cause, mechanism of disease and 2 CPs

A

Removal of adrenals–> loss of cortisol’s inhibition on ACTH production–> large adenomas –> mass effect, hyperpigmentation (POMC)

25
Q

2 types of Non-functioning pit adenomas and what is produced/screted

A

Null cell type- nothing produced

Non-secretory variant - hormone I produced but not secreted

26
Q

how dx pituitary carcinoma

A

metastasis

27
Q

5 causes of hypopit

A 
Ischemic necrosis
tumors--> damage
Ablation
pituitary apoplexy
empty sella syndrome
28
Q

What cuases pituitary apoplexy? 4 CPs?

A

sudden hemorrhage into pituitary–> rapid enlargement of tumor–> hypopit, headache, vision, sudden death

29
Q

Ichemic necrosis of pituitary is seen in what condition?

A

Sheehan syndrome

30
Q

Sheehan syndrome is casued by what, why?

A

Postpartum necrosis of Anterior pituitary dt maternal blood loss or shock
Why - Anterior Pituitary has only single blood supply = more susceptible to shock

31
Q

CP of sheehan (3)

A

loss of pubic hair
poor lactation
fatigue

32
Q

What causes empty sella

A

herniation of CSF and arachnoid mater into sella –> compression of pituitary

33
Q

2 functions of oxytocin

A 
Uterine contraction (in gravid uterus only)
Lactiferous duct contraction (milk ejection)
34
Q

3 findings of Diabetes Insipidus

A

Low urine osmolality
Polyuria/dypsia
Hypernateremia (dt relative water loss)

35
Q

3 findings of SIADH

A

Hyponatremia - dt relative water excess
Cerebral edema
Neurologic dysfunction- demyelination

36
Q

MC cause of SIADH

A

SCC of lung or other paraneoplastic syndromes

37
Q

What is the MC Hypothalamic Suprasellar tumor in kids

A

Craniopharyngioma

38
Q

Craniopharyngioma is derived from ?

A

Rathke’s pouch derived

39
Q

Craniopharyngioma is seen in what pops?

A

kids and >60

40
Q

Tumor appearance of Craniopharyngioma (5)

A

Cystic tumor with calcification, squamous epithelium, stroma, “machinery oil”

D&T test 6 - endocrine, dermatology, MSK (22 decks)

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