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LECOM PBL spring 2017 > patho case 1 (1074-1082) > Flashcards

patho case 1 (1074-1082) Flashcards

1
Q

what transcription factor is needed for somatotrophs, mammosomatotrophs, and lactotrophs

A

PIT-1

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2
Q

what transcription factors are needed for gonadotroph differentiation

A

SF-1 and GATA-2

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3
Q

what does hyperpituitarism arise from

A

excess secretion of trophic hormones

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4
Q

what does hypopituitarism arise from

A

deficiency of trophic hormones

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5
Q

what is the most common cause of hyperpituitarism

A

adenoma arising in the anterior lobe

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6
Q

describe functional adenomas

A

associated with hormone excess and clinical manifestations thereof

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7
Q

describe nonfunctioning adenomas

A

without clinical symptoms of hormone excess

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8
Q

how big are micro adenomas

A

less than 1 cm in diameter

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9
Q

what are the associated syndrome with lactotroph adenomas

A

galactorrhea and amenorrhea, sexual dysfunction, infertility

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10
Q

what are the associated syndrome with somatotroph adenomas

A

gigantism and acromegaly

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11
Q

what is the most commonly associated pituitary tumor with gain of function GNAS

A

GH adenoma

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12
Q

what is the most commonly associated pituitary tumor with gain of function PRKAR1A

A

GH and prolactin adenomas

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13
Q

what is the most commonly associated pituitary tumor with gain of function cyclin D1

A

aggressive adenomas

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14
Q

what is the most commonly associated pituitary tumor with gain of function HRAS

A

pituitary carcinomas

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15
Q

what is the most commonly associated pituitary tumor with loss of function MEN1

A

GH, prolactin, and ACTH adenomas

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16
Q

what is the most commonly associated pituitary tumor with loss of function CDKN1B

A

ACTH adenomas

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17
Q

what is the most commonly associated pituitary tumor with loss of function AIP

A

GH adenomas

18
Q

xwhat is the most commonly associated pituitary tumor with loss of function RB

A

aggressive adenomas

19
Q

what is the mechanism of alteration with GNAS

A

activating mutation

20
Q

what is the mechanism of alteration with PRKAR1A gain of function

A

gremlin inactivating mutations of PRKAR1A are present in autosomal dominant carney complex

21
Q

what is the mechanism of alteration with cyclin D1 gain of function

A

overexpression

22
Q

what is the mechanism of alteration with HRAS gain of function

A

activating mutation

23
Q

what is the alpha-subunit of Gs encoded by

A

GNAS gene

24
Q

what chromosome is the GNAS gene on

A

20q13

25
Q

describe the typical pituitary adenoma

A

soft and well-circumscribed

26
Q

what distinguishes pituitary adenomas from nonneoplastic anterior pituitary parenchyma

A

cellular monomorphism and the absence of a significant reticulin network

27
Q

what is the most frequent type of hyper functioning pituitary adenoma

A

prolactin-secreting lactotroph adenomas

28
Q

what adenomas are lactotroph adenomas comprised of chromophoric cells with juxtanuclear localization of PIT-1

A

sparsely granulated lactotroph adenomas

29
Q

what adenomas are characterized by diffuse cytoplasmic PIT-1 expression localization

A

densely granulated lactotroph adenomas

30
Q

what does prolactinemia cause

A

amenorrhea, galactorrhea, loss of libido, and infertility

31
Q

what is lactotroph hyperplasia caused by

A

loss of dopamine-mediated inhibition of prolactin secretion

32
Q

what is densely granulated adenomas composed of

A

monomorphic, acidophilic cells that have strong cytoplasmic GH reactivity on immunohistochemistry

33
Q

what are sparsely granulated variants composed of

A

chromophobe cells with considerable nuclear and cytoplasmic pleomorphism and focal, weak staining for GH

34
Q

describe corticotroph adenomas

A

usually micro adenomas at the time of diagnosis and are most often basophilic (densely granulated) and occasionally chromophoric (sparsely granulated)

35
Q

why does nelson syndrome occur most often due to

A

because of a loss of the inhibitory effect of adrenal corticosteroids on a preexisting corticotrophin micro adenoma

36
Q

what is the most common form of clinically significant ischemic necrosis of the anterior pituitary

A

sheehan syndrome/ postpartum necrosis

37
Q

what are rathe cleft cysts lined by

A

ciliated cuboidal epithelium with occasional goblet cells and anterior pituitary cells

38
Q

what causes diabetes insipidus

A

ADH deficiency

39
Q

what is diabetes insipidus characterized by

A

excessive urination (polyuria) due to an inability of the kindly to resorb water proper from the urine

40
Q

what is nephrogenic diabetes insipidus a result of

A

renal tubular unresponsiveness to circulating ADH

41
Q

what is the craniopharyngioma thought to arise from

A

vestigial remnants of rathke pouch

LECOM PBL spring 2017 (16 decks)

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