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Endocrine > Pathology of Pituitary & Adrenal Glands > Flashcards

Pathology of Pituitary & Adrenal Glands Flashcards

1
Q

True/False. Pituitary macroadenomas may compress the optic chiasm, leading to bilateral hemianopsia.

A

True

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2
Q

What hormone is secreted due to a somatotrophic pituitary adenoma?

A

Growth Hormone

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3
Q

What hormone is released due to a gonadotrophic pituitary adenoma?

A

FSH & LH

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4
Q

What is the most common pituitary adenoma?

A

Prolactinoma

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5
Q

What hormone is secreted by a lactotroph adenoma?

A

Prolactin (aka prolactinoma)

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6
Q

This type of adenoma presents histologically with calcification, psammoma bodies, and amyloid deposition

A

Prolactinoma

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7
Q

In what population are prolactinomas most common?

A

Women 20-40yo

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8
Q

With what type of adenoma are gigantism and acromegaly associated?

A

Somatotroph adenoma (growth hormone adenoma)

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9
Q

What is the clinical manifestation of a corticotroph adenoma?

A

Cushing disease due to hypersecretion of cortisol

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10
Q

These adenomas are most associated with mass effects and pituitary apoplexy.

A

Gonadotroph & thryotroph adenomas

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11
Q

True/False. IGF-1 levels are low in patients with a somatotroph adenoma.

A

False - levels are high and necessary for diagnosis

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12
Q

True/False. Corticotroph adenomas may present with skin hyperpigmentation.

A

True - ACTH stimulates melanocytes

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13
Q

This disorder is characterized by postpartum necrosis of the anterior pituitary due to obstetric hemorrhage.

A

Sheehan Syndrome.

Note, the posterior pituitary is unaffected

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14
Q

What is generally the first symptom of Sheehan Syndrome?

A

Agalactorrhea

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15
Q

This disorder is caused by arachnoid herniation that compresses the pituitary gland.

A

Empty sella syndrome

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16
Q

This disorder is caused by a deficiency of ADH.

A

Central diabetes insipidus

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17
Q

What is the difference between central and peripheral diabetes insipidus?

A

Central - ADH deficiency

Peripheral - ADH resistance

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18
Q

What electrolyte abnormality is associated with SIADH?

A

Hyponatremia - water retention causes dilution of plasma and decreased osmolality

19
Q

From where do craniopharyngiomas arise?

A

Rathke pouch

20
Q

This type of suprasellar tumor is most common in childhood and late adulthood. Histology shows calcifications and cysts and resembles tooth enamel.

A

Craniopharyngioma

21
Q

What is the most common cause of Cushing Syndrome?

A

Exogenous glucocoritcoids

22
Q

Cushing disease is a type of ACTH-dependent hypercortisolism. What lab values would be expected?

A

Increased ACTH, increased cortisol

23
Q

What lab values would be expected in a patient with ACTH-independent hypercortisolism?

A

Decreased ACTH, high cortisol

This is because the adrenals are secreting cortisol independent of ACTH stimulation. High cortisol negatively feeds back to the HPA axis to decreased ACTH.

24
Q

Cushing disease is a type of Cushing Syndrome. What is the cause?

A

Pituitary adenoma

25
Q

This neuroendocrine neoplasm is highly associated with ACTH-dependent hypercortisolism.

A

Small cell lung cancer - releases ACTH

26
Q

True/False. Adrenal adenomas are most associated with bilateral adrenal hyperplasia.

A

False - hyperplasia may be unilateral or bilateral, depending on the number of adenomas present. Pituitary adenomas and paraendocrine neoplasms are associated with bilateral hypertrophy.

27
Q

Primary hyperaldosteronism presents with sodium retention, potassium excretion, and hypertension. What other lab finding is characteristic?

A

Normal renin levels

28
Q

What is Conn Syndrome?

A

Primary hyperaldosteronism

29
Q

Spironolactone bodies are found in patients with this disorder that are treated with spironolactone.

A

Conn Syndrome (Primary hyperaldosteronism)

30
Q

How can primary and secondary hyperaldosteronism be differentiated?

A

Primary has normal renin levels, while secondary has high renin levels

31
Q

Describe the pathophysiology of secondary hyperaldosteronism.

A

Due to excessive activation of the renin-angiotensin system. This is often related to decreased renal perfusion.

32
Q

What is the most common defect associated with adrenogenital syndrome?

A

21-hydroxylase deficiency

33
Q

21-hydroxylase is deficient in patients with adrenogenital syndrome. What is the effect on hormone production?

A

This leads to increased production of testosterone in response to ACTH stimulation. Cortisol production is decreased.

34
Q

Adrenogenital syndrome is associated with salt wasting and potassium retention. Why is this?

A

Deficiency of the 21-hydroxylase reduces synthesis of aldosterone, responsible for salt retention and potassium excretion

35
Q

What is Addison disease?

A

Primary adrenocortical insufficiency

36
Q

What is the most common cause of Addison disease?

A

Autoimmune adrenalitis

37
Q

Primary adrenocortical insufficiency may occur due to bacteremia in children. What is this disorder called?

A

Waterhouse-Friderichsen Syndrome

38
Q

What bacteria is most associated with Waterhouse-Friderichsen Syndrome?

A

Primary acute adrenocortical insufficiency in children - N. meningitides

39
Q

What is the cause of secondary adrenal insufficiency?

A

Pituitary pathologies that lead to decreased ACTH stimulating the adrenals

40
Q

This adrenal neoplasm presents in patients 30-40yo, often with hypertension and tachycardia.

A

Pheochromocytoma - due to excess catecholamine secretion

41
Q

What abnormal urinalysis finding is most associated with pheochromocytoma?

A

Elevated vanillymandelic acid in the urine

42
Q

This adrenal neoplasm commonly presents in young children with Homer-Wright pseudorosettes.

A

Neuroblastoma

43
Q

What gene mutation is associated with MEN2A?

A

RET proto-oncogene

44
Q

What organs are involved with MEN 1?

A

Pituitary, pancreas, parathyroid

Endocrine (15 decks)

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