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Endo II > Pathology of the Pituitary > Flashcards

Pathology of the Pituitary Flashcards

1
Q

location of pituitary

A

sella turcica

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2
Q

80% of pituitary

A

adenohypophysis

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3
Q

ADH and oxytocin production

A

neurohypophysis of pituitary gland

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4
Q

secreted by anterior pituitary

A 
TSH
PRL
ACTH
GH
FSH
LH
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5
Q

control of GH release

A

somatostatin - inhibitory

GHRH - stimulatory

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6
Q

cells of anterior pituitary

A 
somatotrophs
mammosomatotrophs
lactotrophs
corticotrophs
thyrotrophs
gonadotrophs
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7
Q

cells secreting GH

A

somatotrophs

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8
Q

cells secreting GH and PRL

A

mammosomatotrophs

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9
Q

cells secreting PRL

A

lactotrophs

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10
Q

cells secreting ACTH, POMC, and MSH

A

corticotrophs

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11
Q

cells secreting TSH

A

thyrotrophs

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12
Q

cells secreting FSH and LH

A

gonadotrophs

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13
Q

vasopressin

A

ADH

from posterior pituitary

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14
Q

ACTH and POMC

A

same analog

hypopituitary - loss of pigmentation

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15
Q

acidophil

A

cells of pituitary

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16
Q

loss of lateral visual fields

A

bitemporal hemianopsia

local mass effect with pituitary gland size increase

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17
Q

N/V, headaches, papilledema

A

cerebral edema

pituitary growth leading to brain swelling

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18
Q

milky discharge

A

galactorrhea

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19
Q

bilateral galactorrhea, onset of HAs, elevated PRL

A

pituitary adenoma - prolactinoma

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20
Q

combined features of GH and PRL excess

A

mammosomatotroph pituitary adenoma

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21
Q

types of pituitary adenomas

A 
lactotroph - most common
somatotroph
mammosomatotroph
corticotroph
thyrotroph
gonadotroph
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22
Q

gigantism and acromegaly

A

somatotroph pituitary adenoma

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23
Q

HRAS

A

pituitary carcinoma

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24
Q

GNAS

A

GH adenomas

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25
Q

PRKAR1A

A

GH and PRL adenomas

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26
Q

MEN1

A

GH, PRL, ACTH adenomas

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27
Q

larger pituitary adenomas

A

tend to be nonfunctional - more local mass effects

28
Q

bleeding into pituitary adenoma

A

pituitary apoplexy

29
Q

amenorrhea, galactorrhea, loss of libido, infertility

A

prolictinemia

typically female age 20-40

30
Q

1/4 amenorrhea cases

A

lactotroph adenoma

31
Q

men and older women with lactotroph adenoma

A

hormone manifestations may be subtle

-so not detected until large size - macroadenoma

32
Q

dense core granules

A

think endocrine source

33
Q

gigantism

A

children - before epiphyseal plates close

34
Q

acromegaly

A

adults - after epiphyseal plates close

35
Q

IGF-1

A

from liver
-stimulated by GH

causes many of the clinical manifestations of somatotroph adenomas (acromegaly and gigantism)

36
Q

acromegaly growth

A

skin, soft tissue, thyroid, heart, liver, adrenal, bones of face, hands, and feet

37
Q

increased body size with long arms and legs

A

gigantism

38
Q

increased bone density

A

hyperostosis

seen in somatotroph adenomas

39
Q

protrusion of jaw

A

prognathism

seen in somatotroph adenoma

40
Q

sausage hands

A

acromegaly

41
Q

GH excess associations

A 
gonadal dysfunction
DM
muscle weakness
HTN
arthritis
CHF
GI cancer risk increase
42
Q

diagnosis of GH excess

A

elevated serum and IGF-1

43
Q

sensitive test for acromegaly

A

failure to suppress GH production in response to oral load of glucose**

44
Q

cushings disease vs. syndrome

A

syndrome - elevated cortisol

disease - elevated cortisol due to corticotroph adenoma in pituitary

45
Q

predominant hormone in gonadotroph adenoma

A

FSH

46
Q

hyperthyroidism

A

can be due to thyrotroph adenoma

rare**

47
Q

nonfunctioning pituitary adenomas

A

25-30% of all pituitary tumors

aka silent variant or null-cell adenomas

typically present with mass effects

can lead to hypopituitarism

48
Q

middle aged men and women, impaired vision, HA, diplopia, pituitary apoplexy

A

gonadotroph adenoma mass effects

also impaired secretion of LH - decrased energy and libido in men and amenorrhea in premenopausal women

49
Q

most common cause of hyperpituitarism

A

anterior lobe pituitary adenoma

50
Q

macroadenoma

A

greater than 1cm in diameter

51
Q

corticotroph adenoma

A

secrete ACTH

  • cushing syndrome
  • hyperpigmentation
52
Q

25yo M IED explosion with multiple medical problems, hypopigmentation, loss of libido, impotence, loss of pubic and axillary hair

FSH and LH decrease
TSH increase
ACTH decreased

A

hypothyroid

wound to neck - loss of thyroid

53
Q

most common causes of pituitary hypofuction

A

traumatic brain injury

subarachnoid hemorrhage

54
Q

rathke cleft cyst

A

differential for hypopituitarism

55
Q

pituitary growth failure

A

in children

hypopituitary

56
Q

amenorrhea and infertility

A

gonadotropin deficiency

57
Q

MSH

A

synthesized in anterior pituitary

hypopituitarism - can lead to pallor due do loss of MSH stimulation on melanocytes

58
Q

ADH deficiency

A

diabetes insipidus

with polyuria

59
Q

ADH excess

A

SIADH

-hyponatremia - because of excess free water absorption

60
Q

52yo male smoker, confusion, HA, hyponatremia

small cell carcinoma of lung

A

SIADH

61
Q

23yo M head trauma in MVA, confused

hypernatremia

subdural hematoma

A

possible diabetes insipidus

loss of ADH from pituitary

62
Q

diagnosis of diabetes insipidus

A

neurogenic (central) and nephrogenic

63
Q

large volume dilute urine, lower specific gravity, hypernatremia, hyperosmolar, thirst, polydipsia

A

diabetes insipidus

64
Q

craniopharyngioma

A

compact lamellar wet keratin and cords of squamous epitheilum

3-4cm

children - adamantinomatous
adult - papillary

65
Q

motor oil like with tumor aspiration

A

adamantinomatous craniopharyngiomas

also see calcification

66
Q

prognosis of craniopharyngiomas

A

less than 5cm excellent
-recurrent free

larger lesions - mre invasive

malignant transformation is rare

Endo II (12 decks)

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