Pathology of the Pituitary and Adrenal Glands Flashcards
name the trophic hormones released by the anterior pituitary
TSH
ACTH
FSH
LH
name the non trophic hormones released by the anterior pituitary
GH
prolactin
name the cells that secrete GH?
somatotrophs
name the cells that secrete PRL?
mammotrophs
name the cells that secrete ACTH?
corticotrophs
name the cells that secrete TSH?
thyrotrophs
name the cells that secrete FSH and LH
gonadotrophs
what do you call the cells that have a darker appearance on histology of the anterior pituitary?
basophils
what do you call the cells that have a redder appearance on histology of the posterior pituitary?
acidophils
what cells of the anterior pituitary are acidophils?
mammotrophs
somatotrophs
what cells of the anterior pituitary are basophils?
gonadotrophs
corticotrophs
thyrotrophs
what cells are contained in the posterior pituitary?
non-myelinated axons of neurosecretory neurons
tumours arise in the posterior pituitary: T or F?
F, only in the anterior pituitary
SIADH is a problem of the posterior pituitary gland: T or F?
T
what is diabetes insipidus?
lack of ADH secretion
name the 2 types of tumour you can get from the anterior pituitary?
adenoma
carcinoma
is sheehan syndrome caused by hypofunction or hyperfunction of the anterior pituitary?
hypofunction
most common hormone released by a pituitary adenoma?
prolactin
what mutation is a pituitary adenoma associated with?
MEN1
most common functional pituitary adenoma?
prolactinoma
symptoms of a prolactinoma?
infertility
loss of libido
amernorrhoea
2nd most hormone functional pituitary adenoma?
growth hormone secreting
another word for an ACTH secreting functional pituitary adenoma
cushings disease
is pituitary carcinoma rare?
yes
main cause of pituitary hypofunction?
panhypopituitarism
sarcoidosis can cause pituitary hypofunction: T or F?
T
what happens to the pituitary gland in pregnancy?
it gets bigger
what tumour would you suspect in a young patient with headaches, visual disturbances and slow growth?
craniopharyngioma
who gets craniopharyngiomas?
young and old (60s-70s)
how much do the adrenal glands weigh?
4-5g each
where are the adrenal glands located anatomically in relation to the kidney?
superomedial
2 main components of the adrenal gland?
outer cortex
central medulla
what cancer is a particular ectopic cause of excess ADH secretion?
lung
how can adrenal gland pathology be caused by pituitary disease?
if there is an ACTH secreting tumour acting on the adrenal gland
what are the consequences of hyperfunction of the adrenal cortex?
hyperplasia
adenoma
carcinoma
what disease is a result of acute hypofunction of the adrenal cortex?
waterhouse friderichson syndrome
what disease is a result of chronic hypofunction of the adrenal cortex?
addison’s disease
what is the adrenal medulla?
extension of sympathetic nervous system that is responsible for producing adrenergic hormones
what is the adrenal cortex?
secretes endocrine hormones
how can you get adrenocortical hyperplasia?
congenitally
acquiring it eg by excess ACTH exposure
can cushings disease cause adrenocortical hyperplasia?
yes
what kind of lung cancer can cause ectopic ACTH production?
small cell
what symptom is commonly seen in adrenocorticol hyperplasia?
increased androgens so masculinisation
who gets adrenocortical tumours?
adult men usually
when can a carcinoma cause fever?
if there is necrosis
what size are adrenocorticol adenomas typically?
small (2-3cm)
where is an adrenocorticol carcinoma likely to spread?
via vascular route eg liver, lung, bone
peritoneum/pleura
regional lymph nodes
it is difficult to differentiate benign adrenocortical tumours from malignant: T or F?
T
what features would suggests an adrenocortical carcinoma?
large size
haemorrhage
necrosis
frequent, atypical mitosis
another name for primary hyperaldosteronism?
conn’s syndrome
what is a common co-pathology of primary hyperaldosteronism?
diffuse or nodular hyperplasia of both adrenal glands
another name for hypercortisolism?
cushings syndrome or disease
most common exogenous cause of hypercortisolism?
steroid therapy
what can suppress the adrenal cortex leading to adrenocortical hypofunction?
steroid therapy
chronic cause of primary adrenocortical insufficiency?
addisons disease
what are the 3 common causes of addisons disease?
autoimmune adrenalitis
infection
lung/breast mets
what infections are most likely to predispose to addisons disease?
TB
fungal infection
HIV
most common acute cause of primary adrenocortical insufficiency?
rapid withdrawal of steroids
what do electrolyte levels look like in addisons?
decreased sodium
retained potassium
what secretes catecholamines?
chromaffin cells in the adrenal medulla
what innervates the adrenal medulla?
presynaptic fibres from the sympathetic nervous system
2 types of adrenal medulla tumour?
phaeochromocytoma
neuroblastoma
when is neuroblastoma most commonly diagnosed?
by 18 months
if a neuroblastoma doesnt occur in the adrenal medulla, where does it arise?
sympathetic chain
what is phaeochromocytoma a tumour of?
chromaffin cells
complications of phaeochromocytoma?
HYPERTENSION
CVD
how is phaeochromocytoma diagnosed?
detection of urinary excretion of catecholamines and metabolites
which tumour is referred to as the 10% tumour and why?
phaeochromocytoma 10% extra adrenal 10% bilateral 10% malignant 10% wont cause hypertension
what is MEN?
multiple endocrine neoplasia
what cancers are present in MEN2A?
phaeochromocytoma
medullary thyroid carcinoma
parathyroid hyperplasia
what cancers are present in MEN2B?
phaeochromocytoma
medullary thyroid carcinoma
neuroma
marfanoid habitus
name the 3 zones of the adrenal cortex?
zona glomerulosa
zona fasciculota
zona reticularis
what hormones are contained in the zona glomerulosa?
mineralocorticoids
aldosterone
what hormones are contained in the zona fasciculata?
glucocorticoids
cortisol
what hormones are contained in the zona reticularis?
sex steroids
glucocorticoids
