Pathology of the Pituitary and Adrenal Glands

Question 1

name the trophic hormones released by the anterior pituitary

Answer 1

TSH
ACTH
FSH
LH

Question 2

name the non trophic hormones released by the anterior pituitary

Answer 2

GH

prolactin

Question 3

name the cells that secrete GH?

Answer 3

somatotrophs

Question 4

name the cells that secrete PRL?

Answer 4

mammotrophs

Question 5

name the cells that secrete ACTH?

Answer 5

corticotrophs

Question 6

name the cells that secrete TSH?

Answer 6

thyrotrophs

Question 7

name the cells that secrete FSH and LH

Answer 7

gonadotrophs

Question 8

what do you call the cells that have a darker appearance on histology of the anterior pituitary?

Answer 8

basophils

Question 9

what do you call the cells that have a redder appearance on histology of the posterior pituitary?

Answer 9

acidophils

Question 10

what cells of the anterior pituitary are acidophils?

Answer 10

mammotrophs

somatotrophs

Question 11

what cells of the anterior pituitary are basophils?

Answer 11

gonadotrophs
corticotrophs
thyrotrophs

Question 12

what cells are contained in the posterior pituitary?

Answer 12

non-myelinated axons of neurosecretory neurons

Question 13

tumours arise in the posterior pituitary: T or F?

Answer 13

F, only in the anterior pituitary

Question 14

SIADH is a problem of the posterior pituitary gland: T or F?

Answer 14

T

Question 15

what is diabetes insipidus?

Answer 15

lack of ADH secretion

Question 16

name the 2 types of tumour you can get from the anterior pituitary?

Answer 16

adenoma

carcinoma

Question 17

is sheehan syndrome caused by hypofunction or hyperfunction of the anterior pituitary?

Answer 17

hypofunction

Question 18

most common hormone released by a pituitary adenoma?

Answer 18

prolactin

Question 19

what mutation is a pituitary adenoma associated with?

Answer 19

MEN1

Question 20

most common functional pituitary adenoma?

Answer 20

prolactinoma

Question 21

symptoms of a prolactinoma?

Answer 21

infertility
loss of libido
amernorrhoea

Question 22

2nd most hormone functional pituitary adenoma?

Answer 22

growth hormone secreting

Question 23

another word for an ACTH secreting functional pituitary adenoma

Answer 23

cushings disease

Question 24

is pituitary carcinoma rare?

Answer 24

yes

Question 25

main cause of pituitary hypofunction?

Answer 25

panhypopituitarism

Question 26

sarcoidosis can cause pituitary hypofunction: T or F?

Answer 26

T

Question 27

what happens to the pituitary gland in pregnancy?

Answer 27

it gets bigger

Question 28

what tumour would you suspect in a young patient with headaches, visual disturbances and slow growth?

Answer 28

craniopharyngioma

Question 29

who gets craniopharyngiomas?

Answer 29

young and old (60s-70s)

Question 30

how much do the adrenal glands weigh?

Answer 30

4-5g each

Question 31

where are the adrenal glands located anatomically in relation to the kidney?

Answer 31

superomedial

Question 32

2 main components of the adrenal gland?

Answer 32

outer cortex | central medulla

Question 33

what cancer is a particular ectopic cause of excess ADH secretion?

Answer 33

lung

Question 34

how can adrenal gland pathology be caused by pituitary disease?

Answer 34

if there is an ACTH secreting tumour acting on the adrenal gland

Question 35

what are the consequences of hyperfunction of the adrenal cortex?

Answer 35

hyperplasia adenoma carcinoma

Question 36

what disease is a result of acute hypofunction of the adrenal cortex?

Answer 36

waterhouse friderichson syndrome

Question 37

what disease is a result of chronic hypofunction of the adrenal cortex?

Answer 37

addison's disease

Question 38

what is the adrenal medulla?

Answer 38

extension of sympathetic nervous system that is responsible for producing adrenergic hormones

Question 39

what is the adrenal cortex?

Answer 39

secretes endocrine hormones

Question 40

how can you get adrenocortical hyperplasia?

Answer 40

congenitally | acquiring it eg by excess ACTH exposure

Question 41

can cushings disease cause adrenocortical hyperplasia?

Answer 41

yes

Question 42

what kind of lung cancer can cause ectopic ACTH production?

Answer 42

small cell

Question 43

what symptom is commonly seen in adrenocorticol hyperplasia?

Answer 43

increased androgens so masculinisation

Question 44

who gets adrenocortical tumours?

Answer 44

adult men usually

Question 45

when can a carcinoma cause fever?

Answer 45

if there is necrosis

Question 46

what size are adrenocorticol adenomas typically?

Answer 46

small (2-3cm)

Question 47

where is an adrenocorticol carcinoma likely to spread?

Answer 47

via vascular route eg liver, lung, bone peritoneum/pleura regional lymph nodes

Question 48

it is difficult to differentiate benign adrenocortical tumours from malignant: T or F?

Answer 48

T

Question 49

what features would suggests an adrenocortical carcinoma?

Answer 49

large size haemorrhage necrosis frequent, atypical mitosis

Question 50

another name for primary hyperaldosteronism?

Answer 50

conn's syndrome

Question 51

what is a common co-pathology of primary hyperaldosteronism?

Answer 51

diffuse or nodular hyperplasia of both adrenal glands

Question 52

another name for hypercortisolism?

Answer 52

cushings syndrome or disease

Question 53

most common exogenous cause of hypercortisolism?

Answer 53

steroid therapy

Question 54

what can suppress the adrenal cortex leading to adrenocortical hypofunction?

Answer 54

steroid therapy

Question 55

chronic cause of primary adrenocortical insufficiency?

Answer 55

addisons disease

Question 56

what are the 3 common causes of addisons disease?

Answer 56

autoimmune adrenalitis infection lung/breast mets

Question 57

what infections are most likely to predispose to addisons disease?

Answer 57

TB fungal infection HIV

Question 58

most common acute cause of primary adrenocortical insufficiency?

Answer 58

rapid withdrawal of steroids

Question 59

what do electrolyte levels look like in addisons?

Answer 59

decreased sodium | retained potassium

Question 60

what secretes catecholamines?

Answer 60

chromaffin cells in the adrenal medulla

Question 61

what innervates the adrenal medulla?

Answer 61

presynaptic fibres from the sympathetic nervous system

Question 62

2 types of adrenal medulla tumour?

Answer 62

phaeochromocytoma | neuroblastoma

Question 63

when is neuroblastoma most commonly diagnosed?

Answer 63

by 18 months

Question 64

if a neuroblastoma doesnt occur in the adrenal medulla, where does it arise?

Answer 64

sympathetic chain

Question 65

what is phaeochromocytoma a tumour of?

Answer 65

chromaffin cells

Question 66

complications of phaeochromocytoma?

Answer 66

HYPERTENSION | CVD

Question 67

how is phaeochromocytoma diagnosed?

Answer 67

detection of urinary excretion of catecholamines and metabolites

Question 68

which tumour is referred to as the 10% tumour and why?

Answer 68

``` phaeochromocytoma 10% extra adrenal 10% bilateral 10% malignant 10% wont cause hypertension ```

Question 69

what is MEN?

Answer 69

multiple endocrine neoplasia

Question 70

what cancers are present in MEN2A?

Answer 70

phaeochromocytoma medullary thyroid carcinoma parathyroid hyperplasia

Question 71

what cancers are present in MEN2B?

Answer 71

phaeochromocytoma medullary thyroid carcinoma neuroma marfanoid habitus

Question 72

name the 3 zones of the adrenal cortex?

Answer 72

zona glomerulosa zona fasciculota zona reticularis

Question 73

what hormones are contained in the zona glomerulosa?

Answer 73

mineralocorticoids | aldosterone

Question 74

what hormones are contained in the zona fasciculata?

Answer 74

glucocorticoids | cortisol

Question 75

what hormones are contained in the zona reticularis?

Answer 75

sex steroids | glucocorticoids