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Endocrine Pathology > Pituitary > Flashcards

Pituitary Flashcards

1
Q

What is autocrine stimulation?

A

When a cell stimulates itself

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2
Q

What is paracrine signaling?

A

When a cell produces a signal that affects nearby cells

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3
Q

What is endocrine stimulation?

A

When a gland produces a hormone thay travels through the bloostream and had an effect on a distant target tissue

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4
Q

The major disorders of an endocrine gland are?

A

Hypofunction, Hyperfunction and disorders secondary to benign and malignant tumors

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5
Q

The pituitary gland sits in the

A

Sella turcica

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6
Q

The adenohypophysis is mostly composef of

A

Epithelial cells

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7
Q

The neurohypophysis is composed of ?

A

Dual circulation, portal system and capillary plexus (gomitoli)

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8
Q

The anterior pituitary is composed of?

A

Cords or nests of cells

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9
Q

The anterior pituitary has a…

A

Highly vascular stroma

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10
Q

Do chromophobes have minimal or no hormonal content/granules?

A

Yes

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11
Q

What do acidophils cells contain?

A

Polypeptide hormones

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12
Q

What do basophilic cells contain?

A

Glycoprotein hormones

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13
Q

How do corticotroph cells stain and what do they secrete?

A

Basophilic and ACTH

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14
Q

How do thyrotrophs cells stain and what do they secrete?

A

Basiphilic and TSH

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15
Q

How do gonadotrophs stain and what do they secrete?

A

Basophilic and FSH and LH

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16
Q

How do somatotrophs stain and what do they secrete?

A

Esosinophilic and GH

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17
Q

How do lactotrophs stain and what do they secrete?

A

Eosinophilic and prolactin

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18
Q

How do chromophobes stain?

A

Pale

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19
Q

The posterior pituitary is a..

A

Continuation of the hypothalamic region of the brain

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20
Q

Does the posterior pituitary have a synthesis function?

A

No

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21
Q

The posterior pituitary contains the…

A

Axons of neuronal cells

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22
Q

The posterior pituitary is related to which nuclei?

A

Supraoptic and paraventricular nuclei

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23
Q

The posterior pituitary contaisn

A

Pituicyted and support glial cells

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24
Q

Oxytocin and ADH are stored in?

A

The posterior pituitary

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25
pituitary adenomas are ...
The most common adenohypophysial tumours
26
Pituitary adenomas can be
Functioning or nonfunctioning
27
Pituitary adenomas are classified by
Cell types
28
The most common pituitary adenoma is a
Prolactinoma
29
The second modt common pituitary adenoma is the
Growth hormone
30
The MEN-1 gene codes for a...
Transcription regulator
31
What cells are associated with MEN-1 mutations?
Somatotrophs, lactotrophs, or corticotrophs
32
The GNAS gene encodes for a..
Alpha subunit of stimulatory G-protein
33
What is the most common pituitary tumor associated with a GNAS mutation?
Somatotroph adenoma
34
Microadenomas are less than how many centimeters?
Less than 1 cm
35
Macroadenomad have a diameter of
More than or equal to 1cm to less than 4cm
36
Giant adenomas have a diameter of
More than or equal to 4cm
37
Most pituitary adenomas are
Asymptomatic
38
How is prolactinemia defined?
100 ng/mL but may be as low as 30 to 50 ng/mL
39
What are some clinical symptoms of prolactinemia?
Amenorrhea, galactorrhea, and infertility
40
What are other clinical symptoms of a prolactinemia?
Decreased libido | Impotence
41
The second most common pituitary adenoma is the
Somatotroph adenoma
42
The somatotroph adenoma is mostly a
Macroadenoma
43
Somatotrophs adenoma is
Sporadic
44
Somatotroph adenoma is associated to the
Carney syndrome
45
Growth hormone stimulates what?
The hepatic secretion of insulin-like growth factor -1 which is responsible for many of the clinical manifestations
46
Gigantisim occurs before what closes?
The epiphyseal plates
47
95% of patients with acromegaly harbor a GH- secreting pituitary adenoma
48
what is the most common reason a patient with acromegaly passed away?
Cardiovascular problems
49
A corticotroph adenoma is fue to an excess of?
ACTH
50
Corticotrophs adenomas are mostly
Intrasellar microadenomas
51
Corticotrophs adenomas stain how?
Intensely basiphilic
52
The corticotroph adenoma cells can present with
Crooke hyalinization (Crooke change) Ring-like deposition of cytokeratin Aggressive natural history
53
Most gonadotrope adenomas are
Hormonally inactive
54
Gonadotrope adenomas grow in which pattern?
Diffuse
55
Gonadotrope adenomas are...
Chromophobic and PAS negative
56
Do gonadotrope adenomad proliferate slowly?
Yes
57
Thyrotrope adenomas are the...
Rarest of all types of adenomas
58
In thyroid adenomas the patients can present with
Hyperthyroidism, goiter or a pituitary mass lesion
59
In thyrotrope adenomas there is immunoreactivity to
TSH beta, alpha-subunit, GH, PRL, and sometimes ACTH
60
The cells in thyrotrope adenomas will be
Chromophobic
61
Invasive and fibrotic macroadenomas can be seen in
Thyrotrope adenomas
62
Plurihormonal tumors are
Rare
63
Plurihormonal adenomas are
Aggressive
64
Plurihormonal adenomas include GH and Prolactin
65
Do null-cell adenomas secrete hormones?
No
66
Do null-cell adenomas exhibit a mass effect?
Yes
67
Null-cell adenomas involve which type of cells?
Oncocytomas
68
Pituitary carcinomas are undistinguishable from?
Adenomas
69
Pituitary carcinomas can be functional due to
Prolactinomad and acth
70
Pituitary carcinomas can have
Cerebrospinal and extracranial sites
71
Hypopituitarism result from diseases of either the hypothalamus or the
Pituitary
72
During pregnancy, the pituitary gland enlarges due
Estrogen stimulation
73
There can be infarction of the pituitary gland after
Post partum hemorrhage
74
What is diabetes insipidus?
Large volumes of urine, that is hypotonic, dilute, and tastless
75
What happens in hypothalamic/central diabetes insipidus?
There is diminished synthesis or secretion of vasopressin
76
What occurs in diabetes insipidus of pregnancy?
Increased enzymatic metabolism of vasopressin
77
What occurs in nephrogenic diabetes insipidus?
Renal resistance to vasopressin
78
In central diabetes insipidus there is
Decreased release of ADH and variable degree of polyuria
79
Central diabetes insipidus is caused by disorders that act at one or more of the sites involved in ADH secretion
The hypothalamic osmoreceptors Supraoptic or paraventricular nuclei Superior portion of the supraopticohypophyseal tract
80
30-50% of central diabetes insipidus will be categorized as?
Idiopathic
81
What other conditions can cause diabetes insipidus?
Germinomas, craniopharyngioma, trauma/surgery, metastases to the hypothalamus and long portal vessels ( e.g carcinoma of the breast and lung), granulomatosis diseases (Langerhans cell histiocytosis, sarcoidosis, non-langerhans cell histiocytosis, tuberculosis, lymphocytic infundibulo-hypophysitis
82
What can be found in SIADH?
High plasma ADH levels, decrease in osmotic pressure of the body fluids, hypoosmolality and hyponatremia, cerebral edema, water retention
83
In SIADH, although total body water is increased, what remains normal?
Blood volume and perioherla edema doesn not develop
84
What is the schwartz and barrter clinical criteria for SIADH?
1. Decreasef effevtive osmolality of the extracellular fluid. Pseudohyponatremia or hyperglycemia alone must be excluded 2. Inappropriate urinary concentration at some level of hypoosmolality 3. Clinical euvolemia 4. Elevated urinary sodium excretion while on a nornal salt and water intake 5. Absence of other potential causes of euvolemic hypoosmolality
85
What is an important cause of SIADH?
Pulmonary tumors
86
What is another important cause of SIADH?
Drugs

Endocrine Pathology (3 decks)

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