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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
Q

pituitary adenomas are …

A

The most common adenohypophysial tumours

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26
Q

Pituitary adenomas can be

A

Functioning or nonfunctioning

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27
Q

Pituitary adenomas are classified by

A

Cell types

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28
Q

The most common pituitary adenoma is a

A

Prolactinoma

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29
Q

The second modt common pituitary adenoma is the

A

Growth hormone

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30
Q

The MEN-1 gene codes for a…

A

Transcription regulator

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31
Q

What cells are associated with MEN-1 mutations?

A

Somatotrophs, lactotrophs, or corticotrophs

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32
Q

The GNAS gene encodes for a..

A

Alpha subunit of stimulatory G-protein

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33
Q

What is the most common pituitary tumor associated with a GNAS mutation?

A

Somatotroph adenoma

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34
Q

Microadenomas are less than how many centimeters?

A

Less than 1 cm

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35
Q

Macroadenomad have a diameter of

A

More than or equal to 1cm to less than 4cm

36
Q

Giant adenomas have a diameter of

A

More than or equal to 4cm

37
Q

Most pituitary adenomas are

A

Asymptomatic

38
Q

How is prolactinemia defined?

A

100 ng/mL but may be as low as 30 to 50 ng/mL

39
Q

What are some clinical symptoms of prolactinemia?

A

Amenorrhea, galactorrhea, and infertility

40
Q

What are other clinical symptoms of a prolactinemia?

A

Decreased libido

Impotence

41
Q

The second most common pituitary adenoma is the

A

Somatotroph adenoma

42
Q

The somatotroph adenoma is mostly a

A

Macroadenoma

43
Q

Somatotrophs adenoma is

A

Sporadic

44
Q

Somatotroph adenoma is associated to the

A

Carney syndrome

45
Q

Growth hormone stimulates what?

A

The hepatic secretion of insulin-like growth factor -1 which is responsible for many of the clinical manifestations

46
Q

Gigantisim occurs before what closes?

A

The epiphyseal plates

47
Q

95% of patients with acromegaly harbor a GH- secreting pituitary adenoma

A
48
Q

what is the most common reason a patient with acromegaly passed away?

A

Cardiovascular problems

49
Q

A corticotroph adenoma is fue to an excess of?

A

ACTH

50
Q

Corticotrophs adenomas are mostly

A

Intrasellar microadenomas

51
Q

Corticotrophs adenomas stain how?

A

Intensely basiphilic

52
Q

The corticotroph adenoma cells can present with

A

Crooke hyalinization (Crooke change)
Ring-like deposition of cytokeratin
Aggressive natural history

53
Q

Most gonadotrope adenomas are

A

Hormonally inactive

54
Q

Gonadotrope adenomas grow in which pattern?

A

Diffuse

55
Q

Gonadotrope adenomas are…

A

Chromophobic and PAS negative

56
Q

Do gonadotrope adenomad proliferate slowly?

A

Yes

57
Q

Thyrotrope adenomas are the…

A

Rarest of all types of adenomas

58
Q

In thyroid adenomas the patients can present with

A

Hyperthyroidism, goiter or a pituitary mass lesion

59
Q

In thyrotrope adenomas there is immunoreactivity to

A

TSH beta, alpha-subunit, GH, PRL, and sometimes ACTH

60
Q

The cells in thyrotrope adenomas will be

A

Chromophobic

61
Q

Invasive and fibrotic macroadenomas can be seen in

A

Thyrotrope adenomas

62
Q

Plurihormonal tumors are

A

Rare

63
Q

Plurihormonal adenomas are

A

Aggressive

64
Q

Plurihormonal adenomas include GH and Prolactin

A
65
Q

Do null-cell adenomas secrete hormones?

A

No

66
Q

Do null-cell adenomas exhibit a mass effect?

A

Yes

67
Q

Null-cell adenomas involve which type of cells?

A

Oncocytomas

68
Q

Pituitary carcinomas are undistinguishable from?

A

Adenomas

69
Q

Pituitary carcinomas can be functional due to

A

Prolactinomad and acth

70
Q

Pituitary carcinomas can have

A

Cerebrospinal and extracranial sites

71
Q

Hypopituitarism result from diseases of either the hypothalamus or the

A

Pituitary

72
Q

During pregnancy, the pituitary gland enlarges due

A

Estrogen stimulation

73
Q

There can be infarction of the pituitary gland after

A

Post partum hemorrhage

74
Q

What is diabetes insipidus?

A

Large volumes of urine, that is hypotonic, dilute, and tastless

75
Q

What happens in hypothalamic/central diabetes insipidus?

A

There is diminished synthesis or secretion of vasopressin

76
Q

What occurs in diabetes insipidus of pregnancy?

A

Increased enzymatic metabolism of vasopressin

77
Q

What occurs in nephrogenic diabetes insipidus?

A

Renal resistance to vasopressin

78
Q

In central diabetes insipidus there is

A

Decreased release of ADH and variable degree of polyuria

79
Q

Central diabetes insipidus is caused by disorders that act at one or more of the sites involved in ADH secretion

A

The hypothalamic osmoreceptors
Supraoptic or paraventricular nuclei
Superior portion of the supraopticohypophyseal tract

80
Q

30-50% of central diabetes insipidus will be categorized as?

A

Idiopathic

81
Q

What other conditions can cause diabetes insipidus?

A

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
Q

What can be found in SIADH?

A

High plasma ADH levels, decrease in osmotic pressure of the body fluids, hypoosmolality and hyponatremia, cerebral edema, water retention

83
Q

In SIADH, although total body water is increased, what remains normal?

A

Blood volume and perioherla edema doesn not develop

84
Q

What is the schwartz and barrter clinical criteria for SIADH?

A
  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
Q

What is an important cause of SIADH?

A

Pulmonary tumors

86
Q

What is another important cause of SIADH?

A

Drugs

Endocrine Pathology (3 decks)

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