Pituitary Flashcards
What is the most common traumatic cause of compromised pituitary function?
(Williams Chap 8,p232)
Iatrogenic neurosurgical trauma
What pituitary axis is most radiosensitive?
(Williams Chap 8,p232)
GH axis
Most striking determinants of increased fatality in hypopituitarism (Williams Chap 8,p233)
Age at diagnosis
Female
History of craniopharyngioma
The order of diminished trophic hormone reserve function by pituitary compression is:
(Williams Chap 8,p234)
GH > FSH > LH > TSH > ACTH
What level of serum prolactin in a nonpregnant individual is pathognomonic for prolactinoma?
(Williams Chap 9, p239)
PRL level > 500ng/ml
These are slow growing tumors that arise from embryonic squamous remnants of Rathke pouch.
(Williams Chap 9, p 252)
Craniopharyngioma
What is often the earliest feature of Craniopharyngioma?
(Williams Chap 9, p 253)
Diabetes insipidus
What is the major side effect associated with surgery of craniopharyngioma?
(Williams Chap 9, p 253)
Severe postoperative obesity
What carcinoma commonly metastasizes to the pituitary gland?
(Williams Chap 9, p 255)
Breast cancer (37.2%)
What is the most common presenting sign of pituitary metastasis?
(Williams Chap 9, p 255)
Diabetes Insipidus
What is the most common endocrine deficit in Immune Checkpoint Inhibitor-Induced Hypophysitis?
(Williams Chap 9, p257)
Secondary adrenal insufficiency (84%)
Median time to onset following drug administration: 4 months
Pituitary insufficiency is only clinically apparent when approximately ____% of the gland is ischemically damaged.
(Williams Chap 9, p258)
75%
Ischemic damage is limited to anterior lobe
What are environmental factors involved in pituitary tumor pathogenesis?
(Williams Chap 9, p 261)
Irradiation
Estrogen
Which of the ff statements on the pathogenesis of pituitary tumors in FALSE?
A. Pituitary adenomas are polyclonal
B. There is no hyperplasia surrounding adenomas.
C. Surgical resection of well-circumscribed small adenomas leads to biochemical control in 75% of patients.
D. Unrestrained pituitary hormonal hypersecretion persists independent of feedback suppression by elevated target hormones.
E. Hormonal pulsatility pattern is often restored after adenoma resection
(Williams Chap 9, p 261)
A. Pituitary adenomas are monoclonal.
____________ is an alkylating agent that is used to treat aggressive pituitary tumors in patients who have failed to respond to other therapies or who have evidence of pituitary carcinoma.
(Williams Chap 9, p 268)
Temozolomide
What is the most common pituitary tumor associated with MEN 1?
(Williams Chap 9, p 269)
Prolactinoma
For acromegaly who underwent surgery, what is the criteria for remission?
(Williams, Chapter 9, p 289)
Remission:
Normal IGF-1
Nadir glucose suppressed GH < 0.4ug/L OR random GH < 1ug/L
For acromegaly, how long should GH level should be measured after surgery?
(Williams Chap 9, p289)
24 hours
What is the most rigorous marker to assess effectiveness of SRL therapy in acromegaly?
(Williams Chap 9, p289)
IGF-1
The most important determinant of therapeutic responsiveness to SRL in acromegaly is
(Williams Chap 9, p294)
Tumor SST2 expression
What SRL is associated with hyperglycemia and new onset DM in 50% of patients?
(Williams Chap 9, p294)
Pasireotide
What test can differentiate between TSH overproduction by a TSH-secreting tumor and thyroid hormone insensitivity?
(Williams Chap 9, p301)
TRH stimulation test
