Pituitary Gland

Question 1

Describe Endocrine Signaling

Answer 1

Cell –> Bloodstream –> Cell

Question 2

What 2 things does Endocrine Homeostasis require?

Answer 2

1. Hormone effect on end organ

2. Feedback from the end organ upstream

Question 3

Primary Endocrine Disorders

Answer 3

The issue is within the endocrine tissue

Question 4

Secondary Endocrine Disorders

Answer 4

There is an ectopic problem that is acting on the endocrine tissue to cause an issue

Question 5

Endocrine disorders are either hyperfunctioning or hypofunctioning. What is the most common reason for a primary hyperfunction?

Answer 5

Neoplasia!

Question 6

How does the pituitary gland arise?

Answer 6

Rathke’s pouch from the oral ectoderm pinches off and joins the Infundibular process from the brain

Question 7

The Infundibular process will become? What does it secrete?

Answer 7

Posterior lobe
(neurohypophysis)
– ADH
– Oxytocin

Question 8

Rathke’s Pouch will become? What does it secrete?

Answer 8

Anterior lobe
(Adenohypophysis)
– Prolactin, GH, TSH, FSH, LH, ACTH

Question 9

What is the histo of the posterior lobe?

Answer 9

Axonal neurons

Pituicytes = neuroglial cells

Question 10

What is the histo of the anterior lobe?

Answer 10

Acidophils
Basophils
Chromophobes

Question 11

What 2 things do the Acidophils of the anterior lobe secrete?

Answer 11

Prolactin

GH

Question 12

If the hypothalamus releases CRH, what happens?

Answer 12

• Anterior pituitary releases ACTH

- Adrenal Glands release cortisol

Question 13

If the hypothalamus releases PRF, what happens?

Answer 13

• Anterior pituitary releases PRL (prolactin) to the mammary glands

Question 14

If the hypothalamus releases GH-RH, the anterior pituitary will release GH. Where does GH go and what occurs?

Answer 14

Liver

• -> releases Somatomedins
• -> acts on bone, muscles, etc.

Question 15

Specifically, what usually causes Hyperpituitarism?

Answer 15

Adenomas

=> excess hormone release

Question 16

What can cause the Mass Effect?

Answer 16

Neoplasms
Bleeds
Both

Question 17

The Mass Effect in the pituitary gland is caused by an enlarging mass. If it increases the ICP, what are the signs?

Answer 17

Headache
HTN
N/V
Shallow breathing
Decreased HR
Papilledema

Question 18

What can be compressed with the Mass Effect?

Answer 18

Optic Chiasm

Question 19

If the optic chiasm is compressed with the Mass Effect, what vision disturbance will present?

Answer 19

Bilateral Temporal Hemianopsia

– loss of vision on lateral sides of visual field

Question 20

The Mass Effect can also cause Apoplexy. What is that?

Answer 20

Hemorrhage into Adenoma

Question 21

Normally, the Mass Effect will cause ______ of hormones

Answer 21

UNDERPRODUCTION

Question 22

The Mass Effect causes underproduction of hormones except for which one and why?

Answer 22

Prolactin = ELEVATED

– Its release is inhibited by dopamine and with a mass, there is loss of inhibition

Question 23

A Rathke’s Cleft Cyst is derived from Rathke’s pouch. What histology is present?

Answer 23

Respiratory

– from oral ectoderm

Question 24

What can Rathke’ Cleft Cyst do?

Answer 24

Can compress the pituitary or rupture

–> meningitis/inflammation with the rupture

Question 25

What type of Cranipharyngiomas occur in kids?

Answer 25

Adamantinomatous

Question 26

Sign of an Adamantinomatous Craniopharyngioma in a kid?

Answer 26

Growth retardation from hypopituitarism

Question 27

What type of Craniopharyngioma occurs in adults?

Answer 27

Papillary

Question 28

Signs of a Papillary Craniopharyngioma in an adult?

Answer 28

Increased ICP | Hypopituitarism

Question 29

Craniopharyngiomas are dervied from remnants of Rathke's Pouch. What are 3 histo items that will be seen?

Answer 29

Squamous epithelium Wet keratin Calcified cyst

Question 30

Primary Empty Sella Syndrome

Answer 30

CSF leaks into the sella and compresses the pituitary

Question 31

Secondary Empty Sella Syndrome

Answer 31

Pituitary expands and infarcts leaving an empty sella

Question 32

What is Sheehan Syndrome?

Answer 32

Postpartum necrosis of the Anterior Pituitary

Question 33

Postpartum necrosis of the Anterior Pituitary

Answer 33

Sheehan Syndrome

Question 34

The Anterior pituitary is dependent on venous blood supply. What occurs during labor and delivery to cause Sheehan Syndrome?

Answer 34

Ischemia and infarction | => Necrosis of anterior pituitary postpartum

Question 35

ADH Deficiency

Answer 35

Diabetes Insipidus

Question 36

What occurs with Diabetes Insipidus?

Answer 36

(ADH Deficiency) | - Decreased reclaimed free water

Question 37

What is the symptom with Diabetes Insipidus?

Answer 37

Dilute polyuria

Question 38

With Diabetes Insipidus, there is dilute polyuria. What are the SERUM levels of osmolality and sodium?

Answer 38

Increased serum osmolality | Hypernatremia

Question 39

What should you do to test if Diabetes Insipidus is central or nephrogenic?

Answer 39

Administer DDAVP

Question 40

With Diabetes Insipidus, if you administer DDAVP and there is no change, what type is it?

Answer 40

Nephrogenic

Question 41

With Diabetes Insipidus, if you administer DDAVP and there is an increase in water retention and urine osmolality, what type is it?

Answer 41

Central

Question 42

ADH Excess

Answer 42

SIADH

Question 43

What occurs with SIADH?

Answer 43

(ADH Excess) | - Increased reclaimed free water

Question 44

What are the signs of SIADH?

Answer 44

Concentrated urine with low output amounts Muscle weakness Seizures Mental status changes

Question 45

What are the SERUM levels of osmolality and sodium with SIADH?

Answer 45

LOW serum osmolality | Hyponatremia

Question 46

What symptom will present with both ADH deficiency and excess?

Answer 46

THIRST

Question 47

What is a neoplasm that can cause SIADH?

Answer 47

Small cell lung carcinoma

Question 48

Increased reclaimed free water

Answer 48

ADH excess | SIADH

Question 49

Decreased reclaimed free water

Answer 49

``` ADH deficiency (Diabetes Insipidus) ```