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Endocrine II AH > Pituitary - Guerin > Flashcards

Pituitary - Guerin Flashcards

1
Q

What is Sheehan Syndrome?

A

Postpartum necrosis of the anterior pituitary

During pregnancy the ant. Pituitary enlarges twice its normal size

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3
Q

Atypical adenomas have what characteristics?

A

Elevated mitotic activity
P53 expression from TP53 mutations
More likely aggressive, invade

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4
Q

Craniopharyngiomas can bulge where?

Mutation in what?

A

Floor of 3rd ventricle and base of brain

WNT, B-catenin

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5
Q

Hyperostosis is what?

Occurs where?

In what condition?

A

Increased bone density

Spine and hips

Acromegaly

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7
Q

Pts present w/what when they have craniopharyngioma?

Children present w/what?

A

HA, visual disturbances

Growth retardation due to pituitary hypofunction and GH deficiency

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8
Q

How much of the anterior pituitary must be lost to cause hypopituitarism?

A

75%

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10
Q

What are CFs of diabetes insipidus?

A

Thirst and polydipsia
Large V of dilute urine w/low specific gravity
Hypernatremia and hyperosmolar

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12
Q

What are pts w/excess GH at INC risk of developing?

A

GI cancer

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13
Q

Prognosis of craniopharyngioma?

Can transform to what?

A

Excellent

Squamous carcinoma (very Rare)

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14
Q

What can cause pallor?

Due to what?

A

Hypopituitarism

Loss of MSH

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15
Q

What are the most common causes of SIADH?

A

Small-cell carcinoma of the lung
Drugs
CNS disorders

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17
Q

Treatment for somatotroph adenoma?

A

Surgery
Somatostatin
GH receptor antagonist

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22
Q

Nests or cords of stratified squamous epithelium w/peripheral palisading and compact, lamellar keratin is what?

A

Adamantinomatous craniopharyngioma

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23
Q

Pituitary carcinomas are defined by what?

Most are what?

A

Metastases

Functional, commonly PRL and ACTH

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24
Q

Adamantinomatous craniopharyngiomas occur in who?

Typically what?

What kind of reaction?

A

Children

Calcified

Brisk glial reaction

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25
Q

What causes clinical manifestations of hyponatremia, cerebral edema, and neurologic dysfunction?

A

SIADH

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26
Q

Hypopituitarism + post. Pituitary dysfunction (DI) = ?

A

Hypothalamic origin

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27
Q

What indirect pathologic conditions may cause hyperprolactinemia?

A

Renal failure

Hypothyroidism

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28
Q

Excessive ACTH by the pituitary is called what?

Otherwise what?

A

Cushing Disease

Syndrome

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30
Q

Which adenoma is most frequently found in middle-aged men and women causing mass effect and presenting w/impaired vision, HA, diplopia, or pituitary apoplexy?

A

Gonadtroph adenomas

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32
Q

When does Nelson syndrome occur?

What happens to the pt?

A

After surgery to remove adrenal glands to tx Cushing

No hypercortisolism but does get hyperpigmentation bc of ACTH secreting adenoma

35
Q

How does primary empty sella present?

A

Visual field defects, occasionally endocrine anomalies - hyperPRL

36
Q

Sudden hemorrhage into the pituitary gland, often occuring into a pituitary adenoma is what?

A

Pituitary apoplexy

37
Q

Loss of pubic hair and axillary hair in men, decreased libido and impotence indicate what?

A

Gonadotropin deficiency

38
Q

If a patient has DI and desmopressin is given and then the pt’s condition is corrected, what type of DI do they have?

A

Central

Nephrogenic DI will NOT respond to ADH

42
Q

Machine oil is found with what?

Describe the oil

A

Adamantinomatous craniopharyngioma

Cholesterol rich, thick brownish-yellow

43
Q

Nonfunctioning adenomas typically present with what?

A

Mass effects, visual disturbances

44
Q

What causes hypopituitarism in obese females w/multiple pregnancies?

Mechanism?

A

Primary empty sella turcia syndrome

Arachnoid and CSF herniate into sell and compress pituitary

47
Q

What are the corticotrophs?

A

ACTH
POMC
MSH

48
Q

What 2 ways to diagnose excess GH/acromegaly?

A

elevated serum GH and IGF-1

Failure to suppress GH after oral load of glucose

49
Q

Papillary craniopharyngioma occurs in who?

Describe morphologically

A

Adults

Solid sheets and papillae lined by well-diferentiated squamous epithelium

NO peripheral palisading, NO keratin, NO calcification

50
Q

Craniopharyngiomas are typically what?

A

Cystic and sometimes multiloculated

51
Q

Craniopharyngioma arises from what?

Age distribution?

Most are what?

A

remnants of Rathke’s pouch

Bimodal: 5-15 and older than 65 y/o

Suprasellar

54
Q

Lactotroph hyperplasia occurs when there is what?

A

Loss of dopamine-mediated inhibition of prolactin

56
Q

Decreased energy and libido in men and amenorrhea in premenopausal women occurs with what adenoma?

Most commonly what pituitary deficiency?

A

Gonadotrophs

LH

58
Q

What cell types express PIT-1?

A

Somato, Mammo, lactotrophs

Suck My Lips PITch

61
Q

Most common methods to treat hyperprolactinemia?

A

Bromocriptine (DA-agonist)

Surgery

66
Q

What adenomas are PAS (+)?

What type of adenomas are these usually?

A

Corticotrophs adenoma

Microadenomas

67
Q

Dystrophic calcification of psammoma bodies or a pituitary stone is found in what?

A

Lactotroph adenoma

68
Q

Which type of somatotroph adenoma is monomorphic acidophilic w/STRONG reactivity on immunochemistry?

A

Densely granulated

69
Q

Clinical findings seen with excess GH?

A 
Gonadal dysfunction
DM
HTN
Muscle weakness
Arthritis 
CHF
72
Q

Gonadotrophs express what TF?

A

SF-1
GATA-2

San Francisco 2 gays-gonads

73
Q

HA, N, V are signs and symptoms of what?

A

Elevated ICP

74
Q

Mammosomatotroph adenomas make what?

A

GH and PRL

77
Q

Gigantism and acromegaly due to what adenoma cell type?

A

Somatotroph - GH

80
Q

What are the mammosomatotrophs?

A

GH

PRL

81
Q

Densely granulated lactotroph adenoma is what?

Sparsely granulated?

A

Acidophilic

Chromophilic

93
Q

Galactorrhea, amenorrhea in females, sexual dysfunction and infertility due to what adenoma cell type?

What ages common?

A

Lactotroph - PRL

20-40 y/o

94
Q

Uniform, polygonal cells in sheets or cords with NO reticulin (ct) which shows monomorphism is describing what?

A

Pituitary adenoma

95
Q

Local mass effect of the pituitary may compress what?

Causes what?

A

Optic nerves and chiasm

Bitemporal hemianopsia

Endocrine II AH (6 decks)

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