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Endocrine Two > Pituitary Path > Flashcards

Pituitary Path Flashcards

1
Q

Three manifestations of pituitary disease

A

Hyperpituitarism
Hypopituitarism
Local mass effect

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2
Q

Describe the local mass effect of the pituitary

A

Increased ICP, bitermoral hemoanopsia, pituitary apoplexy

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3
Q

What it this?

Acute hemorrhage into adenoma, leading to rapid enlargement of lesion. Neurosurgical emergency.

A

Pituitary apoplexy

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4
Q

Three causes of hyperpitutarism

A

Pituitary carcinoma
Hypothalamic disorders
PITUITARY ADENOMA

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5
Q

Name the Adenoma subtype: galactorrhea and amenorrhea (F); sexual dysfunction and infertility.

A

Lactotroph adenoma, silent lactotroph adenoma

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6
Q

Name the Adenoma subtype: giantism (chidlren) , acromegaly (Adults)

A

Densely granulated somatotroph adenoma, sparsely granulated somatotroph adenoma, silent somatotroph adenoma

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7
Q

Name the Adenoma subtype: combined features of GH and prolactin excess

A

Mammosomatotroph adenoma

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8
Q

Name the Adenoma subtype: Cushing Syndrome and Nelson Syndrome

A

Corticotroph Adenoma

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9
Q

Name the Adenoma subtype: Hyperthyroidism

A

Thyrotroph adenoma, silent thyrotroph adenoma

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10
Q

Name the Adenoma subtype: hypogonadism, mass effects, hypopotutarism

A

Gonadotroph adenomas, silent gonadotroph adenoma (“Null cell”, oncocytic adenomas)

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11
Q

Pituitary tumor most commonly associated with GNAS GoF mutation

A

GH adenoma (40% of somatotroph adenomas)

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12
Q

Pituitary tumor most commonly associated with PRKAR1A GoF mutation

A

GH and PRL adenomas

*Sporadic

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13
Q

Pituitary tumor most commonly associated with Cyclin D1 GoF mutation

A

Aggressive adenomas

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14
Q

Pituitary tumor most commonly associated with HRAS GoF mutation

A

Pituitary carcinomas

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15
Q

Pituitary tumor most commonly associated with MEN1 LoF mutation

A

GH, PRL, ACTH adenomas

*Sporadic

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16
Q

Pituitary tumor most commonly associated with CDKN1B LoF mutation

A

ACTH adenomas

*Sporadic

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17
Q

Pituitary tumor most commonly associated with AIP LoF mutation

A

GH adenomas (esp in people less than 35 years old)

*Sporadic

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18
Q

Pituitary tumor most commonly associated with RB LoF mutation

A

Aggressive adenomas

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19
Q

Acute hemorrhage into an adenoma associated with clinical evidence of rapid enlargement of the lesion. A neurosurgical emergency.

A

Pituitary Apoplexy (gonadotroph adenoma, hypopituitarism,

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20
Q

Transcription factor expressed on stem cells that differentiate into ant-pit hormones: somatotrophs, mammosomatotrophs, and lactotrophs

A

PIT-1

21
Q

Transcription factors (two) expressed on stem cells that differentiate into gonadotrophs

A

SF-1 and GATA-2

22
Q

Cellular _____ and absence of significant _____ _____ distinguishes pituitary adenomas from nonneoplastic anterior pituitary parenchyma?

A

Monomorphism

Reticulin netowks

23
Q

What genetic characteristic of Atypical Adenomas result in higher propensity for aggressive behavior like invasion and recurrence?

A

TP53 mutatin

24
Q

Chromophobic cells with _____ of PIT-1 TF are known as ______ granulated lactrotroph adenomas

A

juxtanuclear localization

Sparsely granulated lactotroph adenoma

25
Q

Acidophilic cells with _____ PIT-1 expression are known as ____ granulated lactotroph adenomas.

A

Diffuse cytoplasmic

Densely granulated lactotroph adenoma

26
Q

Ranging from isolated psammoma bodies to extensive calcification of virtually the entire lactotroph adenoma tumor mass (“pituitary stone”) – due to what?

A

Propensity of Lactotroph adenomas to undergo dystrophic calcification

27
Q

Major clinical manifestation of Lactotroph adenomas

A

1/4 of all amenorrhea is caused by this

28
Q

Age/sex of people who present with lactotroph adenoma

A

Female, 20-40 years old

29
Q

GF associated with Somatotroph adenoma

A

IGF-1. Because perisitently elevated levels of GH stimulate hepatic secretion fo this.

30
Q

Hyperostosis - define

A

Increase in bone density in spine and hips, seen in acromegaly.

31
Q

Prognathism - define

A

Enlargement of jaw and resultant protrusion, as well as broadening of lower face, seen in acromegaly.

32
Q

Six associations with GH excess (other than gigantism and acromegaly).

A
  1. Gonadal dysfunction
  2. Muscle weakness
  3. HTN
  4. Arthritis
  5. CHF
  6. Increased GI cancer risk
33
Q

seven major causes of hyperPRL-emia other than lactotroph adenomas.

A
  1. Pregnancy
  2. Nipple stimulation
  3. Stress response
  4. Lactotroph hyperplasia
  5. Suprasellar compartment mass
  6. Renal failure HypOthyroidism
34
Q

What type of cells present when somatotrophs adenomas and corticotroph adenoomas when densely granulated?

A

basophilic, monomorphic

35
Q

Both dense and sparsely granulated stain positively for what?

A

PAS

36
Q

Syndrome when a large destructive pituitary adenoma develops after surgical removal of adrenal glands for tx of Cushing Syndrome. Results in loss of inhibitory effect of adrenal CS on preexisting corticotroph adenoma. Results in what?

A

Nelson Syndrome

Results in mass effects of pituitary tumor and hyperpigmentation (ACTH stimulatory effect on melanocytes).

37
Q

Does hypercotisolism develop in Nelson Sydnrome?

A

No. Hypercortisolism does not develop.

38
Q

Adenoma that produces FSH and LH. age/sex

A

gonadotroph, middle aged M/F.

39
Q

Middle age, Presents with vision loss, dipoplia, and possibly pituitary apoplexy

A

Gonadotroph adenoma

40
Q

TSH secreting adenoma

A

Thyrotroph adenoma

41
Q

Rare, but requires craniospinal or systemic metastases for diagnosis.
Most functional, with PRL and ACTH most common secreted hormones.

A

Pituitary carcnoma

42
Q

Postpartum necrosis of anterior pituitary, most commonly form of ____.

A

sheehan syndrome - ischemic necrosis of pituitary, resulting in hypopituitarism

43
Q

Physiological pit expansion during pregnancy = relative hypoxia + any obstetric hemorrhage/shock = infarction of anterior lobe. What is this?

A

sheehan syndrome - ischemic necrosis of pituitary, resulting in hypopituitarism

44
Q

An obese woman (with hx of multiple pregnancies) presents with visual field defects, hyperPRL. When arachnoid mater and CSF herniates into sella, expanding and sella and compressive pituitary. What is this?

A

Primary Empty Sella

45
Q

Tumors that met from what two locations can result in clinical hypopituitarism?

A

Breast and lung

46
Q

Primary empty sella can result in clinical manifestations involving what hormones?

A

GH, LH/FSH, TSH, ACTH, PRL, Melanocyte Stimulating Hormone

47
Q

Bimodal age - 5-15, then 65+
Presentation:
Adults – HA, visual
Children – growth retardation

A

Hypothalamic Supracellar Tumors

48
Q

Morphologic defferences btw adamantinomatous cranipharyngioma and papillary pharyngeoma

A

Papillary - lack keratin, calcification, cysts

Endocrine Two (16 decks)

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