Pituitary Path Flashcards
Classify the endocrine disorders associated with pituitary gland and describe their clinicopathologic features Explain the signs, symptoms, prognostic implications and classification of pituitary neoplasms. Describe the major endocrine syndromes associated with pituitary gland
most common cause of hyperpituitarism
anterior lobe adenoma
most common genetic ateration in pititary adenomas
GNAS1
genes in familial pituitary adenomas
MEN1, CDKN1B, PRKAR1A, AIP
causes of hypopituitarism
ischemic injury, surgery or radiation, inflammation, nonfunctional pituitary adenomas
anterior pituitary hormones
ACTH, FSH, GH, PRL. TSH, LH
posterior pititary hormones
ADH, oxytocin
stimulatory hypothalmic hormones
CRHm GHRHm GnRH TRH
inhibtory hypothalmic hormones
GIH, PIH
sx of invading pituitary masses
headache, n/v, visual field defects, seizures
rapid enlargement of pituitary lesion causing lowered conciousness
apoplexy
most common combo of hormones secreted by tumors
GH and prolactin
ACTH secreteing tumors cause
cushings, Nelson syndrome
GH secreteing tumors cause
gigantism and acromegaly
prolactin secreteing tumors cause
galactorreha/amenorrhea in females, sexual disfunction and infertility
FSH/LH secreteing tumors cause
hypogonadism
soft, uniform, gelationous pituitary tumors
adenomas
mutation in more aggressive adenomas
TP53
most common type of hyperfunctioning adenoma
prolactinoma
other, non tumor causes of prolactinoma
pregnancy, high-dose estrogen therapy, renal failure, hypothyroidism, hypolathalmic lesions, dopamine inhibiting drugs
inhibits prolactin
dopamine
persistant hypersecretion of GH causes
hepatic secretion of insulin like growth factor 1
besides gigantism/acromegaly, GH excess causes
DM, muscle weakness, hypertension, arthritis, osteporosis, CHF
stain positive with PAS stains
cortiotrophic hormone producing adenomas
large clinically agressive cortiotrophic hormone producing adenomas appearing after removal of adrenal glands
Nelson syndrome
hypercorticolism caused by excessive pituitary production of ACTH
cushing disease
hyperpigmentation may be a sign of
ACTH secreting tumor
post-partum necrosis of anterior pituary after tramautic childbirth
sheehan syndrome
other causes of pituitary necrosis (than sheehan)
DIC, Sickle Cell, elevated intracranial pressure, traumatic injury, shock
results in pituitary dwarfism
GH deficincy
GnRH or gonadotropin deficincy causes what in men
lost of pubic/axillary hair
lack of ADH
central diabetes insipidis
too much ADH usually a sign of
small cell carcinoma of lung or damage to hypothalmus
