Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ENRP > Pituitary Path > Flashcards

Pituitary Path Flashcards

1
Q

describe the physical findings of ICP

A
  • HA, NV
  • bradycardia
  • shallow breathing
  • HTN
  • papilledema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

bilateral temporal hemianopsia is due to

A

compression of the optic chiasm

result of mass effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how will pituitary apoplexy present?

A

s/o excruciating HA, diplopia and hypopituitarism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the most common type of secretory pituitary adenoma?

A

prolactinoma/lactotroph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

describe the presentation of prolactinoma in females

A

galactorrhea and amenorrhea

also: decreased libido, mass effect (more in men), and infertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

describe the presentation of prolactinoma in men

A

decreased libido, HA, and mass effect

also: decreased sperm count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what has this histology?

  • stomal hyalinization with psammoma bodies
  • stains for PIT-1
A

prolactinoma

“pituitary stone” from the calcification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

describe the treatment for prolactinoma

A

dopamine agonists:
bromocriptine, cabergoline

surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

name other causes (5) of hyperprolactinemia in the absence of adenoma

A
  1. pregnancy
  2. lactation/nipple stimulation
  3. loss of DA —> lactotroph hyperplasia
  4. renal failure
  5. hypothyroidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

loss of DA can cause lactotroph hyperplasia, leading to hyperprolactinemia in the absence of adenoma

how can loss of DA occur?

A
  • damage to neurons via truama, stroke
  • drugs (verapamil; antipsychotics, antidepressants; metoclopramide)
  • mass
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

renal failure can leading to hyperprolactinemia in the absence of adenoma

how?

A

producing excess prolactin yet excreting less because of the decreased clearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

hypothyroidism can lead to hyperprolactinemia in the absence of adenoma

how?

A

increased TRH can stimulate PRL production due to a cross-reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the LAM

A

lactational amenhorrhea method

if a woman is breast feeding, a state of elevated PRL, she will maintain anovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how do you diagnose a somatotroph?

A
  • increased GH
  • increased IGF-1
  • oral glucose tolerance test (lack of GH suppression)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

describe the features of acromegaly in adults

A
  • jaw, spaid-like hands, feet
  • tongue
  • visceral organs (cardiac failure)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

secondary DM is present in somatotrophs

how?

A

GH induces liver gluconeogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

GH induces somatomedin (IGF), describe the effects

A
  • increased linear growth of bone
  • increased organ size
  • decreased adiposity
  • increased lean body mass
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

with respect to somatotrophs, five elements cause negative inhibition of the hypothalamus. what are they?

A
  1. GHRH*
  2. GH*
  3. Glucose
  4. FFA
  5. somatomedin/IGF*

*negative feedback

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

with respect to somatotrophs, what does the hypothalamus secrete to inhibit the pituitary gland and release of GH?

A

somatostatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

in the world of somatotrophs

does somatomedin inhibit the hypothalamus or the pituitary gland?

A

IGF has negative feedback to both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the treatment for somatotrophs?

A
  • somatostatin analog: octreotide
  • GH receptor antagonists
  • surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

40% of somatotrophs have what mutation?

A

GNAS

somatic mutation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what does GNAS encode?

A

Gs-alpha

24
Q

name the chromosome location of GNAS

A

20q13

25
Q

what causes cushing disease?

A

corticotroph adenoma

it will present with cushing syndrome because that is hypercortisolism and all of its baggage: central obesity, diabetes, vellous hirsutism, adrenal hyperplasia, violaceous striate, thin skin…the list goes on

but only corticotroph adenoma can cause cushing disease

26
Q

PAS+

A

corticotroph adenoma

POMC is precursor to ACTH and B-endorphin

27
Q

SF-1, GATA-2

A

gonadotrophs

28
Q

paraneoplastic cushing syndrome

name the three possible ectopic causes

A
  1. small cell carcinoma of the lung
  2. pancreatic carcinoma
  3. neural tumor
29
Q

elevated ACTH in the inferior petrosal sinus means the source is

A

pituitary

30
Q

elevated plasma cortisol
suppressed corticotropin level
(no suppression on dexamethasone)

A

adrenal tumor or hyperplasia

diagnose with CT; will have low ACTH after CRH stimulation test b/c ACTH-independent

31
Q

elevated plasma cortisol
elevated corticotropin level
suppression on high-dose dexamethasone

A

corticotroph adenoma/cushing disease

diagnose with MRI; elevated ACTH after CRH stimulation b/c ACTH-dependent

32
Q

elevated plasma cortisol
elevated corticotropin level
no suppression on high-dose dexamethasone

A

ectopic source
(small cell lung carcinoma, pancreatic carcinoma, neural tumor–all paraneoplastic)

diagnose with MRI; elevated ACTH after CRH stimulation b/c ACTH-dependent

33
Q

describe the treatment for corticotroph adenoma

A
  • somatostatin analogs
  • bromocriptine
  • surgical excision

(corticotroph adenomas express DA receptors and somatostatin receptors)

34
Q

how will a patient with Nelson syndrome present?

A

hyperpigmentation as a result of greatly elevated ACTH (a-MSH stimulated by ACTH)

  • pre-existing corticotroph microadrenoma grows b/c no inhibition from adrenal corticosteroids
35
Q

TPIT

A

corticotroph

36
Q

USP8 mutation

A

corticotroph; results in EGFR upregulation

somatic mutation

37
Q

AIP

A

somatotroph

familial mutation

38
Q

well-circumscribed
erodes bone
bleed

A

adenoma

39
Q

poorly circumscribed

invade brain

A

aggressive adenoma

40
Q

where does pituitary carcinoma metastasize?

A

throughout the brain

v. rare

41
Q

rupture of what can result in inflammation of the pituitary or meningitis?

A

rathke’s cleft cyst

ciliated columnar epithelium

42
Q

10 yr old with growth retardation d/t hypopituitarism likely has

A

adamantinomatous craniopharyngioma

WNT mutation —> B-catenin

43
Q

65 yr old with ICP or hypopituitarism, consider

A

papillary craniopharyngioma

44
Q

solid, multiloculated/cystic mass impinging on optic chiasm describes

A

craniopharyngioma

45
Q

cranipharyngiomas are derived from

A

rathke’s pouch

46
Q

histology showing:

squamous epithelium
wet keratin
dystrophic, calcified cyst

A

craniopharyngioma

47
Q

CSF leaking into the sella causes

A

primary sella syndrome – compresses the pituitary

usually an obese mxparous woman with vision changes

48
Q

expansion of the pituitary resulting in infarct causes

A

secondary empty sella syndrome

49
Q

postpartum woman presents with failure of lactation, loss of pubic hair, fatigue, and hypotension

A

sheehan syndrome – necrosis of anterior pituitary

50
Q

describe the pathogenesis of loss of pubic hair in sheehan syndrome

A

no LH from AP, so no androgens to produce pubic hair

51
Q

is the anterior pituitary mostly dependent on arterial or venous supply?

A

venous

52
Q
  • increased serum osmolality, hypernatremia
  • dilute, excessive urine
  • polyuria
A

diabetes insipidus – central or nephrogenic

53
Q

if the kidney responds to DDAVP with increased water retention and increased urine sodium/osmolality, what kind of diabetes insipidus is it?

A

central DI

54
Q
  • mental status changes, seizures
  • muscle weakness
  • hyponatremia
  • hypernatriuria
A

SIADH

55
Q

name the causes of SIADH

A
  1. small cell carcinoma of the lung
  2. TBI/SAH
  3. SSRIs
  4. pulmonary infection
  5. COPD
  6. cyclophosphamide
56
Q

name two drugs that cause nephrogenic DI

A

lithium, demeclocycline

ENRP (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions