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HRM - Pathology > Pituitary Pathology > Flashcards

Pituitary Pathology Flashcards

1
Q

What six hormones are produced by the anterior pituitary?

A 
GH
ACTH
TSH
LH
FSH
Prolactin
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2
Q

Which anterior pituitary hormone is under inhibitory control? What inhibits it?

A

Prolactin

Dopamine

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3
Q

Which hormones are produced by acidophils? Basophils?

A

Acidophils: GH, PL
Basophils: FSH, LH, ACTH, TSH (BFLAT)

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4
Q

What hormones are released by the posterior pituitary?

A

Oxytocin, ADH

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5
Q

What is the role of Oxytocin?

A

Labor, milk let-down

Cuddling, monogamy, trust

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6
Q

What are five causes of hyperpituitarism? Which is the most common?

A 
Pituitary adenoma (MOST COMMON)
Destruction of end organs
Hypothalmic disorders
Hyperplasia of anterior lobe
Carcinoma of anterior lobe
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7
Q

What are considered “Mass effects” of pituitary adenomas?

A

Visual deficits, increased ICP, HYPOpituitarism

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8
Q

What genetic endocrine disorder oftentimes sees pituitary adenoma?

A

MEN I

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9
Q

Who most often gets pituitary adenomas?

A

Adults

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10
Q

When is a pituitary adenoma a neurosurgical emergency?

A

When it bleeds

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11
Q

What do pituitary adenomas look like on microscopy?

A

Sheets/cords
Uniform cells of one type
May be pleomorphic
May have mitoses

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12
Q

What is the most common hormone produced by a pituitary adenoma? Least common?

A

Most common: Prolactin

Least common: TSH

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13
Q

What proteins are often mutated in pituitary adenomas?

A

GNAS1
MEN1
RAS/cMYC

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14
Q

What type of protein does GNAS code?

A

G3 protein, leads to increased cAMP

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15
Q

How do men present with a prolactinoma? Women?

A

Men: Decreased libido and headache
Women: Amenorrhea, galactorea

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16
Q

How do you treat prolactinomas?

A

Dopamine receptor agonists:
Bromocryptine
Cabergoline

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17
Q

What do people who present with a GH adenoma before adulthood look like? After?

A

Before: Zach Fredman
After: Andre the Giant

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18
Q

Other than being huge, what can GH adenoma manifest as?

A

Diabetes
Hypertension
Arthritis
GI carcinoma

19
Q

What are common lab findings for a GH adenoma?

A

Increased GH
Increased IGF-1
GH unresponsive to glucose

20
Q

How do you treat a GH adenoma?

A

Octreotide
GH receptor antagonists
Surgery

21
Q

What disease does an ACTH adenoma result in?

A

Cushing Disease

22
Q

What is Nelson Syndrome?

A

Take away adrenal glands’ negative feedback (remove cortisol)
Leads to super growth of pituitary adenoma

23
Q

What are two causes of adrenal Cushing syndrome?

A

Tumor

Nodular hyperplasia

24
Q

What is paraneoplastic Cushing Syndrome?

A

ACTH producing nonendocrine cancer (SCC of Lung)

25
Q

What is iatrogenic Cushing syndrome?

A

Cushing syndrome from long term use of corticosteroids

26
Q

What are causes of Hypopituitarism?

A 
Pituitary destruction
Ischemic necrosis
Empty sella syndrome
Pituitary apoplexy
Hypothalmic lesions
27
Q

How can the pituitary be destroyed?

A

Big pituitary adenoma

Surgery or radiation

28
Q

What are the events leading up to ischemic necrosis of the pituitary?

A

Pituitary gets BIG (Pregnancy, e.g.)
Hemorrhage (delivery) causes hypotension
Pituitary becomes necrotic

29
Q

What syndrome is Pituitary Ischemic Necrosis after pregnancy known as?

A

Sheehan syndrome

30
Q

How does Sheehan syndrome present?

A

Poor lactition
Loss of pubic hair
Fatigue

31
Q

What events lead to Empty Sella Syndrome?

A

Arachnoid or CSF herniation

Pituitary compression

32
Q

What is Pituitary Apoplexy and what are the symptoms?

A

Sudden infarction of adenoma

Meningeal symptoms

33
Q

What hormone is affected first in hypopituitarism?

A

GH

then FSH/LH, TSH, ACTH

34
Q

What are signs of decreased GH?

A

Pituitary dwarfism, muscle weakness

35
Q

What are signs of decreased FSH/LH?

A

Loss of libido

Menstrual abnormalities

36
Q

What are signs of decreased PL?

A

Inability to lactate

37
Q

What are signs of decreased TSH?

A

Hypothyroidism

38
Q

What are signs of decreased ACTH?

A

Adrenal insufficiency

39
Q

What hormone is decreased in central Diabetes Insipidus?

A

ADH

40
Q

What happens to serum osmolality as a result of DI?

A

Serum osmolality increases

41
Q

What happens to serum osmolality in SIADH?

A

Serum osmolality decreases

42
Q

What are some causes of SIADH?

A

SCC of Lung
CNS trauma
Pulmonary infection
Drugs (Cyclophosphamide)

43
Q

How do you treat SIADH?

A

Demeclocycline

HRM - Pathology (10 decks)

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