Pituitary Pathology

Question 1

Hormones secreted by post pituitary

Answer 1

oxytocin

ADH

Question 2

Classic non-endocrine presentation of pituitary adenoma

Answer 2

bilateral loss of temporal vision fields

because compressing at optic chiasm

Question 3

Most common and least common hormones secreted by pituitary adenoma

Answer 3

most common: prolactin

least common: TSH

Question 4

Tx of prolactinoma

Answer 4

dopamine receptor agonists

Question 5

Frontal bossing

Answer 5

forehead protrudes anteriorly
seen in acromegaly
from GH adenoma

Question 6

ACTH adenoma causes

Answer 6

Cushing’s disease

*specific form of Cushing syndrome due to pituitary tumor that secretes ACTH

Question 7

Nelson syndrome

Answer 7

result of a stupid surgeon

• removal of adrenal glands in setting of Cushing’s disease
• normally adrenal hormones feed back to adenoma
• if adrenals removed, adrenal hormones not produced
• no feedback to adenoma
• explosion in the size of adenoma

Question 8

Hypopituitarism

hormones involved

Answer 8

usually 1 or 2

Question 9

Causes of hypopituitarism

Answer 9

very large pituitary adenoma

surgery/radiation

Question 10

Sheehans syndrome

Answer 10

ischemic necrosis of pituitary
2˚ to hypovolemic shock
ie in setting of birth or directly after

Question 11

Ischemic necrosis, necrosis type pathologically

Answer 11

coagulative necrosis

Question 12

Empty sella syndrome

Answer 12

pituitary compression via arachnoid or CSF herniation
can’t see pituitary anymore on MRI
but it’s probably still there
might cause hypopituitarism

Question 13

Pituitary apoplexy

Answer 13

sudden hemorrhage/infarction of pituitary
meaningeal/painful Sx
often lethal

Question 14

Central diabetes insipidus mechanism

Answer 14

ADH not released from posterior pituitary
urine cannot be concentrated
polyuria

Question 15

SIADH mechanism

Answer 15

increased ADH from pituitary or paraneoplastic
excessive retention of water
hyponatremia and hypertension