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Endocrinology > Pituitary pathology > Flashcards

Pituitary pathology Flashcards

1
Q

What hormones does the anterior pituitary secrete?

A
  • TSH
  • ACTH
  • FSH
  • LH
  • GH
  • prolactin
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2
Q

What conditions may cause hyperfunction of the pituitary gland?

A
  • adenoma

- carcinoma

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3
Q

What conditions may cause hypofunction of the pituitary gland?

A
  • radiation
  • surgery
  • sudden haemorrhage
  • ischaemic necrosis
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4
Q

What hormones are released from the posterior pituitary?

A
  • ADH

- oxytocin

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5
Q

Diabetes insupidqius is a lack of ____ secretion

A
  • Lack of ADH secretion
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6
Q

SIADH is ectopic production of ____ hormone

A
  • ADH
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7
Q

Pituitary adenomas are associated with _____

A
  • MEN 1
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8
Q

What is the most common cell type for a pituitary adenoma?

A
  • prolactin
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9
Q

Prolactin secreting pituitary adenoma may cause what?

A
  • infertility
  • lack of libido
  • amenorrhea
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10
Q

GH secreting adenoma may cause what?

A
  • Gigantism

- acromegaly

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11
Q

ACTH secreting pituitary adenoma may cause?

A
  • Cushing’s disease
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12
Q

Large adenomas of the pituitary gland may cause what?

A
  • visual field defects
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13
Q

Some causes of pituitary hypofunction?

A
  • primary or metastatic tumours
  • traumatic brain injury
  • subarachnoid haemorrhage
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14
Q

Craniopharyngioma is derived from what?

A
  • remnants of Rathke’s pouch (anterior gland)
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15
Q

Symptoms of carniopharyngioma?

A
  • headaches and visual disturbances
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16
Q

Name 2 syndromes associated with the posterior pituitary

A
  • Diabetes insipidus

- SIADH

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17
Q

Explain the central and nephrogenic effect of diabetes insipidus?

A
  • ADH deficiency

- renal resistance to ADH effects

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18
Q

What are the 2 regions of the adrenal glands?

A
  • Medulla in middle

- Cortex outer

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19
Q

What are the 3 zones of the cortex of adrenal glands?

A
  • zona glomerulosa
  • zona fasciculata
  • zona reticularis
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20
Q

What is the cortex of the adrenal glands responsible for?

A
  • mineralocorticoids (aldosterone)
  • cortisol
  • sex steroids
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21
Q

The medulla of the adrenal glands has what cell type?

A
  • neuroendocrine
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22
Q

Cushing’s is associated with what?

A
  • too much production of cortisol from the cortex of the adrenal glands
  • in response to over secretion of ACTH from anterior pituitary
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23
Q

Addison’s disease is associated with what?

A
  • too little production of cortisol hormones from the adrenal cortex
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24
Q

Name a primary hyperaldosteronism condition?

A
  • Conn’s syndrome
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25
What is Conn's syndrome
- hyperaldosteronism - loss of potassium - sodium retention
26
Name a hypercortisolism condition?
- Cushing's | - too much cortisol
27
What occurs in Addison's disease?
- potassium retention | - sodium loss
28
Describe phaeochromocytoma
- a neoplasm derived from chromaffin cells of the adrenal medulla - secrete catecholamines
29
Side effects of phaeochromocytoma
- secondary hypertensions
30
Diagnosis of phaeochromocytoma
- urinary excretion of catecholamines and their metabolites
31
Phaeochromocytoma is associated with what?
- MEN 2
32
MEN 2 has what associated conditions?
- phaeochromocytoma - medullary thyroid carcinoma - parathyroid hyperplasia
33
Neuroblastoma is usually diagnosed by what age?
- 18months
34
What size of tumour defines a microadenoma?
- less than 1cm
35
What size of tumour defines a macroadenoma?
- more than 1cm
36
Non-functioning adenoma of the pituitary can cause what?
- hypoadrenalism - Hypothyroidism - hypogonadism - diabetes insipidus - GH deficiency
37
What is the treatment of choice in a non-functioning pituitary adenoma?
- transsphenoidal surgery | - hormonal replacement
38
Prolactin is under positive control from dopamine? TRUE OR FALSE
- FALSE - prolactin is under negative control from dopamine - more dopamine = less prolactin
39
What are some physiological causes of raised prolactin?
- breast feeding - pregnancy - stress - dopamine antagonist - antipsychotics
40
Pathological causes of a raised prolactin?
- hypothyroidism (TRH increases) - Stalk lesions - prolactinoma tumour
41
Symptoms in females of prolactinoma?
- galactorrhoea - menstrual irregularity - amenorrhoea - infertility
42
Symptoms in males of prolactinoma?
- late presentation - impotence - visual field abnormalities
43
Investigations for prolactinoma?
- serum prolactin - MRI pituitary - visual fields - pituitary function test
44
Treatment for prolactinoma?
- cabergoline
45
Acromegaly is caused by what?
- Growth hormone excess
46
Symptoms of acromegaly?
- giant - thickened soft tissue - snoring - hypertension - headache
47
Diagnosis of acromegaly?
- IGF1 serum | - GTT suppression test (glucose tolerance)
48
Treatment of acromegaly?
- pituitary surgery - radiotherapy - somatostatin analogues (Sandostatin)
49
What causes cushing's disease?
- excess cortisol by pituitary disease
50
Cushing disease vs cushing syndrome
- disease = caused by pituitary | - syndrome = another cause
51
Symptoms of cushing syndrome
- protein loss - proximal myopathy - osteoporosis - thin skin - striae - obesity
52
How to investigate cushing syndrome?
- 1mg dexamethasone suppression test
53
What are some causes of cushing syndrome?
- not pituitary - adenoma of adrenal - ectopic production of ACTH
54
Treatment of cushing disease?
- transsphenoidal surgery - radiotherapy - bilateral adrenalectomy
55
Treatment of cushing syndrome?
- adrenalectomy | - metyrapone
56
Some effects of hypopituitarism?
- growth failure - hypothyroidism - hypogonadism - hypoadrenalism
57
Investigations for pan hypopituitarism?
- 9am ACTH - 9am cortisol - synacthen test
58
Treatment of hypopituitarism?
- hormone replacement - thyroxine - hydrocortisone - ADH - GH - Sex steroids - testosterone replacement
59
Risks associated with testosterone replacement?
- polycythaemia | - excess RBC in blood
60
Pathology of the posterior pituitary can cause?
- diabetes insipidus
61
What is diabetes insipidus?
- lack of ADH (Vasopressin) - inability to concentrate urine
62
Investigations for diabetes insipidus?
- water deprivation test | - osmolality ratio <2
63
Treatment of diabetes insipidus
- desmospray | - desmopressin

Endocrinology (16 decks)

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