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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
Q

What is Conn’s syndrome

A
  • hyperaldosteronism
  • loss of potassium
  • sodium retention
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26
Q

Name a hypercortisolism condition?

A
  • Cushing’s

- too much cortisol

27
Q

What occurs in Addison’s disease?

A
  • potassium retention

- sodium loss

28
Q

Describe phaeochromocytoma

A
  • a neoplasm derived from chromaffin cells of the adrenal medulla
  • secrete catecholamines
29
Q

Side effects of phaeochromocytoma

A
  • secondary hypertensions
30
Q

Diagnosis of phaeochromocytoma

A
  • urinary excretion of catecholamines and their metabolites
31
Q

Phaeochromocytoma is associated with what?

A
  • MEN 2
32
Q

MEN 2 has what associated conditions?

A
  • phaeochromocytoma
  • medullary thyroid carcinoma
  • parathyroid hyperplasia
33
Q

Neuroblastoma is usually diagnosed by what age?

A
  • 18months
34
Q

What size of tumour defines a microadenoma?

A
  • less than 1cm
35
Q

What size of tumour defines a macroadenoma?

A
  • more than 1cm
36
Q

Non-functioning adenoma of the pituitary can cause what?

A
  • hypoadrenalism
  • Hypothyroidism
  • hypogonadism
  • diabetes insipidus
  • GH deficiency
37
Q

What is the treatment of choice in a non-functioning pituitary adenoma?

A
  • transsphenoidal surgery

- hormonal replacement

38
Q

Prolactin is under positive control from dopamine?

TRUE OR FALSE

A
  • FALSE
  • prolactin is under negative control from dopamine
  • more dopamine = less prolactin
39
Q

What are some physiological causes of raised prolactin?

A
  • breast feeding
  • pregnancy
  • stress
  • dopamine antagonist
  • antipsychotics
40
Q

Pathological causes of a raised prolactin?

A
  • hypothyroidism (TRH increases)
  • Stalk lesions
  • prolactinoma tumour
41
Q

Symptoms in females of prolactinoma?

A
  • galactorrhoea
  • menstrual irregularity
  • amenorrhoea
  • infertility
42
Q

Symptoms in males of prolactinoma?

A
  • late presentation
  • impotence
  • visual field abnormalities
43
Q

Investigations for prolactinoma?

A
  • serum prolactin
  • MRI pituitary
  • visual fields
  • pituitary function test
44
Q

Treatment for prolactinoma?

A
  • cabergoline
45
Q

Acromegaly is caused by what?

A
  • Growth hormone excess
46
Q

Symptoms of acromegaly?

A
  • giant
  • thickened soft tissue
  • snoring
  • hypertension
  • headache
47
Q

Diagnosis of acromegaly?

A
  • IGF1 serum

- GTT suppression test (glucose tolerance)

48
Q

Treatment of acromegaly?

A
  • pituitary surgery
  • radiotherapy
  • somatostatin analogues
    (Sandostatin)
49
Q

What causes cushing’s disease?

A
  • excess cortisol by pituitary disease
50
Q

Cushing disease vs cushing syndrome

A
  • disease = caused by pituitary

- syndrome = another cause

51
Q

Symptoms of cushing syndrome

A
  • protein loss
  • proximal myopathy
  • osteoporosis
  • thin skin - striae
  • obesity
52
Q

How to investigate cushing syndrome?

A
  • 1mg dexamethasone suppression test
53
Q

What are some causes of cushing syndrome?

A
  • not pituitary
  • adenoma of adrenal
  • ectopic production of ACTH
54
Q

Treatment of cushing disease?

A
  • transsphenoidal surgery
  • radiotherapy
  • bilateral adrenalectomy
55
Q

Treatment of cushing syndrome?

A
  • adrenalectomy

- metyrapone

56
Q

Some effects of hypopituitarism?

A
  • growth failure
  • hypothyroidism
  • hypogonadism
  • hypoadrenalism
57
Q

Investigations for pan hypopituitarism?

A
  • 9am ACTH
  • 9am cortisol
  • synacthen test
58
Q

Treatment of hypopituitarism?

A
  • hormone replacement
  • thyroxine
  • hydrocortisone
  • ADH
  • GH
  • Sex steroids
  • testosterone replacement
59
Q

Risks associated with testosterone replacement?

A
  • polycythaemia

- excess RBC in blood

60
Q

Pathology of the posterior pituitary can cause?

A
  • diabetes insipidus
61
Q

What is diabetes insipidus?

A
  • lack of ADH
    (Vasopressin)
  • inability to concentrate urine
62
Q

Investigations for diabetes insipidus?

A
  • water deprivation test

- osmolality ratio <2

63
Q

Treatment of diabetes insipidus

A
  • desmospray

- desmopressin

Endocrinology (16 decks)

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