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Hormonal & Reproductive Week 1 - WLB > Pituitary Pathology - Krafts > Flashcards

Pituitary Pathology - Krafts Flashcards

1
Q

What hormones does the anterior pituitary secrete?

A

GH, ACTH, TSH, LH, FSH, and prolactin.

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2
Q

What hormones does the posterior pituitary store?

A

Oxytocin, ADH (vasopressin)

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3
Q

What five things can cause Hyperpituitarism?

A
  1. pituitary adenoma
  2. destruction of end organs
  3. hypothalamic disorders
  4. hyperplasia of anterior lobe
  5. carcinoma of anterior lobe
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4
Q

What are the clinical findings in a pt with Pituitary Adenoma?

A

None, at first (Common incidental finding)

Endocrine abnormalities (sometimes)

Mass effects: visual deficits, increased intracranial pressure, HYPOpituitarism

Rarely, can be “invasive”

Can bleed suddenly

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5
Q

What visual fields are impaired with a Pituitary Adenoma?

A

Loss of vision in bilateral lateral fields (temporal fields)

AKA = bitemporal hemianopsia

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6
Q

What is the microscopic appearance of a Pituitary Adenoma?

A

Sheets/cords

Uniform cells of one type

May be pleomorphic (bad, cells look different from each other)

May have mitoses

Can’t tell hormonal type

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7
Q

What is the most common secreting-type of Pituitary Adenoma? Least common?

A

Most common = Prolacting-producing

Least common = TSH-producing

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8
Q

What is a Prolactinoma?

A

Commonest type of pituitary adenoma

Efficiently secretes prolactin

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9
Q

What are the two main symptoms of a Prolactinoma?

A

Amenorrhea, galactorrhea

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10
Q

What is the treatment for a Prolactinoma?

A

Can treat with dopamine receptor agonists

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11
Q

What are the symptoms of a Growth Hormone Adenoma?

A

Gigantism (Pre-pubertal adenoma) => Very tall, Very very long arms, legs

Acromegaly (Post-pubertal adenoma) => Very tall, Enlarged bones of face, hands

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12
Q

What are some other manifestations of a Growth Hormone Adenoma other than getting tall/big?

A

Diabetes mellitus
Hypertension
Arthritis
Gastrointestinal carcinoma

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13
Q

What are the laboratory findings in a Growth Hormone Adenoma?

A

↑ GH (spurts)
↑ IGF-I (better)
GH unresponsive to glucose

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14
Q

What are the consequences of an ACTH Adenoma?

A

Makes ACTH

Cushing syndrome

Cushing disease (only when cushing syndrome due to ACTH adenoma)

Nelson syndrome (remove adrenals => no cortisol => no negative feedback => explosive growth of adenoma)

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15
Q

What are the five potential causes of Hypopituitarism?

A

Pituitary destruction

Ischemic necrosis

Empty sella syndrome

Pituitary apoplexy

Hypothalamic lesions

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16
Q

What causes pituitary destruction?

A

big pituitary adenoma (if they get big enough => compress remaining pituitary)

surgery or radiation

17
Q

What happens in ischemic necrosis of the pituitary?

A

Pituitary gets BIG, blood flow stays same

Hemorrhage (delivery after ischemia) causes hypotension

Pituitary (already hypoxic) becomes necrotic

Pregnancy => sheehen syndrome?

18
Q

What is Empty Sella Syndrome?

A

Arachnoid, CSF herniation

Pituitary compression

Usually NO hypopituitarism!

19
Q

What is a Pituitary Apoplexy?

A

Sudden infarction of adenoma

Meningeal symptoms

Can be deadly (can look like a stroke)

20
Q

What are the clinical findings in Hypopituitarism?

A

Insidious, chronic (HARD TO DX)

One or two hormones

Panhypopituitarism rare

GH, then FSH/LH, TSH, ACTH

21
Q

What are the consequences of decreased GH, FSH, LH, PL, TSH, ACTH?

A

↓GH => pituitary dwarfism, pituitary dwarfism

↓FSH/LH=> loss of libido, menstrual abnormalities

↓PL => inability to lactate

↓TSH => hypothyroidism

↓ACTH => adrenal insufficiency

22
Q

What is the two Posterior Pituitary Syndromes that we need to know?

A
  1. Diabetes Syndrome

2. SIADH

23
Q

Diabetes insipidus

A 
Central or nephrogenic
↓ ADH
Pee dilute urine (would taste sweet)
Serum osmolality increases
Head trauma, tumors, alcohol consumption
Increase water intake
24
Q

Syndrome of Inappropriate ADH Secretion (SIADH)

A 
↑ ADH
Retain water 
Blood becomes hypotonic
Usually mild, sometimes bad
Ectopic ADH production (small-cell lung CA)
Decrease water intake

Hormonal & Reproductive Week 1 - WLB (13 decks)

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