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ENR Biweekly 2 > Roveda- pathology of pituitary > Flashcards

Roveda- pathology of pituitary Flashcards

1
Q

sits in sella turcica that is posterior from sphenoid sinus

A

pituitary gland

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2
Q

normal size of pituitary gland

A

1 cm

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3
Q

L
R

A

L: posterior pituitary
R: anterior pituitary

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4
Q

anterior pituitary is derived from ____

A

oral surface ectoderm

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5
Q

posterior pituitary is derived from _____

A

neuroectoderm

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6
Q

hormones of the anterior pituitary are produced where

A

anterior pituitary

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7
Q

hormones of posterior pituitary are produced where

A

hypothalamus

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8
Q
A

anterior pituitary cells

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9
Q

acidophils from anterior pituitary

A

somatotropes (GH)
lactotropes (PRL)

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10
Q

basophils of anterior pituitary

A

corticotropes (ACTH)
gonadotropes (FSH, LH)
thyrotropes (TSH)

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11
Q
A

posterior pituitary

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12
Q

Excess hormones
Usually limited to 1 anterior hormone

A

hyperpituitarism

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13
Q

Deficiency hormones
Usually involves all anterior hormones

A

hypopituitarism

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14
Q

Bitemporal hemianopsia due to compression of the optic chiasm (if they have an enlargement of pituitary gland)

A

tunnel vision (peripheral vision messed up)

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15
Q

sx’s of elevated intracranial pressure due to pituitary disease

A

N/V, HA

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16
Q

manifestation of pituitary disease with sudden hemorrhage and necrosis into pituitary gland—-acute onset of sx’s

A

pituitary apoplexy

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17
Q

main 2 causes of hyperpituitarism

A

pituitary adenoma
ectopic hormone production by extra pituitary tumors

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18
Q

can be functional or silent
invasive/non-invasive
micro or macro

A

pituitary adenomas

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19
Q

size of microadenoma

A

<1 cm

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20
Q

size of macroadenoma

A

> 1 cm

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21
Q

to diagnose pituitary adenoma

A

IHC stain
labs
radiography

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22
Q

L
R

A

L: pituitary adenoma
R: bone marrow b/t bone spicules

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23
Q

monotonous population of cytologically uniform cells

A

pituitary adenoma

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24
Q

pituitary ___adenoma compressing optic chiasm

A

macroadenoma

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25
Q
A

pituitary microadenoma

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26
Q
A

pituitary adenomas

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27
Q

4 most common pituitary adenomas

A

prolactin cell adenoma
GH cell adenoma
ACTH cell adenoma
mixed GH-PRL adenoma

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28
Q
A

pituitary adenoma

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29
Q

Excess hormone
Hypopituitarism (non-functioning adenomas)(if the adenoma is compressing normal pituitary tissue)
Mass effect resulting in visual field defects

A

pituitary adenoma

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30
Q

most common functioning pituitary tumor

A

prolactinomas

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31
Q

elevated ____ causes amenorrhea and galactorrhea, loss of libido and infertility in women

A

increased PRL

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32
Q

elevated _____causes impotence and gynecomastia in males

A

PRL

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33
Q

elevated _____-levels inhibit secretion of GnRH which leads to decreased FSH and LH, which leads to decreased progesterone, estrogen and testosterone which leads to amenorrhea and loss of libido

A

PRL

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34
Q

pregnancy
lactation
hypothyroidism
renal failure
interference with dopamine inhibition

A

other causes of elevated prolactin

35
Q

in hypothyroidism, elevated ____ upregulates prolactin

A

TRH

36
Q

can cause what

A

elevated prolactin

37
Q

treatment for prolactinoma

A

transphenoidal surgery
dopamine receptor agonists

38
Q

increase in _____ increases IGF-1
these act in conjunction to cause overgrowth of bones and muscle

A

GH

39
Q

can cause gigantism in children before epiphyses closure

A

GH adenoma

40
Q

can cause acromegaly in adults (after epiphyses closure)
also can be due to brain injury

A

GH adenoma

41
Q

____ and ____ can cause visceral growth and bone growth

A

acromegaly and gigantism

42
Q

hyperostosis spine
prognathism (protrusion of jaw)
cardiomyopathy

A

acromegaly and gigantism

43
Q

to diagnose GH adenoma

A

elevated serum IGF-1
Imaging

44
Q

to treat GH adenoma

A

transphenoidal surgery
Octreotide

45
Q

Leads to adrenal hypersecretion of cortisol resulting in Cushing disease / syndrome

A

ACTH cell adenoma

46
Q

pituitary adenoma is producing ACTH and acting on adrenal glands and increase in cortisol which results in cushings syndrome

A

Cushing disease

47
Q

cushing ___ can be caused by other factors not just pituitary adenoma

A

syndrome

48
Q

___ and ___ are formed from the cleavage of POMC (proopiomelanocortin)

A

ACTH and MSH

49
Q

patients with ____ often have hyperpigmented skin

A

Cushing syndrome

50
Q

Truncal obesity and thin extremities and buffalo hump; abdominal striae

A

Cushing disease/syndrome

51
Q
A

Cushing syndrome

52
Q

other adenomas may come to clinical attention due to mass effect and/or ______ (compression of normal pituitary tissue)

A

hypopituitarism

53
Q

decrease secretion of anterior pituitary hormones

A

hypopituitarism

54
Q

associated w/ posterior pituitary deficiencies

A

hypopituitarism originating in hypothalamus

55
Q

tumors/lesions
brain injury
surgery
pituitary apoplexy
sheehan syndrome
empty sella syndrome

A

can all cause hypopituitarism

56
Q

postpartum hemorrhage resulting in hypovolemic shock and ischemic necrosis of the pituitary

A

Sheehan syndrome

57
Q

____ can grow so large it can compress normal functioning pituitary tissue

A

tumors/lesions

58
Q

(defect in sella turcica); arachnoid tissue going into where pituitary sits and compression

A

empty sella syndrome

59
Q

treat pituitary deficiencies

A

surgery
or
replace target gland hormone

60
Q

most life threatening pituitary deficiency is ______

A

ACTH deficiency

61
Q
A

pituitary apoplexy

62
Q

red and dead

A

pituitary apoplexy

63
Q

postpartum necrosis of anterior pituitary gland
usually associated w/ obstetric hemorrhage/shock

A

Sheehan syndrome

64
Q

failure to lactate, CV collapse, hypothyroidism

A

Sheehan syndrome

65
Q

enlarged and empty sella turcica
CSF and arachnoid can herniate into sella

A

empty sella syndrome

66
Q

2 main posterior pituitary syndromes

A

diabetes insipidus
SIADH

67
Q

promotes uterine contraction
stimulates myoepithelial cells breast-milk letdown
released in response to suckling and cervix dilation

A

oxytocin

68
Q

Released in response to increased plasma osmotic pressure, left atrial distention, exercise and certain emotional states.
Results in water resorption in the collecting tubules of the kidney

A

ADH (vasopressin)

69
Q

due to ineffective ADH axis
inappropriately dilute urine

A

diabetes insipidus

70
Q

Excessive urination (polyuria) due to an inability of the kidney to resorb water properly from the urine

A

Diabetes insipidus

70
Q

increase water intake
psychiatric patients
(differential for diabetes insipidus)

A

primary polydipsia

70
Q

functions to concentrate urine and conserve water

A

ADH

71
Q

Absence/insufficient ADH

A

Central Diabetes Insipidus

72
Q

Renal resistance to ADH
Normal ADH secretion (kidney just unresponsive to ADH)

A

Nephrogenic Diabetes Insipidus

73
Q

excessive urination and thirst
low urine osmolality
increased serum osmolality
hypernatremia

A

Diabetes Insipidus

74
Q

in _____DI, kidneys are functioning so they will have increase in urine osmolality when given ADH injection

A

central DI

75
Q

in ____DI, kidneys wont respond to ADH

A

nephrogenic DI

76
Q

to treat central DI

A

Desmopressin (ADH analog)

77
Q

to treat nephrogenic DI

A

thiazides (look this up)
indomethacin (also treats PDA)

78
Q

Excess ADH
Results in resorption of excessive amounts of free water

A

SIADH

79
Q

hyponatremia (Acute onset: cerebral edema leading to lethargy, weakness, seizures, coma, etc)

A

SIADH

80
Q

SCLC
TB, pneumonia
head trauma
drugs

A

causes of SIADH

81
Q

decreased serum Na+ and Posm
increase Uosm
plasma Cr normal

A

SIADH

82
Q

to treat SIADH

A

fluid restriction
V2 receptor antagonists
treat cause

ENR Biweekly 2 (11 decks)

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