The Endocrine System: pituitary - Graffeo

Question 1

name hormones secreted by anterior pituitary

Answer 1

• GH
• ACTH
• TSH
• FH
• LH
• PRL

Question 2

name hormones secreted by posterior pituitary

Answer 2

ADH

OT ( oxytocin)

Question 3

from what embryology does ant. pituitary come from

Answer 3

• oral ectoderm

- Rathke’s pouch Stem cell

Question 4

which part of the pituitary has the infundibular stalk

Answer 4

posterior pituitary

Question 5

which pituitary has a venous/portal system

Answer 5

anterior pituitary

Question 6

pituitary sits in what bone structe

Answer 6

sella turcica

- depression in sphenoid bone

Question 7

what is the post. pituitary derived from

Answer 7

nervous system tissue

Question 8

what are 3 types of cells found in normal anterior pituitary and what do they secrete

Answer 8

Acidophil: GH, PRL
Basophil: ACTH, LH, FSH
Chromophobe: TSH

Question 9

the hypothalamus produces 2 hormones that have a negative impact on what pituitary hormones

Answer 9

dopamine –> prolactin

GIH somatostatin –> GH

Question 10

majority of cases of hyperpituitarism is due to what

Answer 10

adenomas

Question 11

How is pituitary adenoma classified

Answer 11

hormone produced, usually one, can be multiple

Question 12

who can get pituitary adenoma

Answer 12

all adults

Question 13

pituitary ademona is associated with what neoplasm

Answer 13

multiple endocrine neoplasia MEN-1

Question 14

What can cause pituitary adenoma?

Answer 14

mass effect of Sella turcica

Question 15

what are 3 effects of pituitary adenoma

Answer 15

• visual field abnormalities - bitemporal hemianopsia
• ICP
• hypopituitarism

Question 16

what can be seen in histo for pituitary adenoma

Answer 16

• red or blue or no stain

- no reticulin network

Question 17

atypical adenomas have increased what

Answer 17

• mitotic figures

- increased KI67

Question 18

what is the most common hyper functioning pituitary adenoma

Answer 18

prolactinoma

Question 19

what do prolactinoma form

Answer 19

• calcify and from psammoma bodies

- pituitary stone

Question 20

signs and symptoms for prolactinoma

Answer 20

• amenorrhea, galactorrhea, infertility

- loss of libido (men)

Question 21

what are physiologic causes of serum hyper-prolactinemia

Answer 21

pregnancy
nursing
stress

Question 22

how does stalk effect create a serum hyper-prolactinemia

Answer 22

• mass in suprasellar compartment

- interferes with normal inhibition by hypothalamus to release dopamine to inhibit PRL secretion

Question 23

name 2 drugs that decrease serum prolactinemia

Answer 23

phenothizines

haloperidol

Question 24

does a mild elevation in prolactin in patient with adenoma mean prolactin-secreting tumor

Answer 24

no

Question 25

how is prolactinoma treated? first line?

Answer 25

- dopamine agonists - Bromocriptine - first line - Transphenoidal surgery

Question 26

what is the second most common adenoma

Answer 26

growth hormone

Question 27

is GH adenoma acidophilic or chromophobic

Answer 27

acidophilic

Question 28

signs and symptoms for GH adenoma

Answer 28

Pre-pubertal children: gigantism | adults: acromegaly

Question 29

GH adenoma patients have increased risk for what

Answer 29

GI cancers

Question 30

are corticotroph adenomas basophilic or chromophobic

Answer 30

basophilic

Question 31

what causes corticotroph adenomas

Answer 31

hypercortisolism

Question 32

what are 2 diseases that cause hypercortisolism

Answer 32

cushing disease: pituitary adenoma | cushing syndrome

Question 33

what is Nelson syndrome

Answer 33

adrenals removed for cushing syndrome - no negative feedback for pituitary - increase ACTH - no increase cortisol

Question 34

clinical feature of Nelson syndrome

Answer 34

hyperpigmentation due to POMC peptides

Question 35

what is pituitary apoplexy

Answer 35

rapid enlargement of pituitary

Question 36

symptoms of pituitary apoplexy

Answer 36

sudden onset of excruciating headache - diplopia - panhypopit - cardiovascular collapse - loss of consciousness - death

Question 37

what causes Null cell? what did this result in

Answer 37

- mass effect | - hypopituitarism

Question 38

men have what symptoms for gonadotroph

Answer 38

loss of libido or no symptoms

Question 39

Hypopituitarism can cause what

Answer 39

diabetes insipdus (lack of ADH)

Question 40

what are signs and symptoms of hypopituitarism

Answer 40

hypofunction: adrenal cortex, thyroid, gonads Amenorrhea, Impotence, loss of libido loss of axillary and pubic hair

Question 41

what are causes of hypopituitarism

Answer 41

``` Sheehan syndrome : postpartum hemorrhage DIC Sickle Cell Anemia Shock increased ICP ```

Question 42

hypopituitarism is a genetic or acquired?

Answer 42

both | genetic , POU1F1

Question 43

what causes empty sella syndrome

Answer 43

- chronic herniation of subarachnoid space into sella turcica

Question 44

who usually gets empty sella syndrome

Answer 44

obese patients with multiple pregnancies

Question 45

what is wrong in primary empty sella syndrome

Answer 45

defect in diaphragma sella - allows CSF to enter - compresses pituitary gland

Question 46

clinical symptoms of abnormal oxytocin levels

Answer 46

no clinical abnormalities

Question 47

what are 2 problems that ADH can cause

Answer 47

- diabetes insipidus (lack) | - syndrome of inappropriate ADH ( excess) SIADH