The Endocrine System: pituitary - Graffeo Flashcards

1
Q

name hormones secreted by anterior pituitary

A
  • GH
  • ACTH
  • TSH
  • FH
  • LH
  • PRL
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2
Q

name hormones secreted by posterior pituitary

A

ADH

OT ( oxytocin)

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3
Q

from what embryology does ant. pituitary come from

A
  • oral ectoderm

- Rathke’s pouch Stem cell

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4
Q

which part of the pituitary has the infundibular stalk

A

posterior pituitary

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5
Q

which pituitary has a venous/portal system

A

anterior pituitary

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6
Q

pituitary sits in what bone structe

A

sella turcica

- depression in sphenoid bone

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7
Q

what is the post. pituitary derived from

A

nervous system tissue

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8
Q

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

A

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

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9
Q

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

A

dopamine –> prolactin

GIH somatostatin –> GH

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10
Q

majority of cases of hyperpituitarism is due to what

A

adenomas

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11
Q

How is pituitary adenoma classified

A

hormone produced, usually one, can be multiple

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12
Q

who can get pituitary adenoma

A

all adults

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13
Q

pituitary ademona is associated with what neoplasm

A

multiple endocrine neoplasia MEN-1

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14
Q

What can cause pituitary adenoma?

A

mass effect of Sella turcica

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15
Q

what are 3 effects of pituitary adenoma

A
  • visual field abnormalities - bitemporal hemianopsia
  • ICP
  • hypopituitarism
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16
Q

what can be seen in histo for pituitary adenoma

A
  • red or blue or no stain

- no reticulin network

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17
Q

atypical adenomas have increased what

A
  • mitotic figures

- increased KI67

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18
Q

what is the most common hyper functioning pituitary adenoma

A

prolactinoma

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19
Q

what do prolactinoma form

A
  • calcify and from psammoma bodies

- pituitary stone

20
Q

signs and symptoms for prolactinoma

A
  • amenorrhea, galactorrhea, infertility

- loss of libido (men)

21
Q

what are physiologic causes of serum hyper-prolactinemia

A

pregnancy
nursing
stress

22
Q

how does stalk effect create a serum hyper-prolactinemia

A
  • mass in suprasellar compartment

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

23
Q

name 2 drugs that decrease serum prolactinemia

A

phenothizines

haloperidol

24
Q

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

25
how is prolactinoma treated? first line?
- dopamine agonists - Bromocriptine - first line - Transphenoidal surgery
26
what is the second most common adenoma
growth hormone
27
is GH adenoma acidophilic or chromophobic
acidophilic
28
signs and symptoms for GH adenoma
Pre-pubertal children: gigantism | adults: acromegaly
29
GH adenoma patients have increased risk for what
GI cancers
30
are corticotroph adenomas basophilic or chromophobic
basophilic
31
what causes corticotroph adenomas
hypercortisolism
32
what are 2 diseases that cause hypercortisolism
cushing disease: pituitary adenoma | cushing syndrome
33
what is Nelson syndrome
adrenals removed for cushing syndrome - no negative feedback for pituitary - increase ACTH - no increase cortisol
34
clinical feature of Nelson syndrome
hyperpigmentation due to POMC peptides
35
what is pituitary apoplexy
rapid enlargement of pituitary
36
symptoms of pituitary apoplexy
sudden onset of excruciating headache - diplopia - panhypopit - cardiovascular collapse - loss of consciousness - death
37
what causes Null cell? what did this result in
- mass effect | - hypopituitarism
38
men have what symptoms for gonadotroph
loss of libido or no symptoms
39
Hypopituitarism can cause what
diabetes insipdus (lack of ADH)
40
what are signs and symptoms of hypopituitarism
hypofunction: adrenal cortex, thyroid, gonads Amenorrhea, Impotence, loss of libido loss of axillary and pubic hair
41
what are causes of hypopituitarism
``` Sheehan syndrome : postpartum hemorrhage DIC Sickle Cell Anemia Shock increased ICP ```
42
hypopituitarism is a genetic or acquired?
both | genetic , POU1F1
43
what causes empty sella syndrome
- chronic herniation of subarachnoid space into sella turcica
44
who usually gets empty sella syndrome
obese patients with multiple pregnancies
45
what is wrong in primary empty sella syndrome
defect in diaphragma sella - allows CSF to enter - compresses pituitary gland
46
clinical symptoms of abnormal oxytocin levels
no clinical abnormalities
47
what are 2 problems that ADH can cause
- diabetes insipidus (lack) | - syndrome of inappropriate ADH ( excess) SIADH