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22 Cards in this Set
- Front
- Back
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How can TRH help differentiate b/t hypo and hyper thyroid?
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exaggerated TSH response to TRH in hypothyroid
no TSH response in hyperthyroid |
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What are the uses of GnRH clinically speaking?
- what about superagonists and antagonists? |
induction of ovulation or spermatogenesis in hypothalamic disorders
- contraception, delay of puberty, control of estrogen dependent uterine dz, suppression of sex-steroid dependent tumors. |
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GHRH therapy for hypogrowth disorders requires what?
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an intact pituitary; otherwise, you'd just use recombinant growth hormone itself to tx the deficiency.
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What do bromocriptine and cabergoline do?
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direct action on pituitary DA receptors inhib prolactin.
--> normalize serum prolactin. |
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Qualitative or quantitative perturbation of trophic factors leads to (primary/secondary) endocrine dz?
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secondary.
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re: VINDICATE, which letters are esp important in endocrine dz?
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Neoplastic, AI, and Endocrine (i.e. trophic influences)
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If the cell population is heterogenous in a gland, but hypercellular, what might be the etiology?
Homogeneous? |
hyperplasia, or AI dz if the there are chronic inflammatory cells present.
neoplasm (adenoma, carcinoma) |
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What are the 2 general possible underlying etiologies of endocrine gland hyperfunction?
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^ in # of secretory cells
autonomous secretory cells - adenoma (more likely) >>>> carcinoma |
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How much of an endocrine gland has to be destroyed before hypofunction will present clinically?
- two general etiologies? |
80-90%; this is due to a v.large reserve.
- destruction of endocrine cells - atrophy |
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What types of clinical sx might present from a non-functional endocrine gland neoplasia?
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mass effects / local impingement.
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Since histopatholgy of benign and malignant endocrine neoplasia is often similar, what can be used to dx difference?
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malignant = met's and/or local vascular/neural invasion.
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What two general things can AI dz do to affect endocrine glands?
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1) interact w/ cell receptors --> hyper/hypo fx
2) tissue destruction --> hypo fx |
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What types of vessels connect the hypothalamus and the adenohypophysis?
What is the origin of the adenohypophysis? Neurophyophysis? |
portal vessels.
oral cavity invagination (Rathke's pouch) ventral ext. of hypothalamus. |
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What are the 2 acidophil secretory cells in the ant. pituitary? 3 basophil cells? What is the other class of cell found?
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Somatotrophs & Lactotrophs
Thyrotrophs, Corticotrophs, Gonadotrophs. Chromophobes |
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If we look at a histo slide of the pituitary, and we see axons and pituicytes (glia), where are we?
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posterior pituitary.
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^ in size of the pituitary can lead to impingement on which four groups of things?
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pituitary itself (panhypopituitarism)
optic chiasm cavernous sinus (CN 3, 4, 5, 6 palsies) CSF (HA, etc) |
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How do we make the dx of *which* type of secretory cell has become cancerous in a pituitary adenoma?
Are most pituitary carcinomas functional or non-functional? |
immunohistochemistry
non-functional; they're rare in general. |
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What are craniopharyngiomas?
- more commonly infrasellar or suprasellar? - can it infiltrate? - cystic or solid? - presenting sx - microscopic appearance? |
benign, slow-growing tumor that arises from the remnants of rathke's pouch;
- suprasellar - can infiltrate - both cystic and solid regions - mass effects. - nests or cords of stratified squamous cells edged w/ periphery of columnar cells + cholesterol-rich cysts, fibrosis, calcification seen on X-ray... resemble germinal teeth. |
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What is Sheehan syndrome?
- frequency? - describe pathogenesis |
postpartum necrosis of anterior pituitary.
- the most common ischemic pituitary event, but still rare. - ant pituitary enlarges while preg, maj of blood sup. is venous..... hemorrhage during/after delivery --> hypotension --> ischemia |
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What is pituitary apoplexy?
- clinical sx? |
Sudden expanding hemorrhage (usually in adenoma) leads to destruction of adjacent pituitary cells.
- hypopituitarism |
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What is Empty Sella syndrome?
- etiology What are Mass lesions? What can both of these lead to re: clinical presentation? |
Destruction of all or part of pituitary
- Etiology : surgery, radiation, congenital defect those which impinge upon entire pituitary. - Pituitary adenomas, carcinoma - Craniopharygioma - Hypothalamic neoplasms panhypopituitarism |
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What is the etiology of most posterior pituitary pathology?
- clinical sx? |
destruction of the tissue from mass effects or necrosis.
- \ADH --> CDI. |
