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16 Cards in this Set
- Front
- Back
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most common cause of hyperpituitarism?
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anterior pituitary adenoma
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most common cause of hypopituitarism?
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anterior pituitary adenoma
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most common cause of diabetes insipidus?
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head trama damaging hypothalamus commonly seen when a basal skull fracture is present
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most common cause of SIADH?
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ectopic ADH production
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most common suprasellar mass lesion?
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craniopharyngioma
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describe the pathology of a GH adenoma?
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GNAS1 gene mutation leads to a GHRH receptor which has a defective alpha subunit making it resistant to GTPase which is normally responsible for stopping the pathway --> increased HG hormone production
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if you had to do imaging on the pituitary, what type would you most likely use?
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MRI post-gadolinium enhancement
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what are the top 3 most frequent pituitary adenomas and give the percentages?
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1. Prolactin 30%
2. GH 20% 3. Null cell 20% |
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describe the microscopic appearance of a pituitary adenoma?
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monotonous cells with no acinar grouping or reticulin framework
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interestingly the Prl-cell adenoma does not directly cause hyperprolactinemia seen with the lesion, what does?
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the tumor compresses dominergic neurons that control release of prolactin and cause incontrolled release from normal prolactin secreting cells in the pituitary (causing them to hypertrophy)
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treatment of prolactinomas is?
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treat anything smaller than 1 cm with bromocriptine and then surgury if it is larger than 1 cm or surgery fails
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what test would you perform on a person you suspected to have a GH adenoma?
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a somatomedin C test (IGF-1) in stead of the actual GH which fluctuates more
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what is the treatment for a GH adenoma?
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surgical excision and somatostatin analogues to suppress GH and therefor IGF-1 levels
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what type of adenoma would you be concerned about if you saw clacifications on microscopic stains?
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prolactinoma
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whats the difference between cushings syndrome and cushings disease?
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syndrome = increased cortisol secreting
disease = ACTH producing tumor is the cause of increased cortisol |
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what is sheehans syndrome?
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ischemic nercrosis of anterior lobe after traumatic birth
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