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26 Cards in this Set

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Hormones from anterior pituitary
TSH(TRH)
Prolactin(DA-)
ACTH(CRH)
GH(GHRH+, Somatostatin-)
FSH and LH(GnRH)
Homones from Posterior pituitary
ADH, Oxytocin
Clinical manifestations of pituitary adenoma
Visual abnormalities: bitemporal hemianopsia, Increased ICP, hypopituitarism, Pituitary apoplexy
Pituitary apoplexy
Acute hemmorrhage in an adenoma
Causes adenoma of somatotrophs and corticotrophs
GNAS1 gene or gsp oncogene. codes for Gsa, lose GTPase activity so always activated
Mutations found in pituitary adenomas
RAS, c-myc, MEN-1(only with syndrome), GNAS-1
Clinical manifestation of Prolatinoma-men
Impotence, infertility, hypogonadism
Clinical manifestation of Prolatinoma-women
Galactorrhea, hypogonadism-amenorrhea
Most common Pituitary adenoma
Prolactimoma(30%)
Somatotrophic adenoma(5%)
nonfunctional(25%)
morphology of pituitary adenoma
Uniform sheets of polygonal cells, lack of CT of reticulin,
invade brain, bone and dura but no mets
Clinical manefestations of Somatotrophic adenoma
gigntism
Acromegally: overgrowth, hyperglycemia, osteoporosis, hypertension
Test for Somatotrophic adenoma
Oral glucose test does not supress GH
Morphology of Corticotrophic adenoma
Basophilic, dense granules, PAS+ b/c of POMC(ACTH precursor)
Cushing disease
From corticotrophic adenoma, increased ACTH-> increase in cortisol.
Nelson Syndrome
Surgical removal of adrenals, loss of inhibition on adenoma, adenoma gets bigger and causes mass effect
Tumors/masses causing hypopituitarism
adenomas, mets, cysts
Rathke Cleft Cyst
lined by cuboidal epithelium with ir without goblet cells
Sheehan's disease
Increase size of pituitary in pregnancy, then obstetric shock/hemorrhage, then hypotension, then vasospasm, then ischemic necrosis. Increase incidence with DM, not just pregnars
Other causes of hypopituitarism
Empty sella syndrome, tuberculosis, sarcoidosis
Clinical manifestation of Hypopituitarism
Dwarfism, Amenhorria(FSH,LH), Hypothyroid, hypoadrenalism, Pallor(MSH), decrease postpartum lactation
Causes of Diabetes Insipidus
Head trauma, tumors, inflamation of hypothalamus/pituitary, Surgery leads to ADH insufficiency
Clinical manifestation
polyuria, polydipsia
Cause of SIADH
Syndrome of inappropriate ADH secretion, paraneoplastic syndrome: small cell carcinoma,
Clinical manifestation of SIADH
Unable of excret urine, expanded extracellular fluid, hyponatremia cna lead to cerebral edema which can lead to neurologic dysfunction
Cause of Craniopharyngioma
Remnant of Rathke's pouch
Morphology of Craniopharyngioma
Benign suprasellar location, Resembals enamal organ of tooth, bimodal age distribution, often cystic with flat or columnar cells with papillary projections