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48 Cards in this Set
- Front
- Back
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What part of the skull does the pituitary sit in?
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the sella turcica
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What is the embryologic origin of the adenohypophysis (anterior pituitary)
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Rathke pouch, from the oral cavity
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What part of the pituitary does the portal vascular system pass through?
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the anterior pituitary
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What is secreted from the anterior pituitary?
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GH, FSH, LH, TSH
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What is the posterior pituitary also called?
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neurohypophysis
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Does the posterior pituitary have the same circulation as the anterior?
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no it does not
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What does the posterior pituitary secrete?
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ADH
Oxytocin |
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What causes most hyperpituitarism?
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pituitary adenomas
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What is the genetic cause of pituitary adenomas?
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MEN 1 gene
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What do pituitary adenomas usually produce?
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GH, Prolactin, ACTH
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What are the two sizes of pituitary adenomas?
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micro<1cm
macro>1cm |
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What are the three common local effects of macroadenomas?
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Enlarged sella turcica
Bitemporal hemianospia- visual field defect increased intracrainal pressure |
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What is the most common pituitary tumor?
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a Prolactioma*
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What are the four symptoms of a prolacintoma? (related to high prolactin)
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Amenorrhea
Galactorrhea loss of libido Infertility |
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What are the lab vales for a somatotropic adenoma (anterior pituitary)
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elevated GH and IGF-1
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How does a somatotroph adenoma (anterior pituitary) affect someone? (both before/ after puberty)
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causes gigantism before puberty
causes Acromegaly if occurs after epiphyseal closure |
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What are the metabolic complications of a Somatotroph adenoma (anterior pituitary, GH secreting)
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hyperglycemia/DM (antagonizes insulin)
Osteoporosis HTN gondal dysfunction CHF |
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What is Octerotide?
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this is a somatostatin receptor ligand - and in effect mimics somatostatin- used to inhibit GH
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What is Pegvisomant?
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this is a GH receptor antagonist
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What types of things does a Cortiocotroph adenoma secrete?
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POMC-> which in turn secretes ACTH, MSH
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What are the symptoms of a corticotroph adenoma? (anterior pituitary)
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Cushings disease, due to high cortisol
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What are the symptoms of a cushing disease anterior pituitary tumor (ACTH over secretion, or POMC over secretion)
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HTN
Hyperglycemia Osteoporosis |
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What are the clinical features of gonadotroph adenomas
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paradoxical gonadal hypofunction
Decreased LH*** - lowers mens energy and libido |
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What are the clinical features of a thyrotroph adenoma?
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these produce TSH, and cause secondary hyperthyroidism
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What do nonfunctioning adenomas typically present as?
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local effects (opthalmic effects)
and can produce hypopituitarism (blind spots on the lateral fields of vision) |
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What is panhypopituitarism?
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a deficiency of the anterior pituitary
occurs when 75% or more of pituitary is destroyed |
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What is Sheehan syndrome?
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panyhypopituitarism due to ischemic necrosis- occuring postpartum
Affects ANTERIOR pituitary** |
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What is pituitary apoplexy?
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sudden hemorrhage into the gland
Sxs- excriating headache -Diplopia -hypopituitarism |
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What are the signs of sheehan syndrome?
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hypogonadism years later
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What is the most common cause of hypopituitarism?
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hypothalamic origin- tumors/rads destroying it
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What are the signs of hypopituitaryism?
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central obesity
preservation of scalp hair gynecomastic testicular volumes reduced Low T, LOW LH** |
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What is the origin of a craniopharyngioma?
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vestigial remnants of rathkes pouch
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Who gets craniopharyngioma?
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bimodal, below 15, or over 50
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What are the clinical features of craniopharyngioma?
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may produce hypo OR hyper function of the pituitary
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How does panyhypopituitarism affect children?
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pituitary drawfism
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how does panyhypopituitarism affect adults?
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insulin sensitivity, hypoglycemia, decreased muscle strength (remember, GH promotes insulin intolerance)
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What does acquired panyhypopituitarism manifest as?
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initial loss of gonadotrophs, followed by loss of thyrothroph, deficiency of ACTH-> Death
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How does a deficiency of gonadotrophis affect children?
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retarded sexual maturation
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How does a deficiency of gonadotrophis affect adult males
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loss of libido, impotence, loss of muscle mass
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How does a deficiency of gonadotrophis affect females
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loss of libido, amenorrhea, infertility
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What causes central diabetes insipidus?
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posterior pituitary failure to produce ADH*
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What are the clinical signs of central diabetes insipidus?
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polyuria, polydipsia
excessive thirst |
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What is Hand Schuller Christian disease?
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diabetes insipidus due to eosinophilic granulomas/Langerhans cell infiltrates
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What is the triad of Hand Schuller Christian disease?
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calvarial defects (funny head), exopthalmos, diabetes insipidus
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What are the clinical signs of SIADH?
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hyponatremia
hemodilution cerebral edema/neruo dysfunction |
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What causes causes SIADH?
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paraneoplastic syndrome from small cell carcinoma of the lung
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What is a pituitary dwarf?
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this is proportionate dwarfism
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What are the signs of Diastrophic dwarfinsm?
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autosomal recessive, short limbs, cauliflower ears
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