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Endocrine Week 4 2017/18 > 2: Pathology of pituitary and adrenal glands > Flashcards

2: Pathology of pituitary and adrenal glands Flashcards

1
Q

Pituitary pathologies are caused by what two types of abnormal function?

A

Hyperfunction

Hypofunction

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2
Q

Which recess of the middle cranial fossa is the pituitary gland found in?

A

Sella turcica

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3
Q

What membrane of dura mater covers the pituitary gland?

A

Diaphragm sellae

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4
Q

Which structure connects the pituitary to the hypothalamus?

A

Pituitary stalk

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5
Q

Which pituitary gland is

a) an extension of the neural aspect of the hypothalamus?
b) anterior?

A

a) posterior

b) anterior

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6
Q

What is the anterior pituitary also known as?

A

Adenohypophysis

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7
Q

Which hormones does the anterior pituitary secrete?

A

Trophic: TSH, ACTH, LH and FSH

Non-trophic: GH and PRL

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8
Q

Which hormones does the posterior pituitary secrete?

A

ADH

Oxytocin

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9
Q

What is the posterior pituitary also known as?

A

Neurohypophysis

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10
Q

On histology of the pituitary gland, all the cells look different - why is this?

A

Loads of different cells which produce different hormones

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11
Q

What causes anterior pituitary hyperfunction?

A

Pituitary tumours

Adenomas and carcinomas

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12
Q

What causes anterior pituitary hypofunction?

A

Surgery, radiation

Haemorrhage into gland

Tumours

Inflammatory conditions

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13
Q

What is Sheehan syndrome?

What kind of abnormal pituitary function does it cause?

A

Ischaemic necrosis of pituitary gland following childbirth

Pituitary hypofunction

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14
Q

What are two notable conditions associated with the posterior pituitary?

A

Diabetes insipidus

SIADH

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15
Q

What is a benign tumour of the anterior pituitary known as?

A

Pituitary adenoma

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16
Q

What genetic syndrome are numerous pituitary adenomas a presentation of?

A

MEN1

multiple endocrine neoplasia

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17
Q

Pituitary adenomas are classified by the type of ___ they produce.

A

hormone

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18
Q

Can pituitary adenomas produce more than one hormone?

A

Yes

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19
Q

Do pituitary adenomas have to produce hormone?

A

No, similarly to thyroid, some are non-functional

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20
Q

Why may large pituitary adenomas cause visual field defects?

A

Compression of optic chiasm

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21
Q

What disease involves multiple hormone deficiencies of the pituitary gland?

A

Panhypopituitarism

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22
Q

Why may large pituitary adenomas cause hypopituitarism?

A

(Infarction due to) compression

23
Q

What are three types of pituitary adenoma and which diseases will they cause?

A

Prolactinoma - hyperprolactinaemia (galactorrhoea, infertility, loss of libido, amenorrhoea)

GHoma - acromegaly

ACTHoma - Cushing’s disease

24
Q

What are three causes of panhypopituitarism?

A

Tumours (primary or metastatic)

Granulomatous disease e.g sarcoidosis

Sheehan syndrome

25
Q

The anterior pituitary gland is a remnant of which embryological structure?

A

Rafke’s pouch

26
Q

Which rare, benign tumour is most commonly seen in children and arises from Rafke’s pouch during development?

A

Craniopharyngioma

27
Q

What are two important posterior pituitary syndromes?

A

Diabetes insipidus

SIADH

28
Q

Production of ectopic hormone e.g ADH, ACTH may be caused by what?

A

Functioning tumours elsewhere e.g small cell carcinomas of the lung

“Paraneoplastic syndrome”

29
Q

What are the two parts of the adrenal gland?

A

Cortex

Medulla

30
Q

The adrenal medulla is an extension of the ___ nervous system.

A

sympathetic

31
Q

What hormones do the adrenal

a) cortex
b) medulla

produce?

A

Adrenal cortex - cortisol (glucocorticoids), aldosterone (mineralocorticoids), androgens (sex hormone)

Adrenal medulla - adrenaline and noradrenaline (catecholamines)

32
Q

Again, what two types of abnormal adrenal function are there?

A

Hyperfunction

Hypofunction

33
Q

Adrenal disease can be caused by which other endocrine gland?

A

Pituitary gland

34
Q

What are three causes of adrenal cortex hyperfunction?

A

Hyperplasia (too much ACTH stimulation)

Adenoma, carcinoma

35
Q

What are diseases causing acute and chronic adrenal cortex hypofunction?

A

Acutely - Waterhouse-Friederichsen disease

Chronic - Addison’s disease (the important one)

36
Q

What is Waterhouse-Friderichson syndrome?

A

Adrenal hypofunction

caused by bleeding secondary to infection

usually Neisseria meningitidis

37
Q

What causes adrenal cortex hyperplasia?

A

Overstimulation by ACTH

38
Q

Which diseases are associated with overproduction of ACTH?

Which adrenal pathology is associated with this?

A

Cushing’s DISEASE

2ndary hyperaldosteronism

Ectopic ACTH production e.g small cell carcinoma of lungs

Androgen excess

ADRENAL HYPERPLASIA

39
Q

Why are adrenal cortex adenomas yellow?

A

Lipid content

40
Q

How do adrenocortical carcinomas tend to spread?

A

Locally - to retroperitoneum, kidneys

Haematogenously - to liver, lungs and bone

41
Q

What syndromes do overproduction of

a) aldosterone
b) cortisol

by the adrenal cortex tumours produce?

A

a) Conn’s syndrome

b) Cushing’s syndrome

mind that pituitary ACTH excess causing symptoms would be Cushing’s disease and secondary hyperaldosteronism

42
Q

Problems with which axis can cause secondary adrenocortical hypofunction?

A

Hypothalamic-pituitary-adrenal axis

43
Q

Which type of drug suppresses the adrenal cortex?

A

Steroids

44
Q

What is the name given to chronic adrenocortical insufficiency?

A

Addison’s disease

45
Q

Addison’s disease is a type of (primary / secondary) adrenocortical insufficiency.

A

primary adrenocortical insufficiency

46
Q

Which part of the nervous system innervates the adrenal medulla?

A

Sympathetic

47
Q

Which cells in the adrenal medulla secrete catecholamines?

A

Neuroendocrine / Chromaffin cells

48
Q

What are two types of tumour found in the adrenal medulla?

A

Phaeochromocytoma

Neuroblastoma

49
Q

Which type of endocrine tumour is common in infancy?

A

Neuroblastoma

Craniopharyngioma

50
Q

What is a neoplasm of neuroendocrine cells called?

A

Phaeochromocytoma

51
Q

What cardiovascular disease does phaeochromocytoma cause?

A

Hypertension

(secondary)

52
Q

What is a lab sign of phaeochromocytoma?

A

Urinary excretion of catecholamines

makes sense cuz you’re overproducing them

53
Q

Phaeochromocytoma is known as the __% tumour.

A

10% tumour

10% extra-adrenal

10% bilateral

10% malignant

10% familial (think MEN2A)

10% DON’T cause hypertension

Endocrine Week 4 2017/18 (10 decks)

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