Pituitary Pathophysiology Flashcards Preview

Endocrinology > Pituitary Pathophysiology > Flashcards

Flashcards in Pituitary Pathophysiology Deck (20)
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1
Q

What are hormonal consequences of pituitary and hypothalamic diseases?

A

Hypersecretion: only pituitary adenomas
Hyposecretion: Any disease of pituitary/hypothalamus for anterior pituitary hormones

Hyposecretion of vasopressin can only be caused by disease of hypothalamus or infundibulum

2
Q

What are signs of GH deficiency? (3)

A

Short stature prior to epiphyseal closure
Decreased muscle/increased fat mass
Decreased BMD

3
Q

GH Replacement: What is it approved for and what is its effect

A

Approved for short stature.

Effects: growth, increase in BMD

4
Q

Which adenomas involve peptide hormones? What is noticeable effect?

A

Adenomas involving somatotrophs, lactotrophs, corticotrophs.

Effect: people “look funny”

5
Q

Which adenomas involve glycoprotein hormones? Are they recognizable?

A

Ones involving gonadotrophs, thyrotrophs

Only recognizable once they are much larger

6
Q

Somatotroph Adenomas: Presenation

A

Acromegaly (huge facial features, big hands) and gigantism

7
Q

Somatotroph Adenomas: Diagnosis via chemical confirmation (2)

A

Lack of suppression of Gh in response to oral glucose load

Elevated IGF-1

8
Q

Somatotroph Adenomas: Dx via pathologic confirmation

A

Histologic appearance of pituitary adenoma

IHC staining

9
Q

Consequences of Somatotroph Adenomas (7)

A

Arthritis (OA), cancer (esp colon cancer), CVD, DM, Neuropathy (carpal tunnel), sleep apnea, death

10
Q

Somatotroph Adenomas: Pharma Options (3) and other options (2)

A

Pharmacologic: DA agonists (cabergoline), SS analogs (octreotine), GH receptor antagonists (pegvisomant)
Surgical
Radiation

11
Q

How does pegvisomant antagonize GH receptor?

A

Dimerizes GHR

12
Q

Lactotroph adenomas: Clinical Syndromes
Premenopausal women? (2)
Postmenopausal women? (1)
Men? (3)

A

Premenopausal: amenorrhea and galactorrhea
Postmenopausal: neurological syndromes
Men: Decreased libido, fertility, potency

13
Q

Causes of hyperprolactinemia: Physiologic (4) and pathologic (6)

A

Phys: Pregnancy, nursing, exercise, stress
Path: lactotroph adenomas, DA receptor antagonist, catecholamine inhibitor, H2 antagonists, estrogens, opiates

14
Q

Treatment of lactotroph adenomas

A

Dopamine agonists: cabergoline, bromocriptine

15
Q

Px of Corticotroph Adenomas (2)

A

Cushing’s syndrome, neurological symptoms

16
Q

Thyrotroph Adenoma Presentation (2)

A

(Hyperthyroidism): A-fib and CHF

17
Q

Thyrotroph Adenoma Treatment and Effect

A

SS Analogs (octreotide): reduces T4 and TSH…also decreases adenoma size

18
Q

Gonadotroph Adenomas: Clinical Px (3)

A

Neurological symptoms: visual field impairment and headaches
Incidental finding on MRI
Hormonal abnormality: Premature puberty in boys, ovarian hyperstimulation

19
Q

Lab values in Gonadotroph Adenomas:

A

Elevated FSH, alpha subunit, estradiol

Low LH

20
Q

What do you see on US in women with gonadotroph adenomas?

A

Big ol ovaries (due to hyperstimulation)