Pathoma Chapter 15 Exam Study Guide
Latest Updated 2024/2025
Endocrine system is composed of... - ansA group of glands that
maintain body homeostasis
What controls hormone release of endocrine system? -
ansFeedback mechanism
How do hormones of endocrine system travel? - ansVia blood
Pituitary adenoma - ansBenign tumor of anterior pituitary cells
Classification of pituitary adenoma - ansFunctional (hormone-
producing) or non-functional (silent)
How do nonfunctional pituitary adenomas present? - ansMass
effect
1. Bitemporal hemianopsia (loss of peripheral vision) due to
compression of optic chiasm
2. Hypopituitarism due to compression of normal pituitary tissue
3. Headache
How do functional pituitary adenomas present? - ansFeatures
based on the type of hormone produced
How does prolactinoma (pituitary adenoma) present? -
ansGalactorrhea and amenorrhea (females) or decreased libido
and headache (males)
What is the most common type of pituitary adenoma? -
ansProlactinoma
Treatment of prolactinoma - ansDopamine agonists to suppress
prolactin production
Surgery for larger lesions
Dopamine agonists used to treat prolactinoma -
ansBromocriptine
Cabergoline
,Pathoma Chapter 15 Exam Study Guide
Latest Updated 2024/2025
What inhibits prolactin, and what does prolactin inhibit? -
ansDA inhibits
PRL inhibits GnRH release (explaining symptoms in women
and men with prolactinoma)
How does growth hormone cell pituitary adenoma present? -
ans1. Children: gigantism (increased linear bone growth,
epiphyses are not fused)
2. Adults: acromegaly
3. Secondary DM (GH induces liver gluconeogenesis)
Signs of acromegaly in adults - ans1. Enlarged bones of hands,
feet, and jaw
2. Growth of visceral organs leading to dysfunction (cardiac
failure)
3. Enlarged tongue
What is the most common cause of death in those with growth
hormone pituitary adenoma? - ansCardiac failure (growth of
visceral organs leading to dysfunction)
What does GH induce? - ansLiver gluconeogenesis
How do you diagnose growth hormone cell adenoma? -
ansElevated GH and insulin growth factor (IGF-1), along with
lack of GH suppression by oral glucose
Where is IGF-1 synthesized? - ansLiver
Treatment of growth hormone pituitary adenoma - ans-
Octreotide (somatostatin analogue that suppresses GH release)
-GH receptor antagonist
-Surgery
What inhibits GH release? - ansSomatostatin
,Pathoma Chapter 15 Exam Study Guide
Latest Updated 2024/2025
Octreotide - ansSomatostatin analogue used to treat GH pituitary
adenoma
Where is somatostatin normally produced? - ansHypothalamus,
it inhibits GH secretion
Name the types of pituitary adenomas - ans1. Prolactinoma
2. Growth hormone cell adenoma
3. ACTH cell adenoma
4. TSH, LH, FSH producing adenomas are rare (can occur)
What does ACTH producing pituitary adenoma cause? -
ansCushing Syndrome
Insufficient production of hormones by the anterior pituitary
glands - ansHypopituitarism
When do symptoms of hypopituitarism arise? - ansOver 75% of
pituitary parenchyma is lost
Name causes of hypopituitarism - ans1. Pituitary adenomas
(adults) or craniopharyngiomas (children)
2. Sheehan Syndrome
3. Empty sella syndrome
How does pituitary adenoma/craniopharyngioma cause
hypopituitarism - ansMass effect of pituitary apoplexy (bleeding
into an adenoma)
What is sheehan syndrome, how does it cause hypopituitarism,
and how does it present - ansSheehan syndrome is pregnancy
related infarction of pituitary gland; gland doubles in size during
pregnancy, but blood supply does not increasing, so blood loss
during parturition (birthing) precipitates infarction
-Presents as poor lactation, loss of pubic hair, fatigue
, Pathoma Chapter 15 Exam Study Guide
Latest Updated 2024/2025
What is empty sella syndrome - ans-Congenital defect of the
sella caused by herniation of the arachnoid and CSF into sella,
compressing and destroying pituitary gland
-Pituitary gland absent on imaging
-Could also be caused by trauma
What hormones are released from the posterior pituitary gland? -
ansAntidiuretic hormone (ADH) and oxytocin (made in the
hypothalamus and transported via axons to posterior pituitary for
release)
ADH action - ansActs on distal tubules and collecting ducts of
kidney to promote free water retention
Oxytocin action - ansMediates uterine contraction during labor
and release of breast milk (let-down) in lactating mothers
(prolactin actually helps produce the milk)
Prolactin vs. oxytocin in breast feeding - ansProlactin: induces
milk production
Oxytocin: induces milk let down
Central Diabetes Insipidus - ansADH deficiency due to
hypothalamic or psoterior pituitary pathology (tumor, trauma,
infection, inflammation)
Clinical features of diabetes insipidus - ansBased on loss of free
water
1. Polyuria and polydipsia with risk of life-threatening
dehydration
2. Hypernatremia and high serum osmolality
3. Low urine osmolality and specific gravity
4. High serum osmolality with low urine osmolality
Latest Updated 2024/2025
Endocrine system is composed of... - ansA group of glands that
maintain body homeostasis
What controls hormone release of endocrine system? -
ansFeedback mechanism
How do hormones of endocrine system travel? - ansVia blood
Pituitary adenoma - ansBenign tumor of anterior pituitary cells
Classification of pituitary adenoma - ansFunctional (hormone-
producing) or non-functional (silent)
How do nonfunctional pituitary adenomas present? - ansMass
effect
1. Bitemporal hemianopsia (loss of peripheral vision) due to
compression of optic chiasm
2. Hypopituitarism due to compression of normal pituitary tissue
3. Headache
How do functional pituitary adenomas present? - ansFeatures
based on the type of hormone produced
How does prolactinoma (pituitary adenoma) present? -
ansGalactorrhea and amenorrhea (females) or decreased libido
and headache (males)
What is the most common type of pituitary adenoma? -
ansProlactinoma
Treatment of prolactinoma - ansDopamine agonists to suppress
prolactin production
Surgery for larger lesions
Dopamine agonists used to treat prolactinoma -
ansBromocriptine
Cabergoline
,Pathoma Chapter 15 Exam Study Guide
Latest Updated 2024/2025
What inhibits prolactin, and what does prolactin inhibit? -
ansDA inhibits
PRL inhibits GnRH release (explaining symptoms in women
and men with prolactinoma)
How does growth hormone cell pituitary adenoma present? -
ans1. Children: gigantism (increased linear bone growth,
epiphyses are not fused)
2. Adults: acromegaly
3. Secondary DM (GH induces liver gluconeogenesis)
Signs of acromegaly in adults - ans1. Enlarged bones of hands,
feet, and jaw
2. Growth of visceral organs leading to dysfunction (cardiac
failure)
3. Enlarged tongue
What is the most common cause of death in those with growth
hormone pituitary adenoma? - ansCardiac failure (growth of
visceral organs leading to dysfunction)
What does GH induce? - ansLiver gluconeogenesis
How do you diagnose growth hormone cell adenoma? -
ansElevated GH and insulin growth factor (IGF-1), along with
lack of GH suppression by oral glucose
Where is IGF-1 synthesized? - ansLiver
Treatment of growth hormone pituitary adenoma - ans-
Octreotide (somatostatin analogue that suppresses GH release)
-GH receptor antagonist
-Surgery
What inhibits GH release? - ansSomatostatin
,Pathoma Chapter 15 Exam Study Guide
Latest Updated 2024/2025
Octreotide - ansSomatostatin analogue used to treat GH pituitary
adenoma
Where is somatostatin normally produced? - ansHypothalamus,
it inhibits GH secretion
Name the types of pituitary adenomas - ans1. Prolactinoma
2. Growth hormone cell adenoma
3. ACTH cell adenoma
4. TSH, LH, FSH producing adenomas are rare (can occur)
What does ACTH producing pituitary adenoma cause? -
ansCushing Syndrome
Insufficient production of hormones by the anterior pituitary
glands - ansHypopituitarism
When do symptoms of hypopituitarism arise? - ansOver 75% of
pituitary parenchyma is lost
Name causes of hypopituitarism - ans1. Pituitary adenomas
(adults) or craniopharyngiomas (children)
2. Sheehan Syndrome
3. Empty sella syndrome
How does pituitary adenoma/craniopharyngioma cause
hypopituitarism - ansMass effect of pituitary apoplexy (bleeding
into an adenoma)
What is sheehan syndrome, how does it cause hypopituitarism,
and how does it present - ansSheehan syndrome is pregnancy
related infarction of pituitary gland; gland doubles in size during
pregnancy, but blood supply does not increasing, so blood loss
during parturition (birthing) precipitates infarction
-Presents as poor lactation, loss of pubic hair, fatigue
, Pathoma Chapter 15 Exam Study Guide
Latest Updated 2024/2025
What is empty sella syndrome - ans-Congenital defect of the
sella caused by herniation of the arachnoid and CSF into sella,
compressing and destroying pituitary gland
-Pituitary gland absent on imaging
-Could also be caused by trauma
What hormones are released from the posterior pituitary gland? -
ansAntidiuretic hormone (ADH) and oxytocin (made in the
hypothalamus and transported via axons to posterior pituitary for
release)
ADH action - ansActs on distal tubules and collecting ducts of
kidney to promote free water retention
Oxytocin action - ansMediates uterine contraction during labor
and release of breast milk (let-down) in lactating mothers
(prolactin actually helps produce the milk)
Prolactin vs. oxytocin in breast feeding - ansProlactin: induces
milk production
Oxytocin: induces milk let down
Central Diabetes Insipidus - ansADH deficiency due to
hypothalamic or psoterior pituitary pathology (tumor, trauma,
infection, inflammation)
Clinical features of diabetes insipidus - ansBased on loss of free
water
1. Polyuria and polydipsia with risk of life-threatening
dehydration
2. Hypernatremia and high serum osmolality
3. Low urine osmolality and specific gravity
4. High serum osmolality with low urine osmolality
