Anterior Pituitary
A patient experiences difficulty lactating following a pregnancy which involved a delivery complicated for hemorrhage. What is the cause of her failure to lactate? (Name of syndrome)
What is Sheehan Syndrome?
DAILY DOUBLE: Explain the Pathophysiology of this disease
What is oxytocin
Approximately this percentage of microadenomas achieve an initial cure rate
What is 80-90%? (according to up to date)
This is considered a cosmetic advantage to the trans-sphenodial resection of a pituitary adenoma?
What is no facial scaring?
The following receptors in the adrenal cortex are bound by ACTH
What are melanocortin 2 receptors?
What is high T4/T3 in Graves disease, low T4/T3 in hypopituitarism.
DAILY DOUBLE: Provide the first and last name of the other PBL patient
This is a common paraneoplastic syndrome of lung cancer. These patients have low plasma osmolarity and may appear to be fluid overloaded.
What is SIADH
What is the second line treatment is resection of the tumor fails to achieve remission or a patient experiences reoccurance of disease?
What is pituitary irradiation?
Many women have the following complaint as a result of a pituitary tumor resection or gland removal. However the same condition can in some cases be reversed through the removal of a prolactinoma, without resecting the entire gland.
What is infertility?
Cortisol level are typically highest around this time of day?
What is early morning (sources vary between 6-9am)
DAILY DOUBLE: What is the name and function of the gene mutation in MEN1?
This is the other name for the posterior pituitary
neurohypophysis
What is the approximate cumulative reoccurrence rate over 10 years?
What is 26% (according to uptodate)
If a man were to have the most common type of pituitary adenoma, he might experience this embarrassing growth pattern?
What is gynecomastia?
What is Nelson Syndrome?
What are ACTH, TSH, GH, FSH, LH, Prolactin
What is prolactin?
Accidental trauma to the posterior pituitary during removal of an adenoma can cause this syndrome which has patients constantly thirsty
What is Central Diabetes Insipidus
DAILY DOUBLE: How does a physician determine whether a patient has central or nephrogenic DI?
What is diabetes insipidus?
What is cortisol?
Cortisol is produced in this region of the adrenal gland.
What is the zona fasiculata?
Draw the Endocrine signaling pathway of that is abnormal in Claudia at diagnosis, and the same pathway following surgical resection.
Drawing of HPA axis, with high ACTH and then low ACTH
What is the hypothalamus?
Based on her post surgical symptoms, which lobe of Claudia's thyroid is most likely negatively impacted by her surgery?
What is the anterior pituitary?
The following is a symptom of Cushing's disease that a patient is likely to deny if asked. They are likely to blame this symptom on other people, and may become angry that they were even asked about this symptom.
What is irritability/ anger problems.
The following condition is sometimes considered the "opposite" of Cushing disease. President JFK was diagnosed with this condition. A secondary form of this disease can occur as a result of pituitary resection.
What is Addison's disease?
Fun fact- some people believe that President Kennedy bled out more quickly because he was chronically hypovolemic and hypotensive as a result of low cortisol. This has never been directly proven, but has a basis in physiology.