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ENDOCRINOLOGY > 1) Hyposecretion of from APG > Flashcards

1) Hyposecretion of from APG Flashcards

1
Q

Define panhypopituitarism:

A

reduced production of ALL APG hormones

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2
Q

What is the anterior pituitary gland also called and what type of tissue is it made up of?

A

APG=adenohypophysis (glandular)

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3
Q

What is the posterior pituitary gland also called and what type of tissue is it made up of?

A

PPG=neurohypophysis (neural)

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4
Q

5 APG hormones:

A 
ACTH (cortisol)
FSH/LH (oestrogen/testosterone)
GH
Prolactin
TSH (T3/4)
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5
Q

How are APG hormones stimulated + actually released?

A

1) Hypothalamus secretes releasing/inhibiting hormones
2) APG secretes APG hormone into blood
3) APG hormone stimulates endocrine gland to secrete primary hormone

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6
Q

2 types of APG disease:

A

Primary disease-issue with endocrine gland

Secondary disease-issue with APG

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7
Q

Summarise the hypothalamic pituitary thyroid axis:

A

1) TRH released from hypothalamus
2) TRH stimulates TSH release from APG into bloodstream–>thyroid gland
3) Thyroid gland secretes T3 + 4
4) T3 + 4 negatively feedback on both hypothalamus + PG

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8
Q

2 possible causes of panhypopituitarism with examples:

A

Congenital

  • genetic mutation
  • deficient in GH + another hormone
  • short stature
  • hypoplastic (shrunken PG)

Acquired

  • pituitary apoplexy
  • tumour
  • trauma
  • infection
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9
Q

What is pituitary apoplexy and what is it a sign of?

A

pituitary infarction/haemorrhage

sign of pituitary adenoma

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10
Q

What does presentation of panhypopituitarism depend on?

A

Which hormone(s) are deficient

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11
Q

How would an FSH/LH deficiency present?

A

secondary hypogonadism e.g. low libido, secondary ammenorrhoea, erectile dysfunction

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12
Q

How would an ACTH deficiency present?

A

secondary hypoadrenalism=fatigue

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13
Q

How would a TSH deficiency present?

A

Secondary hypothyroisim =fatigue

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14
Q

What is sheehan’s syndrome and what is it caused by?

A

Panhypopituitarism specifically post partum haemorrhage

Caused by hypotension-poor PG perfusion

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15
Q

What happens to the PG during pregnancy?

A

Enlarges due to lactotroph hyperplasia

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16
Q

What could happen if the PG enlarges?

A

Compression of optic chiasm

17
Q

2 symptoms of a bitemporal hemniaopia?

A

Loss of peripheral vision

Headache

18
Q

2 ways panhypopituitarism is diagnosed?

A

Stimulated pituitary function tests

Pituitary MRI

19
Q

Why must stimulated pituitary function tests be carried out, why can’t we just measure plasma conc of the APG hormones?

A 
Hormone levels fluctuate throughout the day
Cortisol-changes in the day
Thyroxine-half life
GH + ACTH=pulsatile
FSH/LH=cyclical
20
Q

How do we test for each of the APG hormones in a stimulated pituitary function test?

A

GH & ACTH are stress hormones so we induce hypoglycaemia

TSH is given to measure thyroixine
FSH/LH are given to measure oestrogen/progesterone/testosterone levels

21
Q

How is hypopituitarism treated specifically for each APG hormone?

A

ACTH=hydrocortisone
FSH/LH=HRT (oestrogen + progesterone/testosterone)
GH=GH
TSH=thyroxine

22
Q

Why is hormone treatment not 100% effective?

A

Tablets release the hormone steadily not at different levels in response to need

23
Q

What stimulates + inhibits GH release from the APG?

A

Inhibits=somatostatin

Simulates=GnRH

24
Q

What does GH stimulate?

A

IGF-1 release from liver

25
Q

3 types of GH deficiency + the condition they cause?

A

Issue with hypothalamus=Prader Willi syndrome
Issue with APG (secondary disease)=pituitary dwarfism
Issue with GH receptor=laron dwarfism

26
Q

What is the issue in normal dwarfism?

A

Skeletal

27
Q

5 causes of GH deficiency?

A 
Trauma
Surgery
Tumour
Radiotherapy
Cranial
28
Q

Causes of short stature?

A 
Short parents 
Endocrine
Genetic e.g. turners/downs/prader willi
Malnutrition/Malabsorption e.g. coeliac 
Emotional deprivation 
Puberty delay
FGR/SGA
Significant illness-inflammation blocks IGF-1 signalling
29
Q

How is short stature diagnosed?

A

Falling off centile charts

30
Q

How is GH deficiency diagnosed?

A

GH provocation tests-do/give things that should normally increase GH levels
e.g. excercise/insulin/GnRH

If levels dont increase=GH deficiency

31
Q

What does insulin do to GH levels normally?

A

Increases them

32
Q

4 symptoms of GH deficiency?

A

1) reduced lean mass + muscle strength
2) increased adiposity
3) decreased HDL & increased LDL
4) reduced Qual

33
Q

How is GH treated + how is treatment monitored?

A

GH injections daily

Monitor by measuring IGF-1

34
Q

2 disadvantages of GH therapy?

A

Expensive

Cancer??

ENDOCRINOLOGY (19 decks)

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