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D1 Spring - Physiology Exam 2 > 2/12-15: Pituitary Hormones > Flashcards

2/12-15: Pituitary Hormones Flashcards

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1
Q

What is a true endocrine gland?

A

Anterior pituitary gland

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2
Q

What gland contains axon terminals of hypothalamic neurons?

A

Posterior pituitary gland

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3
Q

What hormones does the pituitary gland secrete?

A

Peptide hormones

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4
Q

What hormones are in the anterior pituitary?

A
  • Growth Hormone
  • Adrenocotricotropin (ACTH)
  • Thyroid-Stimulating
    Hormone (TSH)
  • Follicle-Stimulating
    Hormone (FSH)
  • Luteinizing Hormone (LH)
  • Prolactin
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5
Q

What hormones are in the posterior pituitary?

A
  • Antidiuretic Hormone
    (ADH)/Vasopressin
  • Oxytocin
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6
Q

What do somatotrophs secrete?

A

GH

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7
Q

What do corticotrophs secrete?

A

ACTH

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8
Q

What do thyrotrophs secrete?

A

TSH

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9
Q

What do gonadotrophs secrete?

A

LH and FSH

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10
Q

What do mammotrophs secrete?

A

Prolactin

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11
Q

What do adenomas involving somatotropic cells cause?

A

gigantism if occurring in
children before closure
of the long bones’
epiphyseal plates or
acromegaly in adults,
with musculoskeletal,
neurologic, and other
medical consequences

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12
Q

What do neurons in the hypothalamus do?

A

Synthesize and secrete hypothalamic releasing and inhibiting hormones that control the endocrine cells in the anterior pituitary

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13
Q

Where are hypothalamic hormones released into?

A

Primary capillary plexus in the median eminence

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14
Q

What do hypothalamic-hypophyseal portal blood vessels carry?

A

The hypothalamic hormones to the sinuses of the anterior pituitary gland

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15
Q

What hormones stimulate release?

A

TRH (thyrotropin releasing hormone)
GnRH (gonadotropin releasing hormone)
CRH (corticotropin releasing hormone)
GHRH (growth hormone releasing hormone)
PRH (prolactin releasing hormone)

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16
Q

What hormones inhibit release?

A

GHIH (somatostatin)
PIH (prolactin inhibiting hormone - dopamine)

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17
Q

What do hypothalamic regulatory hormones bind to?

A

G-protein coupled receptors in various endocrine cells of the anterior pituitary

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18
Q

How do hypothalamic regulatory hormone stimulate or inhibit AP hormone secretions?

A

Through generation of second messenger

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19
Q

What kind of hormone is GH?

A

Peptide hormone

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20
Q

What does GH release?

A

Insulin-like growth factor-1 (IGF-1)

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20
Q

What does GH act on?

A

Target tissues and as a tropic hormone to the liver

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21
Q

What is pulsatile secretion?

A

Lower concentrations during the day with highest levels a few hours after sleep

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22
Q

What is growth hormone secretion stimulated by?

A

starvation
(protein deficiency), fasting
(hypoglycemia), stress,
exercise, and excitement

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23
Q

When is secretion of the growth hormone?

A

neonatal period but decreases in childhood. Peak levels during puberty and then they decline with age

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24
What are growth and metabolic effects of GH produced by?
IGFs (also called somatomedins)
25
Where is IGF-1 produced?
Most tissues
26
What does IGF-1 act on?
Neighboring cells in a paracrine manner
27
What is the major site of IGF-1 synthesis?
The liver
28
How many different IGF binding proteins are there?
6 (IGFBP-1 and IGFBP-3)
29
Growth in nearly all tissues in the body (increased size of cells, mitosis and differentiation of bone and muscle cells) acts mainly via?
IGF 1 ↑Organ size ↑Organ function ↑Linear growth
30
What does amino acid uptake and protein synthesis in most cells do?
↑Lean body mass
31
What does reduced glucose utilization cause?
decreased uptake, increased hepatic glucose production and increased insulin secretion (insulin resistance; diabetogenic)
32
What does mobilization of fatty acids from adipose tissue result in?
Increased FFA in blood and use of FFA for energy
33
What are the main mechanisms of action of GH and IGF-1?
↑Organ size ↑Organ function ↑Linear growth ↑Lean body mass ↓ adiposity
34
What do GH and IGF-1 stimulate?
Stimulate chondrogenesis and widening of the epiphyseal plates, followed by bone matrix deposition stimulating linear growth
35
In adults, GH and IGF-1 play a role in regulating the normal physiology of bone formation by
increasing bone turnover (increasing bone deposition via the activation of OSTEOBLASTS and also increasing bone resorption via activation of OSTEOCLASTS, though to a lesser extent)
36
What is growth hormone excess called in children and adults?
Gigantism in children Acromegaly in adults
37
What are symptoms of growth hormone excess?
Kyphosis Paresthesias Hyperthidrosis and oily skin Coarse facial features, large fleshy nose, frontal bossing, jaw malocclusion Coronary heart disease Diabetes mellitus
38
What is treatment for pituitary microadenoma?
Surgical resection of the tumor (adenomectomy) via transphenoidal approach followed by medication (somatostatin (GHIH) receptor ligand or GH receptor antagonist).
39
What are oral manifestations of GH excess?
- Thick rubbery skin, enlarged nose, and thick lips - Macrocephaly - Macrognathia - Disproportionate mandibular growth o Mandibular Prognathism o Generalized Diastemata - Anterior open bite and malocclusion (macrognathia and tooth migration) - Macroglossia, Dyspnea, Dysphagia, Dysphonia, Sialorrhea - Hypertrophy of the pharyngeal and laryngeal tissues -> sleep apnea
40
What are causes of growth hormone deficiency?
- hypothalamic disorders - mutations - Combined pituitary hormone deficiencies (panhypopituitarism) - Radiation - Psychosocial deprivation
41
What are mutations that cause GH deficiency?
GHRH receptor, GH gene, GH receptor, IGF-1 receptor
42
What do complete clinical manifestations depend on?
The time of onset and the severity of hormone deficiency
43
What does complete GH deficiency manifest as?
* slow linear growth rates * normal skeletal proportions * pudgy, youthful appearance (decreased lipolysis) * in the setting of cortisol deficiency -> hypoglycemia
44
What is the most common form of dwarfism?
Achondrodisplasia
45
What is achondrodisplasia?
autosomal dominant condition that results from a mutation of FGF-3 receptor in cartilage and brain
46
What does a mutation in FGF-3 cause>
This mutation makes the receptor overly active and it inhibits cartilage growth at growth plates so limb growth is reduced (growth of the trunk of the body is not impacted)
47
What are oral manifestations of GH deficiency?
Disproportionate delayed growth of the skull & facial skeleton -> small facial appearance
48
What happens to tooth formation in a GH deficiency?
Tooth formation & growth of the alveolar regions of the jaws are abnormal and may be disproportionately smaller than adjacent anatomic structures, I - tooth crowding and malocclusion - a high tendency for plaque accumulation - difficulty maintaining good oral hygiene - prone to gingivitis and periodontal disease
49
What is a common oral condition in someone who has a GH deficiency?
Solitary median maxillary central incisor
50
What is management of solitary median maxillary central incisor?
correct dental & skeletal malocclusions
51
What does the posterior pituitary/neurohypophysis secrete?
(1) Antidiuretic Hormone (ADH)/Arginine Vasopressin (AVP) (2) Oxytocin
52
What is the mechanism of action of ADH/AVP in blood vessels?
Contraction of vascular smooth muscle via V1 receptors
53
What does ADH/AVP bind to in renal tubules?
Binds to V2 receptors in the late distal tubule and collecting duct
54
What is the mechanism of action of ADH/AVP in renal tubules?
Aquaporin-2 (AQP-2) proteins are then inserted into the apical membrane of tubular epithelial cells, allowing for water reabsorption (along with AQP-3 and AQP-4 on the basolateral membrane)
55
What are stimuli that would lead to the body secreting ADH?
Decreased Blood Volume (Isotonic) Increased Osmolarity (Isovolemic) Decreased Blood Pressure
56
What do normal changes in osmolarity sitmulate?
ADH secretion by the posterior pituitary
57
What is hypodipsia?
Decreased or absent feeling of thirst, which results in reduced intake of water
58
What can hypodipsia cause?
Hypernatremia
59
What is hypodipsia associated with?
A common problem in elderly people, but is also associated with lesions in the hypothalamus (thirst center), head trauma, occult hydrocephalus or subarachnoid hemorrhage
60
What are ADH imbalances?
* Diabetes Insipidus (DI) – Neurogenic/Central – Nephrogenic/Peripheral * Syndrome of Inappropriate ADH (SIADH)
61
What is diabetes inspidus due to?
insufficient production (Neurogenic/Central) or lack of kidney response (Nephrogenic/Peripheral) to ADH
62
What is diabetes insipidus present with?
Polyuria: Excretion of a large volumes of urine that is hypotonic and tasteless (insipid)
63
What is a diagnostic test of diabetes inspidus?
dehydration test in a controlled environment
64
What are other causes of polyuria?
1. Primary ingestion of excess fluid: Primary Polydispia 2. Increased metabolism of ADH (ex. pregnancy)
65
What is syndrome of inappropriate ADH (SIADH)?
Increased and uncontrolled secretion of ADH that causes volume expansion and hyponatremia
66
What can syndrome of inappropriate ADH (SIADH) result from?
surgery, pain, stress, temperature changes, tumor, TB, Pneumonia, positive pressure breathing, Hydrocephalus, Meningitis, HIV, etc
67
What does oxytocin stimulate?
Contraction of the uterus towards the end of gestation
68
What does oxytocin cause?
Milk ejection from the breasts in lactation

D1 Spring - Physiology Exam 2 (7 decks)

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