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Endocrine > 2-2-16-Hypothalamic-Pituitary Relationships (Lopez) > Flashcards

2-2-16-Hypothalamic-Pituitary Relationships (Lopez) Flashcards

1
Q

The relationship between the hypothalamus and the anterior pituitary is ___

The relationship between the hypothalamus and the posterior pituitary is ___

A

Both neural and hormonal

Neural

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2
Q

The anterior pituitary is connected to the hypothalamus by ___

A

Hypothalamic-hypophysial portal vessels

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3
Q

The ___ provide most of the blood supply to the anterior pituitary

A

hypothalamic-hypophysial portal vessels

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4
Q

___ is when you have low or high levels of hormone due to a defect in the peripheral endocrine gland (i.e., thyroid gland)

A

Primary endocrine disorder

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5
Q

___ is when you have low or high levels of hormone due to a defect in the pituitary gland

A

Secondary endocrine disorder

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6
Q

____ is when you have low or high levels of hormone due to a defect in the hypothalamus

A

Tertiary endocrine disorder

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7
Q

In the anterior pituitary,

\_\_\_ releases ACTH
\_\_\_ releases TSH
\_\_\_ releases FSH and LH
\_\_\_ release GH
\_\_\_ releases prolactin
A 
Corticotroph=ACTH
Thyrotroph=TSH
Gonadotroph=FSH and LH
Somatotroph=GH
Lactotroph=Prolactin
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8
Q

List the hypothalamic releasing hormone for the secretion of:

a-TSH
B-ACTH
C-LH, FSH
D-GH
E-Prolactin
A 
A-TRH
B-CRH
C-GnRH
D-GHRH
E-PIF (dopamine) or TRH (elevated)
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9
Q

The anterior lobe hormones can be separated into these organizational families based on structural and functional homology

A
  • ACTH family
  • TSH, FSH, and LH family
  • GH and prolactin family
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10
Q

___ has melanocyte-stimulating hormone activity

A

ACTH

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11
Q

In ___ disease, ACTH levels increase and skin pigmentation is a symptom of this disorder

A

Addison

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12
Q

ACTH stimulates these 2 zones of the adrenal gland:

A

Medulla and Cortex

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13
Q

The actions from GH result from 2 different effects:

___ has an effect on the target tissues (e.g., skeletal m., liver, adipose)

__ is mediated by the production of somatomedins in the liver (e.g., IGF-1)

A

Direct

Indirect

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14
Q

This particular action/effect from GH causes an increase in [blood glucose] which can cause insulin resistance, decreased glucose uptake and utilization by target tissue, increased lipolysis in adipose. The result is an increase in blood insulin levels.

A

Diabetogenic effect

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15
Q

This particular action of GH leads to an increased uptake of AA’s, stimulation of synthesis of DNA, RNA, and protein, and is mediated by somatomedins.

A

Increased protein synthesis and organ growth

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16
Q

This particular action of GH stimulates synthesis of DNA, RNA, protein, is mediated by somatomedins, and increases metabolism in cartilage-forming cells and chondrocyte prolfieration

A

Increased linear growth

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17
Q

Acromegaly can be a result of what?

A

GH excess

GH excess is mostly due to a GH-secreting pituitary adenoma

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18
Q

What happens if you have GH excess before puberty?

What happens if you have GH excess after puberty?

A

Gigantism

Increased periosteal bone growth, increased organ size, increased extremities size, coarsening of facial features, insulin resistance, and glucose intolerance

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19
Q

___ supports the actions of estrogen and progesterone

A

Prolactin

20
Q

List 3 actions of prolactin:

A

Breast development: at puberty –> stimulate proliferation and branching of mammary ducts; during pregnancy –> stimulate growth and development of the mammary alveoli

Lactogenesis–> induce synthesis of lactose, casein, and lipids

Suppression of ovulation –> inhibits synthesis and secretion of GnRH

21
Q

___ is a condition of inadequate or absent production of the anterior pituitary hormones.

A

Panhypopituitarism

22
Q

What are some causes of hypopituitarism?

A

Brain damage–> traumatic brain injury, subarachnoid hemorrhage, irradiation, stroke

Pituitary tumors–> adenomas

Non-pituitary tumors–> cranipharyngioma: most common tumor affecting the HP axis in children

Infections–> meningitis, encephalitis, hypophysitis

Infarction–> sheehan syndrome: pituitary in pregancy is enlarged and more vulnerable to infarction

Autoimmune disorders, pituitary hypoplasia or aplasia, genetic or idiopathic causes

23
Q

___ syndrome is when the pituitary gland is enlarged and more vulnerable to infarction during pregnancy

A

Sheehan

24
Q

Most pituitary tumors are ___ and occur spontaneously

A

pituitary adenomas

25
Q

___ adenomas release an active hormone in excessive amounts into the bloodstream. The pt usually experience symptoms related to the hormone action in the body

A

Hormone-producing pituitary

26
Q

A prolactinoma is a tumor that overproduces prolactin and is associated with ____

A

Hypogonadism and galactorrhea

27
Q

Acromegaly and gigantism are caused by an excess of ___

A

GH

28
Q

___ is caused by a pituitary tumor stimulating an overproduction of cortisol

A

Cushings disease

29
Q

The precursor peptide of ADH is ___

The precursor peptide of Oxytocin is ___

A

Preprossophysin

Prepro-oxyphysin

30
Q

___ is the major hormone concerned with the regulation of body fluid

A

ADH

Prepropressophysin to Propressophysin in the hypothalamus –> Goes down hypothalamic-hypophyseal tract (axons of neurons) to the posterior pituitary –> ADH in the posterior pituitary –> when needed, ADH into the bloodstream –> target tissues of kidneys and blood vessel

31
Q

What are triggers of ADH secretion?

A
  • Decreased BP –> cardiac and aortic baroreceptors –> sensory neuron to hypothalamus
  • Decreased arterial stretch due to low blood volume –> atrial stretch receptors –> sensory neuron to hypothalamus
  • Increased osmolarity –> hypothalamic osmoreceptors –> interneuron to hypothalamus

These all act on hypothalamic neurons that synthesize ADH –> ADH released from posterior pituitary

32
Q

Secretion of ADH is most sensitive to ___ changes. An increased of only 1% of this factor will increased ADH secretion

A

Osmolarity

33
Q

Aquaporin-2 channels can be found on the ___ membrane and Aquaporin-3 channels can be found on the ___ membrane

A

Aq2=Apical

Aq3=Basolateral

34
Q

Too little water will result in ___ levels of ADH in the bloodstream

Too much water will result in ___ levels of ADH in the bloodstream

A

Increased

Decreased

35
Q

When the hypothalamus detects too little water, the pituitary gland releases ADH, the kidneys remove less water from the blood and the urine becomes ___

A

More concentrated

Will also increase thirst levels as plasma [ADH] exceed ~295 mOsm

36
Q

WHen the hypothalamus detects too much water in the blood, the pituitary gland releases less ADH, the kidneys remove more water from blood and the urine becomes ____

A

More dilute

37
Q

___ is characterized by a lack of an effect of ADH on the renal CD which causes frequent urination and a large volume of dilute urine

A

Diabetes Insipidus

38
Q

___ results from damage to the pituitary and destruction of the hypothalamus that leads to a lack of or decrease in plasma ADH

A

Central DI

39
Q

___ is caused by drugs such as lithium or chronic disorders such as polycystic kidney disease and sickle cell anemia. The kidneys are unable to respond to ADH (Increased plasma ADH)

A

Nephrogenic DI

40
Q

Desmopressin can be used to treat ___ DI

A

Central DI–> Desmopressin does not work for Nephrogenic DI

Desmopressin prevents water excretion

41
Q

Plasma ADH levels are expected to be lower than normal in ___

Plasma ADH levels are expected to be higher than normal in ___

A

Central DI

Nephrogenic DI

42
Q

___ is characterized by excessed ADH secretion, excessive water retention, and/or hypoosmolarity fails to inhibit ADH release

A

SIADH

43
Q

How do you treat SIADH?

A

Fluid restriction
IV hypertonic saline
V2 receptor antagonist
Demeclocycline

44
Q 
Predict anatomic/physiologic changes as a result of pituitary failure and the following hormones:
A-GH
B-FSH/LH
C-TSH
D-ACTH
E-ADH
A

A-Children: short stature, Adults: no effect
B-Infertility, hypogonadism, reduced sperm count in men; Menstrual irregularity in women
C-Hypothyroidism
D-Loss of pigmentation, hypoadrenalism
E-Diabetes insipidus

45
Q

___ is a collection of axons whose cell bodies are located in the hypothalamus

A

Posterior pituitary –> secretes neuropeptides

  • Supraoptic nucleus (primarily ADH)
  • Paraventricular nucleus (primarily oxytocin)
46
Q

SIADH is characterized by ___

A

Euvolaemia –> Total body water is increased but normal total body sodium

Endocrine (14 decks)

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