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REB > 3. Hypothalamus/ Pituitary 2 > Flashcards

3. Hypothalamus/ Pituitary 2 Flashcards

1
Q

What is the name for a decrease in secretion of all anterior pituitary hormones?

A

Panhypopituitarism

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2
Q

What are the causes of panhypopituitarism?

A

Congenital
Pituitary tumour
Pregnancy (infarction of portal vessels

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3
Q

What does a deficiency of AP hormones in childhood result in?

A

Panhypopituitary dwarfism
Greatly decreased rate of development
Person never passes through puberty

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4
Q

What are the symptoms of panhypopituitarism in the adult?

A

Hypothyroidism
Decreased production glucocorticoids
Loss of sexual function

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5
Q

How is panhypopituitarism in the adult treated?

A

Adrenocortical and thyroid hormones

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6
Q

What type of hormone is growth hormone?

A

Peptide

191 amino acids

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7
Q

What 5 factors influence a person’s final height?

A 
Growth hormone
Genes
Diet
Stressfulness of environment
Thyroid and sex hormones
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8
Q

What is the most abundant hormone produced by the anterior pituitary?

A

Growth Hormone

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9
Q

What are the target organs of GH?

A

Adipose tissue
Skeletal muscle
Liver

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10
Q

What are the metabolic effects of GH?

A

Increases mobilisation of fatty acids from adipose
Decreases glucose utilisation
Increases rate of protein synthesis

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11
Q

What are somatomedins?

A

Stimulated by GH
Structurally and functionally similar to insulin
IGFs

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12
Q

What is a major source of circulation IGF-1?

A

Liver

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13
Q

What effect does GH have on bone growth?

A

Increases rate of osteoblasts
Increases division of chondrocytes
Older chondrocytes expand
When these die, osteoblasts fill the space with bone

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14
Q

What stimulates GH secretion?

A

GHRH

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15
Q

What inhibits GH release?

A

GHIH/somatostatin

High blood levels IGF-1

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16
Q

What factors can influence GH secretion?

A 
Diurnal rhythm
Exercise
Stress
Low blood glucose
High protein meal
Low blood fatty acids
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17
Q

What can cause a deficiency in GH?

A

Hypothalamic dysfunction
Pituitary defect
Mutations in GH receptor

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18
Q

What is dwarfism?

A

Hyposecretion of GH as a child
Short stature
Poorly developed muscles
Excess subcutaneous fat

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19
Q

What is Laron Dwarfism?

A

Abnormal GH receptors on tissues

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20
Q

What is the defect in African pygmies?

A

Lack IGF-1

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21
Q

What does a GH deficiency in adults result in?

A

Reduced skeletal mass and strength
Decreased bone density
Increased risk of heart failure

22
Q

How is GH deficiency treated?

A

Recombinant GH

23
Q

What are the causes of GH excess?

A

Tumour of GH producing cells in anterior pituitary

Defect in GH secreting mechanisms

24
Q

What does overproduction of GH result in in a child?

A

Gigantism
Rapid growth in height
Hyperglycaemia

25
Q

What does hypersecretion of GH after adolescence result in?

A

Thickening of bones
Skin and connective tissue proliferates
Acromegaly
Possible insulin resistance and hyperglycaemia

26
Q

How is GH excess measured?

A

Glucose Loading Test

27
Q

How is GH excess treated?

A

Somatostatin mimetics

28
Q

Who is recombinant GH approved for use in?

A

GH deficient children
Adults with pituitary tumours
AIDS patients with muscle wasting
Shortest 1.2% of children

29
Q

What are the disadvantages of extended or excessive use of GH?

A

Increases likelihood of: diabetes, kidney stones, high BP, headaches, joint pain, carpal tunnel, cancer
Expensive

30
Q

How long does it take for PRL levels to decline if a mother does not nurse?

A

3-6 weeks

31
Q

How long do PRL levels remain elevated if a mother breastfeeds?

A

8-12 weeks

32
Q

How is PRL secretion regulated?

A

PIH/Dopamine and PRH

Short loop feedback

33
Q

What are the biological effects of PRL?

A
  1. Branching of ducts in breasts (puberty)
  2. Development of lobules for milk production (pregnancy)
  3. Milk synthesis and secretion (after parturition)
  4. Excess stops release of GnRH
  5. Prevents mother’s immune system from attacking foetus
34
Q

What is the cause of a deficiency of PRL?

A

Destruction of the anterior pituitary

35
Q

What are the symptoms of a lack of PRL?

A

Inability to lactate

36
Q

What are the causes of an excess of PRL?

A

Hypothalamic dysfunction

Pituitary tumours

37
Q

What are the symptoms of PRL excess in women?

A

Infertility
Complete loss of menses
Lactation
Decreased libido

38
Q

What are the symptoms of PRL excess in men?

A

Decreased testosterone
Decreased sperm production
Breast development and lactation
Libido decreased

39
Q

How is a lactotroph tumour treated?

A

Removal of tumour

Administration of dopaminergic drugs

40
Q

What are the functions of oxytocin?

A

Milk ejection

Contraction of uterus

41
Q

What increases secretion of oxytocin?

A

Reflexes (suckling infant, birth canal)

42
Q

What is the function of vasopressin?

A

Water retention

Contraction of arteries

43
Q

What influences ADH secretion?

A
  1. Osmotic and volume stimuli
  2. Decreased blood volume of BP
  3. Pain, emotional stress, heat
  4. Age
  5. Alcohol (inhibits secretion)
44
Q

What is the most common form of ADH deficiency?

A

Diabetes Insipidus

45
Q

What causes hypothalamic DI?

A

Deficiency in ADH from PP
Tumours of hypothalamus
Autoimmune disease
Head trauma

46
Q

What causes nephrogenic DI?

A

Kidney is unable to respond to ADH
Renal disease
Mutations in ADH receptor
Drugs

47
Q

What are the major symptoms of DI?

A

Polyuria
Polydipsia
Nocturia

48
Q

How is hypothalamic DI treated?

A

Exogenous ADH

49
Q

What is the name of the condition where ADH is secreted in excess?

A

Syndrome of Inappropriate ADH Secretion

SIADH

50
Q

What are the symptoms of SIADH?

A

Hyponatraemia (low Na+)

Lethargy, anorexia, nausea, muscle cramps, drowsiness, confusion, seizures, coma

51
Q

What are the causes of SIADH?

A

CNS damage
Drugs
Infection

52
Q

How is SIADH treated?

A

Fluid restriction

ADH antagonists

REB (29 decks)

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