Anterior Pituitary (pathophys)

Question 1

what’s the anterior pituitary made of?

Answer 1

red vascular glandular tissue

Question 2

Hormones inhibited by somatostatin (17)

Answer 2

Acetylcholine
Arginine vasopressin 
Cholecystokinin
Epidermal growth hormone 
Glucagon
Gastrin
Gastric inhibitory polypeptide 
Growth hormone
Insulin
Motilin
Neurotensin 
Pancreatic polypeptide 
Secretin
Serotonin
Substance P
Thyrotropin
Vasoactive intestinal polypeptide

Question 3

Results of pitutitary hormone deficiency of GH

Answer 3

short stature

Question 4

Results of pitutitary hormone deficiency of FSH

Answer 4

infertility

Question 5

Results of pitutitary hormone deficiency of LH

Answer 5

men: hypogonadism, reduced sperm count
women: hypogonadism, amenorrhea, oligomenorrhea

Question 6

Results of pitutitary hormone deficiency of TSH

Answer 6

hypothyroidism

Question 7

Results of pitutitary hormone deficiency of ACTH

Answer 7

hypoadrenalism, loss of pigmentation

Question 8

Results of pitutitary hormone deficiency of prolactin

Answer 8

sheehan’s syndrome

Question 9

Results of pitutitary hormone deficiency of ADH

Answer 9

diabetes insipidus

Question 10

other name for ADH

Answer 10

vasopressin

Question 11

Results of pitutitary hormone deficiency of oxytocin

Answer 11

failure of milk letdown, post-partum uterine bleeding?

Question 12

secretary pituitary tumors can release which hormones? (5)

Answer 12

prolacting
ACTH
GH
gonadotropins (rare)
TSH (rare)

Question 13

effect of prolactin excess (females, 5 items)

Answer 13

AMENORRHEA 
OLIGOMENORRHEA 
GALACTORRHEA  (30-80%)
INFERTILITY 
OSTEOPENIA

Question 14

effect of prolactin excess (males, 4 items)

Answer 14

HYPOGONADISM
DECREASED LIBIDO
GALACTORRHEA (RARE <30%)
PITUITARY DEFICIENCIES

Question 15

effect of ACTH excess

Answer 15

cushing’s disease

Question 16

effect of GH excess (2)

Answer 16

acromegaly

gigantism

Question 17

effect of gonadotropins (3 + frequency)

Answer 17

visual disturbances
headaches
hypogonadism

rare

Question 18

effect of TSH excess (+frequency)

Answer 18

hyperthyroidism

rare

Question 19

feedback system of GH

Answer 19

hypothalamus releases GHRH (+GH) and somostatin (-GH) which regulate GH output.

GH (+somotostatin?) –> liver
–> IGF-1 (feeds back to pituitary & hypothalamus)

Question 20

98% of acromegaly due to

Answer 20

pituitary disorders releasing GH

Question 21

60% of pituitary acromegaly due to

Answer 21

GH - cell adenoma releasing GH

Question 22

25% of pituitary acromegaly due to

Answer 22

mixed GH-cell and prolactin-cell adenoma releasing GH

Question 23

extripituitary cause of acromegaly

Answer 23

pancreatic islet-cell tumor (very rare) releasing GH

Question 24

excess GHRH secreting types of acromegaly (2)

Answer 24

central ectopic (<1%)
peripheral ectopic (1%)

Question 25

risks of long-term GH conc elevation

Answer 25

malignancy:colon, esophagus, melanoma, stomach ~3x risk

arthropathy
hypertension
neuropathy
respiratory disease
CV disease
carbohydrate intolerence (DM)

Question 26

From where could GHRH come from that would cause gigantism? (2)

Answer 26

lung carcinoid tumors

islet cell tumors

Question 26

From where could GHRH come from that would cause gigantism? (2)

Answer 26

lung carcinoid tumors

islet cell tumors

Question 27

Manifestations of GH excess see in >40% of patients

Answer 27

Acral enlargement 100%
Soft Tissue overgrowth 88%
Hyperhidrosis 87%
Lethargy of fatigue 73%
Paresthesias 70%
Joint Pain 69%
Photophobia 46%
Papillomas 45%

Question 27

Manifestations of GH excess see in >40% of patients

Answer 27

Acral enlargement 100%
Soft Tissue overgrowth 88%
Hyperhidrosis 87%
Lethargy of fatigue 73%
Paresthesias 70%
Joint Pain 69%
Photophobia 46%
Papillomas 45%