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Stage 3 Case 4 > AVP, oxytocin, growth hormones and pituitary > Flashcards

AVP, oxytocin, growth hormones and pituitary Flashcards

1
Q

What is the pituitary gland?

A

Integrates signals and releases hormones that regulate the functions of other endocrine glands.
Vital roles in homeostasis

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2
Q

What is the two lobes the pituitary gland split into?

A

Anterior and posterior

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3
Q

What is the driving force of the pituitary gland?

A

The hypothalamus

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4
Q

Where is the pituitary gland located?

A

Base of the brain attached to the hypothalamus

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5
Q

Anterior lobe of the pituitary gland

A

Synthesizes and secretes hormones in response to hypothalamic regulation.

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6
Q

Posterior lobe of the pituitary gland

A

Stores and secrets hormones synthesized in the hypothalamus. (Does not produce any hormones)

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7
Q

Does the posterior pituitary produce hormones?

A

No

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8
Q

What two hormones are stored secreted by the posterior pituitary?

A 
Antidiuretic hormones (ADH/vasopressin)
 Oxytocin
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9
Q

What does antidiuretic hormone regulate (ADH/vasopressin)?

A

Regulation of renal failure

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10
Q

What does oxytocin regulate?

A

Regulation of uterine contraction

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11
Q

What the 4 things that feed into the hypothalamus that stimulate the posterior pituitary gland?

A
  1. Hyperosmolarioty (main)
  2. Angiotensin II (main)
  3. Decreased atrial receptor firing
  4. Sympathritric stimulation
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12
Q

What two reports does ADH/vasopressin work on?

A

V1 and V2

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13
Q

What does activation of the V1 receptor do?

A

Acts on the blood vessels casing constriction, increased systemic vascular resistance.

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14
Q

What does activation of the V2 receptor do?

A

Kidneys, fluid reabsorption, increased blood volume

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15
Q

What is the overall affect of vasopressin/ADH after activation V1 and V2?

A

Increased arterial pressure (increased BP). V2 regulates water excretion by decreasing, so retaining water.

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16
Q

Effect of reduced ADH/vasopressin

A

Diabetes insipidus, copious hypotonic urine.

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17
Q

Treatment for reduced ADH/vasopressin

A

V2 agonist - desmopressin (mimics vasopressin)

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18
Q

Effect of excess ADH/vasopressin

A

Hyponatremia (diluted NA due to excess water)

Oedema

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19
Q

Treatment for excess ADH/vasopressin

A

Demeclocycline (blocks transduction of V2)
Tolvaptan (V2 antagonist) (expensive)
Restrict fluids

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20
Q

Cause of excess ADH/vasopressin

A

Tumor, head injury, TB

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21
Q

ADH/vasopressin mechanism (5)

A
  1. Hypothamalus stimulates posterior pituitary through hyperosmolarity and angiotensin, II
  2. Vapsoresisibe secreted and acts of V1 and V2 receptor.
  3. V1= blood vessel constriction = increased systemic vascular resistance
  4. V2= Kidney fluid reapportion = increased blood volume (water retention)
  5. Increased arterial pressure
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22
Q

Oxytocin mechanism (3)

A
  1. Stretch of uterus, uterine cervix and stimulation of breasts increases action potentials in axons of oxytocin-secreting neuron.
  2. Action potential go to hypothalamus and simulation secretion of oxytocin via posterior pituitary
  3. Oxytocin release increased uterine contraction and milk release from breasts.
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23
Q

Clinical use of oxytocin (3)

A

Labour induction (Slow IV)
Prevention/treatment of hemorrhage (Prophylactic IM)
Labour too quick (Antagonist: Atosiban)

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24
Q

Two types of hormones produced and secrete by anterior pituitary

A

Tropic and directly acting

25
Q

What do tropic pituitary hormones do?

A

Affect the section of other endocrine glands

26
Q

What do directly pituitary hormones do?

A

Act directly on pituitary glands

27
Q

Tropic pituitary hormones (3)

A
  • Adrenocorticoid hormones (corticotrophin)
  • Follicle-stimulating hormone (FSH) and luteinising hormone (LH)
  • Thyrotropin (Thyroid stimulating hormone
28
Q

Directly pituitary hormones (2)

A 
Growth hormone (somatropin)
 Prolactin
29
Q

Adrenocorticotropic hormone

(corticotropin) target

A

Adrenal glands

30
Q 
Follicle-stimulating hormone (FSH) and 
 luteinising hormone (LH) target
A

Reproductive system

31
Q

Thyrotropin (thyroid-stimulating

hormone) target

A

Thyroid gland

32
Q

Growth hormone (somatotropin) target

A

Liver, bone, muscles

33
Q

Prolactin target

A

Mammary glands

34
Q

Adrenocorticotropic hormone

(corticotropin) effect

A

Stimulate production of glucocorticoids, which regulate metabolism and stress response

35
Q 
Follicle-stimulating hormone (FSH) and 
 luteinising hormone (LH) effect
A

FSH stimulates maturation/production of sex cells LH stimulates sex hormones by the gonads

36
Q

Thyrotropin (thyroid-stimulating

hormone) effect

A

Stimulates the release of thyroid hormones which regulate metabolism

37
Q

Growth hormone (somatotropin) effect

A

Induce production of insulin-like growth factors, which stimulate body growth and higher metabolic rate

38
Q

Prolactin effect

A

Promotes milk production

39
Q

Adrenocorticotropic hormone

(corticotropin) RH/IH

A

Corticotropin-RH

40
Q 
Follicle-stimulating hormone (FSH) and 
 luteinising hormone (LH) RH/IH
A

Gonadotropic RH

41
Q

Thyrotropin (thyroid-stimulating

hormone) RH/IH

A

Thyrotropin-RH

42
Q

Growth hormone (somatotropin) RH/IH

A

Growth hormone-RH and Growth

hormone-IH (somatostatin)

43
Q

Prolactin RH/IH

A

Prolactin-RH and prolactin-IH

(dopamine)

44
Q

What are hypothalamic releasing factors?

A

Peptides
Some regulate more than one hormone, and some hormones regulated by more than one releasing factor
They also can on neurotransmitters in the CNS.

45
Q

Anterior pituitary hormone regulation mechanism general

A
  1. Hypothalamus detects need for inhibition or increase of hormones and relapses RH/IH.
  2. IH turns pituitary off
  3. RH stimulates pituitary release of hormone to act on tissue which has an effect.
  4. After desired effect, feedback to hypothalamus and pituitary to stop.
46
Q

When are high levels of growth hormone released? (4)

A
  • Exercise
  • Sleep
  • Stress
  • Thyroid hormone enhanced secretion
47
Q

What is the growth hormone sensitive to?

A

Very sensitive to noradrenergic activation, beta-antagonist promotes secretion and alpha antagonist inhibit secretion.

48
Q

Two types of growth hormone deficiency

A

Secretion deficiency

Receptor defects

49
Q

Growth hormone secretion deficiency effects

A

Hypothalamic or pituitary dysfunction e.g. turners syndrome

50
Q

Growth hormone receptor defects effects

A

Laron type dwarfism; fail to produce IGF in response to GH

51
Q

Clinical manifestation of growth deficiency dependent on age

A

Children: growth retardation/dwarfism

Adult: increased body fat, decreased muscle and bone mass

52
Q

Treatment for dwarfism due to growth hormone section deficiency

A

Somatropin – SC injection strict guidelines for use and specialist initiation.

53
Q

What neurotransmitter can reduce growth hormone secretion?

A

Dopamine

54
Q

Growth hormone and glucose

A

Counter-regulates glucose:
Hyperglycemia action
Causes insulin resistance

55
Q

What neurotransmitter can reduce prolactin release?

A

Dopamine

56
Q

Hyperprolactinemia

A

Too much prolactin

57
Q

Treatment for hyperprolactinemia: Bromocriptine

A

Dopamine agonist

Reduces prolactin secretion

58
Q

Treatment for hyperprolactinemia: Cabergoline

A

Alternative dopamine agonist
Less side effects
Less data in pregnancy

59
Q

Treatment for hyperprolactinemia: Quinagolide

A

Non-ergot alkaloid

Stage 3 Case 4 (11 decks)

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