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endo 1 > berverly 1 > Flashcards

berverly 1 Flashcards

1
Q

how does the hypothalamus regulate the anterior and posterior pituitary gland

A
  • Controls OUTPUT of the ANTERIOR PITUITARY BY MEANS OF RELEASING HORMONES
  • Controls OUTPUT of hte POSTERIOR PITUITARY by means of DIRECT NERVE STIMUALTION
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2
Q

What are the two hormones that posterior pituitary secrete

A
  • Antidiuretic hormone (ADH) or Arginine vasopressin (AVP)
  • Oxytocin
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3
Q

list the 6 anterior pituitary gland hormones

A
  • prolactin
  • growth hormone
  • thyroid stimulating hormone
  • follicle stimulating hormone
  • adrenocorticotropic hormone
  • luteinizing hormone
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4
Q

Growth Hormone

A

Anterior pituitary

  • pulsatile secretion with greates levels at ONSET OF SLEEP (at night)
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5
Q

deficiency of Growth hormone

A
  • Childhood = dwarfism

–> short stature, micropenis, increased fat, high-pitched voice

TX = replacement therapy with recombinant GH

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6
Q

Growth hormone Hypersecretion

A
  • Youth –> Gigantism
  • Adults –> Acromegaly

–> increased height, hand and foot sizes

–> soft tissue swelling

–> generalized visceromegaly (heart and tongue)

TX

–> surgery for tx of tumors

–> Somatostatin analogues

–> dopamine agonists

–> GH antagonist = Pegvisomant

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7
Q

Prolactin

A

anterior pituitary

  • Pulsatile secretion with peaks during REM SLEEP
  • Under hypothalamic inhibition by Dopamine
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8
Q

Hyperprolactinemia

A
  • Most common benign neoplasm (prolactomas)
  • Female = amenorrhea, galactorrhea, infertility, mild hisutism
  • Male = diminished libido or visual loss from optic nere compression, headaches, gynecomastia, impotence
  • TREATMENT

–> dopamine agonist = alleviate gonadal dysfunction

–> surgery = debulking

–> readiotherapy

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9
Q

ADrenocorticotropin hormone (ACTH)

A

Anterior pituitary

  • pulsatile secretion with a circadian rhythm (peaks at 6am and lowest at midnight)
  • Stimulates the adrenal gland to produce corticosteroids and androgens
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10
Q

ACTH defiiciency

A

Primary adrenal insufficiency or ADDISON’S DISEASE

  • results in secondary adreanl insufficeincy with increasing fatigue, weakness, anorexia, nausea, vomiting, weight loss, low blood pressure, depression, sometimes hypoglycemia
  • TREATMENT = LUCOCORTICOID; hydrocortisone or prednisone
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11
Q

ACTH hypersecretion

A
  • CUSHING SYNDROME

  • most are iatrogenic
  • thin, brittle skin, central obesity with moon facies, buffalo hump, hypertension, purple striae and easy brusiing
  • TREATMENT
  • surgery followed by cortisol replacement
  • pituitary radiation if surgery unsuccessful
  • adrenalectomy if necessary
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12
Q

FSH and LH

A

anterior pituitary

  • regulated by GnRH
  • secreted in discrete pulses every 60-120 minutes
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13
Q

FSH and LH deficiency

A
  • WOmen = menstrual irregularities, infertility, decreased vaginal secretions, decreased libido, and breast atrophy, osteoporosis

–> TX = cyclical replacment of estrogen and progesterone, gonadotropin therapy for ovulation induction, hCG to induce ovulation

  • MALES = decreased libido and potency, decreased muscle mass with weakness, reduced beard and body hair growth, soft testes and osteoporosis

–> TX = testosterone replacement and hCG restores fertility

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14
Q

FSH and LH hypersecretion

A
  • Gonadotropin producing adenomas typically produce only SMALL AMOUNTS OF FSH AND LH
  • may see attenutaed Lh and hypogonadism due to compression of pituitary stalk with optic chaism pressure causing visual problems
  • TREATMENT = if large, surgery followed by radiation if postoperative rediual mass is present
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15
Q

Thyroid stimulating hormone (TSH) deficiency

A
  • fatigue; dry skin, cold, hair loss; wiehgt gain with poor appetitie; puffy face hands and feet (myxedema)
  • TREATMENT = levothyroxine
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16
Q

TSH hypersecretion

A
  • Heat intolerance, palpitations, weight loss with increased appetitie, goiter, periorbital edema and proptosis (exophthalmia)
  • TREATMENT = surgery followed by somatostatin analogue

**GRAVES DISEASE**

17
Q

AVP – VASOPRESSIN

A

posterior pituitary

  • reduces water excretion by increasing concentration of urine
  • secretion regulated by the effective osmotic pressure of body fluids –> osmoreceptors
18
Q

Vasopressin deficiency

A

DIABETES INSIPIDUS

  • abnormally large volumes of dilute urine
  • idiopathic or vascular and many other caues
  • urinary frequency, enuresis and or nocturia, thirst and polydipsia
  • TREATMENT = synthetic analog of AVP = DESMOPRESSIN
19
Q

vasopressin HYPERsecretion

A

SIADH = syndrome of inappropriate ADH

  • decreased volumes of more highly conc urine
  • hyponatremia and water retention
  • IF ACUTE, water intoxication; headache, confusion, anorexia, nausea, vomiting, coma, convulsions and death
  • TREATMENT

–> ACUTE = restrict total fluid intake

–> chornic demeclocycline or fludrocortisone

20
Q

Pituitary apoplexy

A
  • due to intrapituitary hemorrhagic vascular event
  • endocrine emergency
  • ACUTE SYMPTOMS = severe headache, bialteral visual changes, in severe cases, CV collapse, loss of consciousness
  • May result in severe hypoglycemia, hypotension, CNS hemorrhage and death
  • TREATMENT = surgery

endo 1 (17 decks)

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