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MEDICINE > CEP WK5 - pituitary > Flashcards

CEP WK5 - pituitary Flashcards

1
Q

PITUITARY ANTERIOR LOBE SECRETION

A

ACTH, FSH/LH, prolactin, GH, TSH

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2
Q

PITUITARY POSTERIOR LOBE SECRETION

A

ADH & oxytocin

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3
Q

PITUITARY GLAND

A

connected to hypothalamus by infundibulum & is in bony cavity of the brain

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4
Q

ANTERIOR LOBE

A
  • neurosecretory neurones go through arterial blood from hypothalamus to anterior pituitary (released in venous blood)
  • can’t synthesise & secrete own hormones (like pituitary can)
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5
Q

POSTERIOR LOBE

A

neurones go down (through stalk - from SON & PVN) & reach posterior lobe where they secrete products (it is pretty much just a neural extension of hypothalamus)

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6
Q

GH

A
  • regulated by GH releasing hormone (excites) & somatostatin (inhibits)
  • promotes IGF-1 production in liver (leads to growth, glucose metabolism)
  • stimulated by hypoglycaemia & has many peaks & troughs in the day
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7
Q

FSH/LH

A
  • regulated by gonadotropin releasing hormone (GnRH)

- in testes (testosterone production) & ovaries (oestrogen release)

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8
Q

PROLACTIN

A
  • regulated by dopamine (inhibits)

- suppresses GnRH (leads to low LH/FSH) & used for lactation

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9
Q

ACTH

A
  • regulated by corticotropin releasing hormone
  • high levels in morning & should be undetectable during sleep
  • secreted in anterior, goes to adrenal & secretes cortisol (stress, regulate metabolism)
  • adrenals deprived of ACTH look small but adrenals with excess look large
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10
Q

ADH

A
  • opens aquaporins to allow water release

- low circulation volume = more ADH released = water excretion = water retention

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11
Q

OXYTOCIN

A

contraction of smooth muscle of breast & uterus (synthetic oxytocin can induce labour)

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12
Q

GH deficiency

A
  • poor growth, higher abdominal fat
  • diagnosed by GH stimulation (injectc insulin to lower glucose as GH stimulated by hypoglycaemia) & treated by hormone replacement
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13
Q

FSH/LH deficiency

A
  • in children, leads to delayed puberty
  • in males, leads to infertility & poor 2nd sex features
  • in females, leads to low sex drive
  • treated by hormone replacement
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14
Q

ACTH deficiency

A
  • fatigue, weakness, weight loss, nausea/vomiting

- diagnosed by measuring morning cortisol (higher in morning)

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15
Q

HYPOPHYSEAL PORTAL VESSELS

A

where neurotransmitters (from hypothalamus to pituitary) are secreted into

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16
Q

HOW ADENOMA LEADS TO BLURRED VISION

A

adenoma compresses optic chiasm (which is superior to the pituitary)

17
Q

TSH deficiency

A
  • TSH usually goes to thyroid & promotes secretion of thyroid hormones
  • fatigue, weakness, anorexia, nausea
  • diagnosed by measuring TSH & treated by hormone replacement (levothyroxine)
18
Q

ADH deficiency

A
  • caused by tumours, autoimmune destruction of secretory cells, trauma
  • leads to polyuria which leads to thirst (treated by ADH analogues)
  • diagnosed by measuring urine output, blood glucose, urine deprivation test (deprive patient of fluids & see if they continue urine output)
19
Q

ACROMEGALY

A
  • larger hands/feet, headache, more sweating
  • GH hyper-secretion due to pituitary adenoma
  • diagnosed by checking IGF-1 & doing oral glucose test (give glucose tablet & check GH level as high blood glucose breaks down GH)
  • treated by pituitary surgery, GH receptor antagonists
20
Q

HIGH PROLACTIN LEVELS

A
  • caused by prolactinoma (benign tumour hypersecreting prolactin) which leads to hypogonadism (low FSH/LH)
  • diagnosed by pituitary imaging
  • treated by dopamine agonist (as dopamine inhibits prolactin secretion) or surgery
21
Q

CUSHING SYNDROME

A
  • excess cortisol leading to weight gain, fatigue, infection risk
  • ACTH-dependent (due to pituitary tumour hyperproducing cortisol) (cushing disease) or ACTH-independent (due to steroid administration)(cushing syndrome)
  • measure 24hr cortisol level (should be 0 at night) OR give dexamethasone (steroid which lowers cortisol level in patients without cushing)
  • treated by pituitary surgery
22
Q

ANATOMICAL POSITION OF PITUITARY

A
  • sits in sella turcica
  • anterior is sphenoid sinus
  • posterior is dorsum sellae (posterior wall of sella turcica)
  • superior is optic chiasm & diaphragm sellae (fold of dura mater which covers pituitary gland
23
Q

ANTERIOR PITUITARY ANATOMY

A
  • split into pars anterior (large & for hormone secretion) pars intermedia (separates pars anterior from posterior lobe) pars tuberalis (surrounds anterolateral of infundibulum)
24
Q

ANTERIOR PITUITARY VASCULATION

A

receives arterial supply from superior hypophyseal artery

25
Q

POSTERIOR PITUITARY VASCULATION

A

infundibulum & posterior pituitary receive blood supply from many arteries (superior hypophyseal, infundibular artery & inferior hypophyseal)

MEDICINE (27 decks)

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