Disorders of Anterior Pituitary Gland

Question 1

Cells Found in TSH

Answer 1

Thyrotropic cells

Question 2

Cells found in Prolactin (PRL)

Answer 2

Mammatropic

Question 3

Cells found in ACTH

Answer 3

Corticotropic cells

Question 4

Cells found in 
Growth Hormone (GH)

Answer 4

Somatotropic cells

Question 5

Cells found in LH and FSH

Answer 5

Gonadotropic cells

Question 6

Cells found in Melanocyte-stimulating hormone (MSH)

Answer 6

Pars intermedia cells

Question 7

TSH regulates secretion of what hormones

Answer 7

T3 and T4

Question 8

Increased activity of the thyroid gland

Answer 8

Hyperthyroidism

Question 9

state of thyroid hormone excess

Answer 9

Thyrotoxicosis

Question 10

Differentiate thyrotoxicosis and hyperthyroidism

Answer 10

Thyrotoxicosis is defined as the state of thyroid hormone excess and is not synonymous with hyperthyroidism, which is the result of excessive thyroid function

Question 11

If the problem is at the level of the pituitary gland it is considered

Answer 11

Secondary hyperthyroidism

Question 12

Cause of Primary hyperthyroidism

Answer 12

Primary thyroid gland disease (Grave’s disease)

Question 13

Cause of secondary hyperthyroidism

Answer 13

TSH secreting adenoma, Pituitary resistance to thyroid hormone

Question 14

TSH level in Primary HyperT

Answer 14

Decreased

Question 15

TSH level in secondary hyperT

Answer 15

Normal or elevated

Question 16

In primary hyperthyroidism, why is there increased thyroid gland activity and increased thyroid hormone formation?

Answer 16

because there is a disease that primarily involves the thyroid gland making it produce more hormones

Question 17

Most common primary thyroid gland disease

Answer 17

Grave’s disease

Question 18

T or F TSH is responsible for the increased thyroid hormone production in Grave’s disease

Answer 18

False: The body produces an antibody that acts on the cells of the thyroid gland and stimulates it to produce hormones independent of the levels of the TSH

Question 19

Primary hyperT due to Grave’s dse is usu associated with

Answer 19

Exophthalmia

Question 20

Why is the bulging of the eyes found more on primary hyperT than 2nd

Answer 20

because it is due to stimulation by the same antibodies that stimulate the thyroid gland. It is not TSH induced but antibody induced.

Question 21

Why is there bulging of the eyes in primary hyperT

Answer 21

There is sympathetic stimulation that causes retraction of the lids

Question 22

What is the normal response of a normal pituitary gland to a high level of thyroid hormone

Answer 22

To decrease it, if there’s high thyroid hormone level and TSH is still normal then it means that it’s abnormal

Question 23

Most common cause of central/secondary hyperthyroidism

Answer 23

TSH secreting adenoma

Question 24

What happens if there’s TSH secreting adenoma

Answer 24

There’s increased TSH secretion that stimulates increase thyroid hormone production but the adenoma is abnormal

Question 25

If you find normal levels of TSH but there’s high T3 and T4 what would be your diagnosis

Answer 25

There’s Pituitary resistance to thyroid hormone

Question 26

Low thyroid hormone secretion

Answer 26

Hypothyroidism

Question 27

Cause of primary HYPOthyroidism

Answer 27

Thyroiditis or autoimmune disorders

Question 28

Cause of Secondary HYPOthyroidism

Answer 28

Lymphocytic hypophysitis, Sheehan’s syndrome

Question 29

Level of TSH in primary HYPOt

Answer 29

Increased

Question 30

Level of TSH in secondary HYPOt

Answer 30

Normal or low

Question 31

Most common cause of primary hypothyroidism

Answer 31

Autoimmune Thyroiditis

Question 32

inflammation that results in the destruction of the thyroid gland

Answer 32

Thyroiditis

Question 33

Cardiac drug that may cause hypothyroidism

Answer 33

Amiodarone

Question 34

Substrate for thyroid hormone production

Answer 34

Iodine

Question 35

Why is there enlarged goiter in cases of primary hypothyroidism

Answer 35

There’s increase stimulation of the thyroid gland but no concomitant increase production of thyroid hormone production

Question 36

ACTH promotes the secretion of

Answer 36

Cortisol

Question 37

Cortisol is secreted by what cells

Answer 37

Zona fasciculate

Question 38

Differentiate cushing’s syndrome from cushing’s disease

Answer 38

Cushing’s syndrome reflects a constellation of clinical features that result from chronic exposure to excess glucocorticoids of any etiology while Cushing’s Disease: increased cortisol secretion because of a problem at the level of the pituitary gland

Question 39

In secondary hypercortisolism the problem is at the level of the

Answer 39

Pituitary gland

Question 40

Cushing’s disease is primary or secondary hypercortisolism?

Answer 40

Secondary

Question 41

Cause of primary HYPERcort

Answer 41

Cortisol secreting adrenal adenoma

Question 42

Cause of secondary hypercortisolism

Answer 42

Acth-secreting adenoma

Question 43

Ectopic acth is more frequently identified in M or F

Answer 43

M

Question 44

Most common cause of cushing’s syndrome

Answer 44

Glucocorticoids for immunosuppression or for treatment of inflammatory d/o

Question 45

This refers to cushing’s syndrome caused by a pituitary corticotrope adenoma

Answer 45

Cushing’s dse

Question 46

T or F Cushing’s disease affects more frequently in women in all ages

Answer 46

False, It does affects women except in prepubertal where it’s more common in boys

Question 47

Potent glucocorticoid that suppresses CRH/ACTH and endogenous cortisol

Answer 47

Dexamethasone

Question 48

Used to rule out pseudocortisolism

Answer 48

Low dose dexam

Question 49

Used to distinguish pituitary from adrenal

Answer 49

High dose dexam

Question 50

Addison’s disease is considered hypo or hypercortisolism?

Answer 50

Primary Hypocortisolism

Question 51

Hyperpigmentation can be seen in primary or sec hypocortisolism

Answer 51

Primary

Question 52

consequence of dysfunction of the hypothalamic-pituitary component of the HPA axis

Answer 52

Secondary hypocortisolism

Question 53

Why is there no hyperkalemia in secondary hypocortisolism

Answer 53

RAA controls secretion of aldosterone therefore no matter what happens at the level of pituitary, aldosterone is not affected

Question 54

Hyperkalemia and hyperpigmentation is only manifested in primary or secondary Hypocortisolism?

Answer 54

Primary hypocortisolism

Question 55

In what group of women does lymphocytic hypophysitis most often occur?

Answer 55

Postpartum

Question 56

How does post partum hemorrhage lead to sheehan’s syndrome

Answer 56

The pituitary enlarges in pregnancy thus it requires more blood, if there’s hemorrhage it could lead to hypotension so it may compromise blood supply to the pituitary and can lead to necrosis

Question 57

Most common manifestation of sheehan’s syndrome

Answer 57

Lactation failure

Question 58

protein hormone of about 190 amino acids that is synthesized and secreted by cells called somatotrophs in the anterior pituitary.

Answer 58

Growth hormone

Question 59

What are some stimulators of GH secretion

Answer 59

GHRH, exercise and low lvls of blood sugar

Question 60

2 hormones which manage gh secretion

Answer 60

GHRH and somatostatin

Question 61

Somatostatin inhibits gh secretion in response to lvls of

Answer 61

IGF-1 (insulin like growth factor 1)

Question 62

hormone released when you are awake at a time when you should be sleeping. It stimulates appetite and leads to weight gain.

Answer 62

Ghrelin

Question 63

result of excessive growth hormone secretion that begins in young children or adolescents.

Answer 63

Gigantism

Question 64

elevated IGF-I level in a patient with appropriate clinical suspicion is almost always indicative of

Answer 64

Acromegaly

Question 65

This procedure generally results in a rapid and substantial reduction of serum GH levels immediately

Answer 65

Surgical excision

Question 66

Non surgical treatment for acromegaly would include

Answer 66

Somatostatin analogs or dopamine agonists and radiotherapy

Question 67

Difference btn achrondroplastic dwarf and pituitary dwarf

Answer 67

In achrondroplastic dwarf, there’s no prob in GH secretion

Question 68

T or F in pituitary dwarfism there’s maintenance of the symmetry of the features

Answer 68

True

Question 69

Relatively long trunk and shortened upper parts of their arms and legs is a feature of

Answer 69

Achrondoplasia

Question 70

T or F random lvls of GH is the gold standard for the diagnosis of GH deficiency )

Answer 70

False, it is not useful, the gold standard is ITOT: Insulin TOlerance Test (ITT na..hehe

Question 71

If there’s severe GH deficiency, what is the peak GH response in ITT

Answer 71

<3mcg/L

Question 72

Secretion of prolactin is regulated by

Answer 72

Hypothalamus, predominantly dopamine

Question 73

Prolactin is secreted by

Answer 73

Lactorophs

Question 74

What stimulates prolactin secretion

Answer 74

Estrogen

Question 75

Why is there increased prolactin during pregnancy

Answer 75

Due to high lvls of estrogen

Question 76

Agent of choice for prolactinoma

Answer 76

Bromocriptine (BEC) it’s a dopamine agonist that decreases the synthesis and secretion of PRL

Question 77

Btn transphenoidal and transcranial which one is more preffered?

Answer 77

Thransphenoidal