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Block 17 Endocrinology Module 1 > Disorders of Anterior Pituitary Gland > Flashcards

Disorders of Anterior Pituitary Gland Flashcards

1
Q

Cells Found in TSH

A

Thyrotropic cells

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2
Q

Cells found in Prolactin (PRL)

A

Mammatropic

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3
Q

Cells found in ACTH

A

Corticotropic cells

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4
Q 
Cells found in 
Growth Hormone (GH)
A

Somatotropic cells

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5
Q

Cells found in LH and FSH

A

Gonadotropic cells

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6
Q

Cells found in Melanocyte-stimulating hormone (MSH)

A

Pars intermedia cells

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7
Q

TSH regulates secretion of what hormones

A

T3 and T4

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8
Q

Increased activity of the thyroid gland

A

Hyperthyroidism

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9
Q

state of thyroid hormone excess

A

Thyrotoxicosis

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10
Q

Differentiate thyrotoxicosis and hyperthyroidism

A

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

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11
Q

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

A

Secondary hyperthyroidism

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12
Q

Cause of Primary hyperthyroidism

A

Primary thyroid gland disease (Grave’s disease)

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13
Q

Cause of secondary hyperthyroidism

A

TSH secreting adenoma, Pituitary resistance to thyroid hormone

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14
Q

TSH level in Primary HyperT

A

Decreased

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15
Q

TSH level in secondary hyperT

A

Normal or elevated

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16
Q

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

A

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

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17
Q

Most common primary thyroid gland disease

A

Grave’s disease

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18
Q

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

A

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

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19
Q

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

A

Exophthalmia

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20
Q

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

A

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

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21
Q

Why is there bulging of the eyes in primary hyperT

A

There is sympathetic stimulation that causes retraction of the lids

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22
Q

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

A

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

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23
Q

Most common cause of central/secondary hyperthyroidism

A

TSH secreting adenoma

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24
Q

What happens if there’s TSH secreting adenoma

A

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

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25
Q

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

A

There’s Pituitary resistance to thyroid hormone

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26
Q

Low thyroid hormone secretion

A

Hypothyroidism

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27
Q

Cause of primary HYPOthyroidism

A

Thyroiditis or autoimmune disorders

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28
Q

Cause of Secondary HYPOthyroidism

A

Lymphocytic hypophysitis, Sheehan’s syndrome

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29
Q

Level of TSH in primary HYPOt

A

Increased

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30
Q

Level of TSH in secondary HYPOt

A

Normal or low

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31
Q

Most common cause of primary hypothyroidism

A

Autoimmune Thyroiditis

32
Q

inflammation that results in the destruction of the thyroid gland

A

Thyroiditis

33
Q

Cardiac drug that may cause hypothyroidism

A

Amiodarone

34
Q

Substrate for thyroid hormone production

A

Iodine

35
Q

Why is there enlarged goiter in cases of primary hypothyroidism

A

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

36
Q

ACTH promotes the secretion of

A

Cortisol

37
Q

Cortisol is secreted by what cells

A

Zona fasciculate

38
Q

Differentiate cushing’s syndrome from cushing’s disease

A

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

39
Q

In secondary hypercortisolism the problem is at the level of the

A

Pituitary gland

40
Q

Cushing’s disease is primary or secondary hypercortisolism?

A

Secondary

41
Q

Cause of primary HYPERcort

A

Cortisol secreting adrenal adenoma

42
Q

Cause of secondary hypercortisolism

A

Acth-secreting adenoma

43
Q

Ectopic acth is more frequently identified in M or F

A

M

44
Q

Most common cause of cushing’s syndrome

A

Glucocorticoids for immunosuppression or for treatment of inflammatory d/o

45
Q

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

A

Cushing’s dse

46
Q

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

A

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

47
Q

Potent glucocorticoid that suppresses CRH/ACTH and endogenous cortisol

A

Dexamethasone

48
Q

Used to rule out pseudocortisolism

A

Low dose dexam

49
Q

Used to distinguish pituitary from adrenal

A

High dose dexam

50
Q

Addison’s disease is considered hypo or hypercortisolism?

A

Primary Hypocortisolism

51
Q

Hyperpigmentation can be seen in primary or sec hypocortisolism

A

Primary

52
Q

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

A

Secondary hypocortisolism

53
Q

Why is there no hyperkalemia in secondary hypocortisolism

A

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

54
Q

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

A

Primary hypocortisolism

55
Q

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

A

Postpartum

56
Q

How does post partum hemorrhage lead to sheehan’s syndrome

A

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

57
Q

Most common manifestation of sheehan’s syndrome

A

Lactation failure

58
Q

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

A

Growth hormone

59
Q

What are some stimulators of GH secretion

A

GHRH, exercise and low lvls of blood sugar

60
Q

2 hormones which manage gh secretion

A

GHRH and somatostatin

61
Q

Somatostatin inhibits gh secretion in response to lvls of

A

IGF-1 (insulin like growth factor 1)

62
Q

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

A

Ghrelin

63
Q

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

A

Gigantism

64
Q

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

A

Acromegaly

65
Q

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

A

Surgical excision

66
Q

Non surgical treatment for acromegaly would include

A

Somatostatin analogs or dopamine agonists and radiotherapy

67
Q

Difference btn achrondroplastic dwarf and pituitary dwarf

A

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

68
Q

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

A

True

69
Q

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

A

Achrondoplasia

70
Q

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

A

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

71
Q

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

A

<3mcg/L

72
Q

Secretion of prolactin is regulated by

A

Hypothalamus, predominantly dopamine

73
Q

Prolactin is secreted by

A

Lactorophs

74
Q

What stimulates prolactin secretion

A

Estrogen

75
Q

Why is there increased prolactin during pregnancy

A

Due to high lvls of estrogen

76
Q

Agent of choice for prolactinoma

A

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

77
Q

Btn transphenoidal and transcranial which one is more preffered?

A

Thransphenoidal

Block 17 Endocrinology Module 1 (3 decks)

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