Disorders Of Hypothalamus & Pituitary Disease

Question 1

Imagine the anatomy of the hypothalamus-pituitary

Answer 1

Question 2

Explain the blood supply of the pituitary

Answer 2

1. From paired superior and inferior hypophyseal arteries (branches of internal carotid arteries)
2. Superior hypophyseal arteries - near median eminence
3. Blood supply to the posterior pituitary is from the inferior hypophyseal arteries directly from the systemic blood flow
4. Venous drainage is into the Dural sinuses surrounding the pituitary gland

Question 3

Describe histology of Somatotrophs

Answer 3

Somatotropes: 50%, acidophilic

Question 4

Describe histology of lactotrophs/mammotrophs

Answer 4

Lactotropes/Mammotropes: 25%, acidophilic

Question 5

Describe the histology of corticotrophs

Answer 5

Corticotropes: 15-20%, basophilic

Question 6

Describe the histology of thyrotrophs

Answer 6

Thyrotropes: 5-10%, basophilic

Question 7

Describe the histology of gonadotrophs

Answer 7

Gonadotropes: 5-10%, basophilic

Question 8

Describe the histology Chromophobes

Answer 8

Chromophobes: Nonsecretory, undifferentiated cells.

Question 9

How can pituitary hormones be stimulated by hypothalamic factor?

Answer 9

Question 10

What are the biochemical types of anterior pituitary hormones ?

Answer 10

3 different groups
Pro-Opiomelanocortin & ACTH Glycoprotein Hormones: TSH, LH & FSH
Growth Hormone & Prolactin

Question 11

Describe synthesis of pituitary of hormones related to stress

Answer 11

Synthesis of pituitary hormones related to stress:

Any form of stress (metabolic, physical, or mental) activates hypothalamic neurons and stimulates secretion of corticotrophin releasing hormone (CRH). CRH stimulates synthesis of pro-opiomelanocortin (POMC, a precursor molecule) in corticotropes. POMC is further processed to produce ACTH. ACTH triggers synthesis and secretion of corticosteroids and adrenal androgens by the adrenal gland. This is called hypothalamo-hypophysio-adrenal activation in stress

Question 12

Discuss physiological effect of GH

Answer 12

Question 13

What are the hormonal implications of muscle, adipose and liver in hyperprolactinemia?

Answer 13

Question 14

Describe the epidemiology of hyperprolactinemia

Answer 14

Question 15

What are the causes of hyperprolactinemia?

Answer 15

Question 16

Describe 5he lab evaluations of a pituitary microadenomas

Answer 16

Question 17

What’s the physiology of ADH?

Answer 17

Question 18

What are the associations of SIADH?

Answer 18

Question 19

What are the clinical features of SIADH?

Answer 19

Question 20

Explain sodium concentration on symptoms of SIADH

Answer 20

Question 21

What’s the differential diagnoses of SIADH?

Answer 21