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Endocrinology > Endo 1 - Hyposecretion of Anterior Pituitary Hormones > Flashcards

Endo 1 - Hyposecretion of Anterior Pituitary Hormones Flashcards

1
Q

What is the difference between primary, secondary and tertiary endocrine gland diseases?

A

1 - problem with the endocrine gland/hormone released
2 - problem with the pituitary gland/hormone released
3 - problem with the hypothalamus

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2
Q

What is the name given to decreased secretion of all anterior pituitary hormones?

A

Panhypopituitarism

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3
Q

What can panhypopituitarism be caused by?

A

1 - Congenital - rare

2 - Gene mutations - more rare

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4
Q

In what order of hormones does loss of secretion occur?

A 
1 - Gonadotrophins
2 - GH
3 - Thyrotrophin 
4 - Corticotrophin
5 - Prolactin
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5
Q

Name the 3 main types of panhypopituitarism.

A
  1. Simmond’s
  2. Sheehan’s
  3. Pituitary Apoplexy
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6
Q

Is the onset of Simmond’s insidious or acute?

A

Insidious

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7
Q

What are the symptoms of Simmond’s?

A
  • Impotence
  • Loss of libido
  • Hypotension
  • Tiredness
  • Secondary amenorrhoea or oligomenorrhoea
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8
Q

What can Simmond’s be caused by?

A

Cranial injury, pituitary adenomas

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9
Q

What is the cause of Sheehans?

A

caused due to post partum haemorrhage

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10
Q

Explain the mechanism of how Sheehans happens

A
  • during pregnancy the prolactin neurones in the anterior pituitary get bigger - hypertrophy
  • they get bigger blood vessels as they need more blood
  • during delivery there is usually a loss of blood
  • this haemorrhage causes hypotension and can cause infarction of the anterior pituitary
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11
Q

What is Pituitary Apoplexy?

A

similar to Sheehan’s but not specific to women

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12
Q

What is pituitary apoplexy usually caused by?

A

Pre existing pituitary adenoma

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13
Q

How do you diagnose hypopituitarism?

A
  • need a stimulation test

- as a single reading is too random due to pulsability

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14
Q

What is the effect of a lack of somatotrophin in children?

A

stunted growth

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15
Q

What is the effect of a lack of somatotrophin in adults?

A

uncertain

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16
Q

Name some causes of short stature

A
  • genetic
  • malnutrition
  • emotional
  • endocrine disorders
17
Q

Describe the release of GH/Somatotrophin

A
  • growth hormone controlled by hypothalamus which secretes GHRH
  • GH releases
  • stimulates liver to make IGF 1 + 2
18
Q

What is laron dwarfism?

A

defect in the GH receptor in the liver - so low IGF

19
Q

What are some genetic causes of GH deficiency?

A
  • deficiency in GHRH
  • mutations of GH gene
  • defect in GH receptor
20
Q

What are some acquired causes of GH deficiency in children?

A
  • tumours
  • radiation
  • brain injury
  • infection
21
Q

What hormone does GH stimulate?

A

IGF 1/2 - Insulin like growth factor
produced in the liver
mediates growth effects around the body

22
Q

Name two examples of tertiary hypopituitarism using GnRH as an example

A
  1. Kallman’s syndrome - hypogonadism and anosmia - neurones do not migrate properly so pituitary missing GnRH neurones
  2. Prader-Willi
23
Q

What is the test for growth hormone release?

A

insulin induced hypoglycaemia

24
Q

Describe what would happen in the insulin induced hypoglycaemia GH provocation test

A
  • insulin causes hypoglycaemia
  • this stress causes GH release
  • normal people will have an increase in GH following insulin
  • people with GH deficiency will have a reduced increase
25
Q

What else can you use instead of insulin?

A
  • glucagon
  • arginine
  • exercise
26
Q

What is the treatment of pituitary deficiency?

A
  • replace missing hormones e.g thyroxine TSH
27
Q

What are the effects of GH therapy in children?

A
  • increased linear growth
  • increases muscle
  • decrease in body fat
28
Q

What is the problem with GH therapy in children?

A

tolerance may develop

29
Q

How is GH administered and how often?

A

daily - IM or SC

30
Q

What are some adverse effects of GH therapy?

A
  • lipotrophy at site
  • intracranial hypertension
    headaches
  • increased risk of tumours
31
Q

State the signs of GH deficiency in adults

A
  • reduced lean mass
  • increased adiposity
  • increased waist:hip ratio
  • decreased HDL and increased LDL
32
Q

How else can you diagnose GH deficiency in adults?

A
  • Low plasma IGF 1
33
Q

What are the benefits of GH therapy in adults?

A
  • improved body composition
  • improved HDL/LDL
  • improved muscle strength
  • increases psychological
34
Q

What are the risks of GH therapy in adults?

A
  • increased risk of Cardio accidents

- increases susceptibility to cancer

Endocrinology (18 decks)

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