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Pathoma LAH > Endocrine: 15.1 and 2: Ant and Post Pituitary Gland > Flashcards

Endocrine: 15.1 and 2: Ant and Post Pituitary Gland Flashcards

1
Q

How is central diabetes insipidus treated?

A

desmopressin/DDAVP (an ADH analog)

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2
Q

What normally inhibits prolactin secretion?

A

dopamine

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3
Q

What is demeclocycline? What is it used to treat?

A
  • a synthetic tetracycline abx
  • tx for SIADH and hyponatremia
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4
Q

What will the serum osmolality level be in central diabetes insipidus?

A

high

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5
Q

This drug is a synthetic tetracycline abx used to tx for SIADH and hyponatremia.

A

demeclocycline

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6
Q

What will the urine osmolality level be in central diabetes insipidus?

A

low (very dilute urine)

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7
Q

What are the s/s of syndrome of inappropriate ADH (SIADH)? Why?

A
  • mental status changes
  • seizures
  • hyponatremia
  • –> neuronal swelling, cerebral edema
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8
Q

What kind of molecule is somatostatin (SST)? What kind of receptor does it work upon?

A
  • a peptide- an inhibitory protein
  • GPCRs
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9
Q

This drug is an alkylating agent used to treat CA, autoimmune diseases, and amyloidosis.

A

cyclophosphamide

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10
Q

What happens when desmopressin/DDAVP binds to V2 receptors on collecting duct cells?

A

aquaporin channels are translocated to the apical membrane for H2O reabsorption

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11
Q

What happens when desmopressin/DDAVP binds to V2 receptors on endothelial cells?

A

vWF is released from the Weibel-Palade bodies

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12
Q

What is pegvisomant? What is it used to treat?

A
  • a GH receptor antagonist
  • tx for acromegaly/gigantism
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13
Q

What is bitemporal hemianopsia?

A

mass effect pushes on optic chiasm –> visual deficits of peripheral fields in both eyes

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14
Q

Where does ADH act upon?

A
  • the distal tubules
  • the collecting ducts
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15
Q

This drug is a GH receptor antagonist used to tx acromegaly/gigantism.

A
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16
Q

What is secreted by D cells of the pancreas and gastric mucosa?

A

somatostatin (SST)

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17
Q

Growth hormone _____ glucose uptake in cells.

A

decreases

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18
Q

Too much _____ causes Cushing syndrome.

A

ACTH

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19
Q

What is the tx for syndrome of inappropriate ADH (SIADH)?

A
  • free water restriction
  • demeclocycline
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20
Q

Where are the hormones of the posterior pituitary synthesized?

A

in the hypothalamus

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21
Q

What other endocrine abnormality is often seen with growth hormone adenomas? Why?

A
  • secondary diabetes
  • GH decreases glucose uptake into cells
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22
Q

What tumor in children can cause hypopituitarism?

A

craniopharyngeoma

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23
Q

This drug is a dopamine agonist used to tx prolactinomas, Parkinsons, and neuroleptic malignant syndrome.

A

bromocriptine

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24
Q

What are the s/s of a prolactinoma in males?

A
  • decreased libido
  • HA
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25
Q

This drug is an ADH analog used to tx for central diabetes insipidus, bedwetting, nocturia, and vWF/factor VIII deficiency.

A

desmopressin/DDAVP

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26
Q

Name 2 places where pathology can occur to cause central diabetes insipidus.

A
  1. the hypothalamus
  2. the posterior pituitary
27
Q

What is desmopressin? What is it used to treat?

A
  • an ADH analog
  • tx for:
    • central diabetes insipidus
    • bedwetting
    • nocturia
    • vWF/factor VIII deficiency
28
Q

What does the word “diabetes” mean?

A

too much urination

29
Q

Name a primary cause of Empty Sella Syndrome.

A
  • arachnoid mater and CSF herniation into the sella turcica –> compression and destruction of pituitary gland
30
Q

How is a growth hormone adenoma diagnosed?

A
  • elevated GH
  • elevated insulin-like growth factor 1 (IGF-1)
  • lack of GH suppression by oral glucose
31
Q

Name a dopamine agonist used to treat prolactinomas.

A

bromocriptine

32
Q

What will the urine specific gravity level be in central diabetes insipidus?

A

low

33
Q

What is syndrome of inappropriate ADH (SIADH)?

A

too much ADH –> retention of free water –> hyponatremia

34
Q

Dx?

  • too much ADH –> retention of free water –> hyponatremia
A

syndrome of inappropriate ADH (SIADH)

35
Q

Dx?

  • water deprivation test –> failure to increase urine osmolality
A

central diabetes insipidus

36
Q

What will the serum sodium status be in syndrome of inappropriate ADH (SIADH)?

A

low (hyponatremia)

37
Q

What are the s/s/ of Sheehan syndrome?

A

poor lactation, loss of pubic hair, fatigue

38
Q

What is bromocriptine? What is it used for?

A
  • a dopamine agonist
  • tx for prolactinomas, Parkinsons, and neuroleptic malignant syndrome
39
Q

What are the s/s of a somatostatinoma?

A
  • ab pain
  • gallstones
  • constipation
  • hyperglycemia
  • steatorrhea
40
Q

Where does endogenous SST come from?

A

D cells of the pancreas and gastric mucosa

41
Q

Prolactin inhibits ____.

A

GNRH

42
Q

What causes nephrogenic diabetes insipidus?

A
  • an inherited mutation
  • drugs (lithium, demeclocycline)
43
Q

What is central diabetes insipidus?

A

ADH deficiency

44
Q

What are the s/s of a prolactinoma in females?

A
  • galactorrhea
  • amenorrhea
45
Q

How is central diabetes insipidus diagnosed?

A

water deprivation test –> failure to increase urine osmolality

46
Q

Normally, ____ suppresses growth hormone secretion.

A

glucose

47
Q

On what kind of receptor does desmopressin/DDAVP act upon?

A

V2

48
Q

What is another name for somatostatin (SST)?

A

growth hormone inhibiting hormone

49
Q

Too much ACTH causes _____.

A

Cushing syndrome

50
Q

What is octreotide? What is it used to treat?

A
  • a somatostatin (SST) analog –> blocks anterior pituitary’s response to GHRH
  • tx for:
    • growth hormone adenomas
    • anterior pituitary adenomas
    • VIP-omas
    • carcinoid syndrome
51
Q

How does demeclocycline work to treat syndrome of inappropriate ADH (SIADH)?

A

it blocks the action of ADH on the renal collecting duct

52
Q

What is apoplexy?

A

bleeding within an organ

53
Q

How is a growth hormone adenoma treated?

A
  • octreotide
  • pegvisomant (GH receptor antagonists)
  • surgery
54
Q

What is cyclophosphamide? What is it used to treat?

A
  • an alkylating agent
  • tx for:
    • CA
    • autoimmune diseases
    • amyloidosis
55
Q

What does somatostatin (SST) do in the GI system?

A
  • stomach:
    • reduces acid secretion by inhibiting parietal cells, gastrin, secretin, CCK, motilin, VIP, GIP, and histamine
    • decreases gastric emptying and motility
  • pancreas:
    • inhibits insulin release
    • inhibits glucagon release
56
Q

Name the hormone:

  • stomach:
    • reduces acid secretion by inhibiting parietal cells, gastrin, secretin, CCK, motilin, VIP, GIP, and histamine
    • decreases gastric emptying and motility
  • pancreas:
    • inhibits insulin release
    • inhibits glucagon release
A

somatostatin (SST)

57
Q

What causes syndrome of inappropriate ADH (SIADH)?

A
  • small cell carcinoma of the lung (ADH produced)
  • CNS trauma
  • pulmonary infection/pathology
  • drugs (cyclophosphamide)
58
Q

In the liver, growth hormone acts to _____ production of insulin-like growth factor 1 (IGF-1).

A

increase

59
Q

What will the serum sodium level be in central diabetes insipidus?

A

high (hypernatremia)

60
Q

What will the serum osmolality be in syndrome of inappropriate ADH (SIADH)?

A

low (dilute)

61
Q

How can central and nephrogenic diabetes insipidus be distinguished?

A

nephrogenic = no response to desmopressin/DDAVP

62
Q

Why do pts with Sheehan syndrome lose their pubic hair?

A

Sheehan = pituitary infarction –> loss of LH production, which is essential for androgen synthesis stimulation

63
Q

What is nephrogenic diabetes insipidus?

A

impaired renal response to ADH (no response to desmopressin)

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