Endocrine: Pituitary Gland Flashcards
Also known as hypophysis: Master gland
Pituitary gland
All pituitary hormones are characterized with
Circardian rhythms
Release other hormones
Tropic hormones
Feedback loop
Pulsatile secretion
Diurnal Rhythms
Environmental and External modification
Features of pituitary gland
Hormones secreted in the morning:
ACAI
ACTH
Cortisol
Aldosterone
Iron
Hormones secreted or high in the Evening:
PTAG
PTH
TSH
ACP
GH
Peak at: 4-6 am or 6-8am
Low: 8-12am
Cortisol
Peak at: 4-8am & 8-10pm
Prolactin
Subject to external modulation and generally influenced or modified by higher neutral input
Open-Loop Negative Feedback System
Open-Loop Negative Feedback System (3)
Short Feedback Loop - Pituitary
Long Feedback Loop - Hypothalamus
Ultra-Short Loop - Hypothalamus and Pituitary
Pituitary Hormones classification (2)
Tropic - stimulates activity of other endocrine glands
Direct Effector - direct effect in pheripheral tissue
Anatomy: Three (3) Major Parts of Pituitary
- Anterior Pituitary /Adenohypophysis
- Intermediate lobe / Pars Intermediate
- Posterior or Neurohypophysis
Considered not true endocrine gland
Posterior Pituitary gland
Pituitary tumors
<1 cm
Microadenoma
Pituitary Hormone
> 1cm
Microadenomas
ANTERIOR LOBE:
Five types of cell by Immunological Test
- Somatotrophs (GH)
- Gonadotrophs (LH, FSH)
- Thythroph (TSH)
- Lactotrophs /Mammotroph (Prolactin)
- Corticotrophs (ACTH, B-endorphins, B-lipoproteins)
Ovary Ovulation and Progesterone production
Testosterone synthesis by Testes
LH
Ovaries (Estrogen synthesis and Oogenesis)
Testis (Spermatogenesis)
FSH
Thyroid Function
TSH (T3 and T4)
Glucocorticoid synthesis; adrenal steroidgenesis
ACTH
IGF-1 Synthesis; metabolism in numerous tissues to produce growth factors
GH (Direct Effector)
Lactation
Prolactin (Direct Effector)
Precursor of endorphins
B-lipoprotein
Most abundant of all pituitary hormones
Growth Hormones
Growth Hormones is controlled by
GnRH
Somatostatin
Stimulate secretion of GHRH is
Ghrelin
Growth Hormone is similar to:
Prolactin
Human Placental Lactogen (HPL)
Excessive Growth hormone seen in adults
Acromegaly
Excess GH in children
Gigantism
Deficient GH
dwarfism
Growth Hormone Deficiency Tests:
- Gold Standard
- 2nd confirmatory test
- Insulin Tolerance Test (<50-55 mg /dL: Coma/CNS problems)
- L-Dopa / Arginine Stimulation Test (stimulate release of GH; every 30 mins monitoring)
Growth Hormone Excess:
Screening Test
Confirmatory
Screening Test: Somatomedin C
Confirmatory: OGGT (75 grams)
OGTT Normal Values
Normal - GH undetectable after glucose load
Acromegaly - GH is not supressed
Amino acid is similar to GH
Prolactin
Prolactin acts in conjugation with ____ and ___
Estrogen and Progesterone
Prolactin
Specimen Requirement
3-4 hrs after patient wakes up
Peak time of Prolactin
4-8am
8-10pm
Major inhibitory factor of Prolactin
Dopamine
3 forms of circulating prolactin:
- Non-glycosylated monomer
- Big prolactin
- macro-prolactin
3 forms of circulating prolactin:
major form of prolactin
Non-glycosylated monomer
3 forms of circulating prolactin:
dimeric and trimeric glycosylated form
Big prolactin
3 forms of circulating prolactin:
Less physiologically active form
Macro-prolactin
Galactorrhea
Amenorhea
Pituitary Adenoma
Hyperprolactinoma
Most common cause of Pituitary Tumor ; anovulation
Prolactinoma
Not a true Pituitary gland; only stores
Posterior Pituitary Gland
Posterior Pituitary Gland Stores
Oxytocin
Vasopressin /ADH
POSTERIOR LOBE:
Stimulates CONTRACTION of gravid uterus ; SMOOTH MUSCLE CONTRACTIONS ; orgasm
Oxytocin
POSTERIOR LOBE:
Plays a role in hemostasis at placental site; useful in predicting Pre-term labor and Tumor (Oat cell carcinoma and Adenocarcinoma of pancreas)
Oxytocin
POSTERIOR LOBE:
Major function of ADH to maintain osmotic homeostasis by regulating water balance (DCT and Collecting tubes)
Vasopressin /ADH
POSTERIOR LOBE:
Maintenance of blood volume, pressure, tonicity
Vasopressin /ADH
POSTERIOR LOBE:
Vasopressin /ADH diagnostics test
Water Deprivation Test
8-12 HRS W/O FLUID
Measure osmolality
NORMAL: not more than 300 mOsm/kg
INCREASED: ETHANOL POISONING
POSTERIOR LOBE:
Deficient in ADH
Normal ADH receptors
Large Volume of Urine excreted (Polyuria)
True Diabetes Insipidus
(Diabetic, Neurogenic, Cranial, Central Diabetes)
POSTERIOR LOBE:
Normal ADH
Abnomal ADH receptors
Failure of kidney to respond to elevated ADH
Urine Output >2.5 L/day
Nephrogenic DI
POSTERIOR LOBE:
Nephrogenic DI diagnostic Test
Water deprivation Test
POSTERIOR LOBE:
uncontrolled secretion of ADH without any known stimulus for release. ADH is released even blood volume is normal or increased and plasma osmolality is low
SIADH