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Endo Repro 1 > HP Relationships > Flashcards

HP Relationships Flashcards

1
Q

What is the pituitary gland (hypophysis) composed of?

A 
anterior pituitary (adenohypophysis) - epithelial portion
posterior pituitary (neurohypophysis) - neural portion
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2
Q

What is the hypophysial stalk?

A

physical connection between the hypothalamus and pituitary gland

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3
Q

What is the posterior pituitary a collection of, and what does it secrete?

A

collection of axons whose cell bodies and located in the hypothalamus: supraoptic nucleus (SON) and paraventricular nucleus (PVN)

it secretes neuropeptides: ADH (mostly SON) and oxytocin (mostly PVN)

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4
Q

What hormones does the anterior pituitary secrete?

A

ACTH, TSH, FSH, LH, GH, prolactin

anterior pituitary is connected to hypothalamus by hypothalamic-hypophysial portal vessels

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5
Q

What are two important implications of the hypothalamic-hypophysial portal vessels?

A
  1. hormones can be delivered to the anterior pituitary directly and in high concentration
  2. hormones do not appear in the systemic circulation in high concentration
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6
Q

What is a primary endocrine disorder?

A

low or high levels of hormone due to defect in peripheral endocrine gland

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7
Q

What is a secondary endocrine disorder?

A

low or high levels of hormone due to defect in pituitary gland

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8
Q

What is a tertiary endocrine disorder?

A

low or high loevels of hormone due to defect in the hypothalamus

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9
Q

What hormones do corticotrophs release?

A

ACTH

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10
Q

What hormones do thyrotrophs release?

A

TSH

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11
Q

What hormones do gonadotrophs release?

A

FSH and LH

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12
Q

What hormones do somatotrophs release?

A

GH

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13
Q

What hormones do lactotrophs/mammotrophs release?

A

prolactin

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14
Q

What causes acromegaly?

A

prolonged, excessive secretion of GH in adult life
characterized by excessive growth of soft tissue, cartilage and bone in face, hands and feet - develops very gradually
can lead to HTN, accelerated osteoarthrosis, hyperglycemia, cardiomegaly
-> GH acts on chondrocytes

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15
Q

What does GH stimulate?

A

somatomedin C (insulin-like growth factor 1, IGF-1) gene transcription and secretion by the liver

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16
Q

How do you diagnose acromegaly and what are the medications given?

A

increase in serum IGF-1 levels, failure to supress serum GH following OGTT, pituitary mass seen on brain MRI

octoreotide/lanreotide (somatostatin analog)
pegvisomant (GH receptor antagonist)
bromocriptine/cabergoline (dopamine receptor agonists)

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17
Q

What leads to a GH deficiency?

A

decreased secretion of GHRH
decreased secretion GH
failure to generate somatomedins
GH or somatomedin resistance

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18
Q

What leads to a GH excess?

A

mostly due to a growth hormone-secreting pituitary adenoma
consequences depend on developmental stage
- before puberty = gigantism
- after puberty = acromegaly

19
Q

What is the diabetogenic effect?

A

increase in blood glucose concentration

  • causes insulin resistance
  • decrease in glucose uptake and utilization by target tissues
  • increase in lipolysis in adipose tissue
  • results in increase in blood insulin levels
20
Q

What do somatomedins (IGF-1) mediate?

A

increase in protein synthesis, organ growth and linear growth

21
Q

What does hyperprolactinemia supress?

A

FSH and LH secretion

22
Q

What is the function of CRH?

A

increase ACTH, MSH

23
Q

What is the function of dopamine?

A

decrease prolactin

24
Q

What is the funtion of GHRH?

A

increase GH

25
Q

What is the function of GnRH?

A

increase FSH, LH

26
Q

What is the function of prolactin?

A

decrease GnRH

27
Q

What is the function somatostatin?

A

decrease GH, TSH

28
Q

What is the function of TRH?

A

increase in TSH, prolactin

29
Q

What causes Cushing’s disease?

A

high levels of ACTH

30
Q

What causes TSH-secreting adenoma?

A

high levels of TSH

31
Q

What causes acromegaly/gigantism?

A

high levels of GH

32
Q

What causes prolactinoma?

A

high levels of prolactin

33
Q

What causes a non-functioning adenoma?

A

high levels of LH and FSH

34
Q

What are the causes of hypopituitarism?

A

brain damage, pituitary tumors, non-pituitary tumors, infections, infarction, autoimmune disorders, pituitary hypoplasia

35
Q

What is Sheehan syndrome?

A

postpartum hypopituitarism due to necrosis of the pituitary gland
most patients present with agalactorrhea (difficulties with lactation)
amenorrhea (lack of menstruation), hypothyroidism

36
Q

What are the posterior lobe neuropeptides?

A

ADH, oxytocin

37
Q

What are the posterior lobe secreting neurons?

A

ADH (mainly from supraoptic nuclei)

oxytocin (mainly from PVN)

38
Q

What are the triggers of ADH secretion?

A

decrease in blood pressure (baroreceptor reflex)
decrease in arterial strethc due to low BV (atrial stretch receptors_
increase in osmolarity (hypothalamic osmoreceptors)

NOTE: secretion most sensiive to plasma osmolarity changes

39
Q

What happens to ADH in hyperosmolar state?

A

hypothalamus detects too little water -> pituitary gland release ADH -> kidneys remove less water from the blood so less water is lost in urine

40
Q

What happens to ADh in a hypo-osmolar state?

A

hypothalamus detects too much water in blood -> pituitary gland release less ADH -> kidneys remove more water from blood so more water is lost in urine

41
Q

What is diabetes insipidus?

A

lack of an effect of ADH on the renal collecting duct
causes frequent urination
large volume of urine is diluted

42
Q

What is central DI?

A

lack of ADH
could result from damage to the pituitary, or destruction of the hypothalamus
tx: desmopressin

43
Q

What is nephrogenic DI?

A

kidneys unable to respond to ADH
causes: drugs like lithium, chronic kidney disorders (polycystic kidney disease)
CANNOT treat with desmopressin (does NOT respond to ADH)

44
Q

What is syndrome of inappropriate ADH secretion (SIADH)?

A

excessive secretion of ADH
excessive water retention
hypo-osmolarity fails to inhibit ADH release

Endo Repro 1 (6 decks)

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