Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RR ENDO > Hyposecretion of anterior pituitary hormones > Flashcards

Hyposecretion of anterior pituitary hormones Flashcards

1
Q

What are the 5 types of hormones released from the adenohypohysis
What is primary endocrine gland disease?

A

FSH/LH, ACTH, TSH, PROLACTIN, SOMATROPHIN (GH)
When it caused by disorder of the endocrine
gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is secondary endocrine gland disease?

A

When it is caused by disorder of the anterior pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is panhypopituitarism?

A

Decreased production of all anterior pituitary hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How can panhypopituitarism be acquired? (6)

A

Tumours- hypothalamic (craniopharyngiomas) and pituitary (adenomas)
Radiation-damage (GH most vuln, TSH resistant)
Infection- meningitis
Traumatic brain injury
Infiltrative disease- often involves pituitary stalk
Inflammatory-hypophysitis
Pituitary apoplexy– haemorrhage or less commonly infarction
Peri-partum infarction-sheehan’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How else can panhypopituitarism be caused?

A

Congenital (rare)

Due to mutation of transcription factor genes needed for adenohypophysis development.

Deficient GH and at least 1 more adenhypophysis hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Panhypopituitarism also known as

A

simmond’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Sheehan’s syndrome

what happens to pituitary

A

Post partum hypopituitarism

  • secondary to hypotension (post partum haemorrhage-leads to pituitary infarction)
  • Less common in developed countries

Anterior pituitary enlarges in pregnancy- lactotroph hyperplasia in preparation
However haemorrhage reduces blood supply to the enlarged pituitary
Gland dies off- adenohypophysis infarction

easy to miss as common symptoms

  • lethargy, anorexia,weight loss
  • Inability to produce milk
  • Secondary ammenhorea usual after postpartum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pituitary apoplexy caused by

Can be precipitated by

presentation in patients

A

Intra-pituitary haemorrhage or less commonly infarction

Anticoagulants

May be first presentation of a pituitary adenoma

  • severe sudden onset
  • visual field defect- compressed optic chiasm, bitemporal hemianopia
  • Cavernous sinus involvement may lead to diplopia (IV,VI), ptosis. (III)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the symptoms of Simmond’s mainly due to?

A

Loss of deficient hormones -FSH/LH, ACTH, TSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the symptoms of Simmond’s?

A 
Secondary hypogonadism
Secondary amenorrhoea
Impotence
Loss of libido
Secondary hypoadrenalism (cortisol def)
Tiredness
Secondary hypothyroidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is different about Sheehan’s compared to the other two?

A

It is specific to women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you diagnose hypopituitarism?

A

You can’t measure hypothalamic hormones so you measure basal values of the plasma for pituitary or target endocrine gland hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why will a single measurement not suffice?

A

Hypothalamic hormones are released in pulses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What test can you use to find out if a person is producing hormones at a normal level?

3 E.G

Another method for diagnosing Hypopituitiarism

A

Stimulation test

1) Inducing release of ACTH and GH
-Stress hormones
-Insulin Induce Hypoglycaemia stimulates:
GH Release
ACTH Release (Cortisol measured)

2) Inject TRH- Stimulates TSH release
3) Inject GnRH stimulates FSH and LH release

Radiological diagnosis
-Pituitary MRI
reveal pituitary pathology e.g haemorrage–> apoplexy, adenoma, empty sella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does a lack of somatotrophin cause in children and adults?

A

Pituitary dwarfism in children

Effects uncertain in adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are other causes of short stature in children? (6)

A

Genetic- Down’s, Turner’s, Prader Willi
Malnutrition
Emotional deprivation
Systemic disease-C.F, Rheumatoid arthritis
Malabsorption-Coeliac
Endocrine disorders- Cushing’s, hypothyroidism, GH deficiency, poorly controlled T1DM
Skeletal dysplasia- OI

17
Q

What controls GH at a hypothalamic level?

A

GHRH and somatostatin

18
Q

What does GH (somatotrophin) stimulate the production of in the liver?

A

IGF-1 (insulin like growth factor) (liver is main source but is produced in many places)

IGF-2 (foetal growth)

19
Q

What does IGF-1 do?

A

Mediate growth effects

20
Q

What is laron dwarfism due to?

A

GH receptor defect

21
Q

What is pituitary dwarfism due to

A

Lack of GH

22
Q

Prader Willi

Dwarfism
Mutation in?

Pituitary dwarfism

Laron Dwarfism
-Can be treated by?

A

GH deficiency secondary to hypothalamic dysfunction

Achondroplasia
FGF3- Fibroblast Growth Factor Receptor 3
Abnormality in growth plate chondrocytes- impaired linear growth
-normal trunk, short arms and legs

-Childhood GH deficiency

-High incidence in village in Ecuador
IGF-1 treatment in childhood can increase height

23
Q

Causes of acquired GH deficiency in adults

A

Trauma
Pituitary tumour pituitary surgery
Cranial radiotherapy

24
Q

What other condition leads to hypogonadism and is a hypothalamic defect?

A

Prader Willi

25
Q

GH provocation test

A
  • GHRH+ARGININE (i.v) in combination more effective
  • INSULIN (i.v) via hypoglycaemia
  • GLUCAGON (i.m)-stimulates ant. pit. to make ACTH and GH –> patients vomit: stress dires out ACTH and GH
  • EXERCISE e.g 10 mins step climbing

Measure GH before and after

26
Q

Growth Hormone therapy

  • preparation
  • administration
A

-Human recombinant GH:SOMATOTROPHIN

Daily, subcutaneous injection
Monitor clinical response & adjust dose to IGF-1

27
Q

GH deficiency in adults:signs and symptoms

A

Reduced lean mass increased adiposity, increased waist:hip ratio

Reduced muscle strength & bulk –> reduced exercise performance

Decreased plasma HDL- cholesterol and raised LDL cholesterol (bad)

Impaired psychological well being and quality of life

28
Q

What is a common problem with GH therapy in adults

A

Increased susceptibility to cancer - no data to support this currently

Expensive

29
Q

Potential benefits of GH therapy

A

Improved body composition- decreased waist:hip, less visceral fat

Improved muscle strength and exercise capacity

More favourable lipid profile higher HDL and reduced LDL

Increased bone mineral density

Improved psychological well being and quality of life

30
Q

When is GH administered?

A

Daily- In the afternoon as levels are normally high at night anyway

31
Q

What is the half life of GH like?

A

Short- 20 mins

32
Q

What does GH work on hence what is its action duration like?

A

Protein synthesis so long

33
Q

What are the adverse effects of GH?

A

Lipoatrophy at site of injection
Intracranial hypertension- headaches
Increased risk of cancer

34
Q

What are the signs and symptoms of GH deficiency in adults?

A 
Reduced lean mass
Increased adiposity 
Increased waist:hip ratio
Reduced muscle strength and bulk
Decreased HDL and increased LDL
Impaired psychological wellbeing

RR ENDO (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions