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Endocrine 1 > Hyposecretory Ant-Pituitary > Flashcards

Hyposecretory Ant-Pituitary Flashcards

1
Q

What neurotransmitter inhibits prolactin?

A

Dopamine

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2
Q

What hormone inhiits Growth hormone?

A

Somatostatin

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3
Q

What is the most common etiology of Hypopituitarism?

A

Pituitary disease 80%
Hypothalamic Disease 13%
Idiopathic 7%

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4
Q

What are the types of Pituitary related etiologies of Hypopituitarism?

A 
Tumor: Pit. adenoma, cysts, mets 
Surgery: loss after adenoma excision
Radiation: long after rad. therapy
Infarction (Sheehan)
Hemorrhage (pit Apoplexy)
Infiltrative disease
Infection
Genetic Mutations
Empty sella synd: Primary, Secondary
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5
Q

What is Addison’s disease?

A

Primary adrenal insufficiency

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6
Q

What are attributes of Secondary Adrenal Deficiency?

A

LOW CORT. with LOW ACTH
No Hyperpigmentation
No Aldosterone Deficiency

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7
Q

How is adrenal insufficiency diagnosed?

A 
Morning Cortisol Level ( 18 normal 
Cortrosyn Stim test
Chech ACTH reserves/axis
-Metyrapone Test
-Insulin induced hypoglycemia
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8
Q

How is ACTH Deficiency Treated?

A

Hydrocortisone 15-30 mg daily
2/3 in morning 1/3 afternoon
Instruct Pt on need to increae dose in times of illness. Stress dose for surgery/trauma
Assess adequacy by BP/electro/sense of wellbeing
Mineralocorticoids not necessary

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9
Q

How is TSH deficiency diagnosed?

A

Measure serum thyroxine
Measure TSH
2ndary HypoTHy
-Low T4 with simultaneous low TSH

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10
Q

What is the Tx of TSH deficiency?

A

L-thyroxine
T4 after adrenal function determined to be normal/treated

TSH measurements in SECONDARY hypothyroidism is usless

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11
Q

How is low gonadotropin diagnosed in Women? Men?

A

F No tests needed if normal menses
LOW Estradiol, LH, FSH
Progesterone Challenge

M: LOW serum Test, LH, Sperm count, FSH

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12
Q

What is the Tx of LH/FSH deficiency?

A 
M: Not seeking fertility: Testost
Seeking Fert: LH/FSH if Pit
GnRH in Hypothal dis
F: Estrogen Progest replacement
Ovulation induction if seeking fertility
 LH/FSH if Pit
GnRH in Hypothal dis
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13
Q

How is GH Deficiency diagnosed?

A

IGF-1 levels (Most COMMON!)
Random GH levels not helpful
Insulin induced hypoglycemia
Arg + GH releasing Hormone

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14
Q

What hormone is the 1st to be lost? Last?

A

GH first lost
LH/FSH
TSH
ACTH last lost

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15
Q

What is the Purpose of Oxytocin?

A

Prolactin release

Uterine contraction

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16
Q

What is the effect of Stimulation of Vasopressin Receptors?

V1 vs V2?

A 
V1: Vasculature = Vaso constriction
V2: Renal Tubules
-Aquaporin Synth and insertion into luminal surface of Collecting duct
-inc Permiability of tubules
-re-abs of solute free water
17
Q

What is the Tx of Vasopressin Deficiency?

A

Adequate water intake

Desmopressin if Urine

18
Q

What are the common causes of ADH deficiency?

A

Transient: After Pit surg. swelling

Permanent: Panhypopituitaryism

Endocrine 1 (15 decks)

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