Hypothalamic and pituitary hormones

Question 1

Tetracosactide is an analogue of (?)

Answer 1

Corticotropin (ACTH)

Tetracosactide = tetracosactrin

Question 2

Failure of the plasma cortisol concentration to rise after administration of tetracosactide indicates (?)

Answer 2

Adrenal insufficiency

Question 3

What are the indications for the use of tetracosactide? (2)

Answer 3

1. Diagnosis of adrenocortical insufficiency (diagnostic 30 minute test or diagnostic 5-hour test)
2. Alternative to corticosteroids in Crohn’s disease or rheumatoid arthritis (unpredictable response that decreases with time)

Question 4

Why are both corticotropin and tetracosactide no longer routinely used as an alternative to corticosteroids in Crohn’s disease?

Answer 4

Variable and unpredictable therapeutic response that decreases with time

Question 5

Which hormones can be used in the treatment of infertility in women with proven hypopituitarism?

Answer 5

FSH
LH

Together or FSH alone (follitropin)

Question 6

If a female patient with infertility has not responded to clomifene citrate, which hormones can be used for treatment?

Answer 6

FSH
LH

Together or FSH alone (follitropin)

Question 7

What are 5 indications for the use of growth hormone in children?

Answer 7

1. Prader-Willi syndrome
2. Turner syndrome
3. Chronic renal insufficiency
4. Short children considered small for gestational age at birth
5. Short stature homeobox-containing gene (SHOX) deficiency

Question 8

What is the name of the growth hormone replacement that is produced using recombinant DNA technology?

Answer 8

somatropin

Question 9

Is somatotrophin or somatropin used in patients with a growth hormone deficiency?

Answer 9

Somatropin (growth hormone of human sequence produced using recombinant DNA technology)

*Somatrotrophin is growth hormone of human origin and has been replaced by somatropin

Question 10

Somatropin is used to treat (?) hormone deficiency

Answer 10

Growth

Question 11

What is the name of the drug used to treat growth failure in children and adolescents with severe primary insulin-like growth factor-I deficiency?

Answer 11

Mecasermin (a human insulin-like growth factor-I [rhlGF-I])

Question 12

Mecasermin is used to treat growth failure in children and adolescents caused by…

Answer 12

Severe primary insulin-like growth factor-I deficiency

Mecasermin = human insulin-like growth factor-I (rhlGF-I)

Question 13

What are the common side effects of somatropin (growth hormone of human sequence produced using recombinant DNA technology)? (8)

Answer 13

Carpal tunnel syndrome
Fluid retention 
Headache
Joint disorders
Lipoatrophy
Myalgia
Oedema
Paraesthesia

Question 14

What is the mode of admnistration of somatropin (growth hormone of human sequence produced using recombinant DNA technology)?

Answer 14

Subcutaneous injection

Question 15

What is the mode of administration of tetracosactide (ACTH analogue)?

Answer 15

IM injection using depot injection

IV injection for diagnostic 30 minute test of adrenocortical insufficiency

Question 16

When gonadorelin is injected intravenously in normal subjects, there is a rapid rise in plasma concentrations of which two hormones?

Answer 16

LH

FSH

Question 17

What is the indication for the use of gonadorelin? (1)

Answer 17

Assessment of pituitary function (subcutaneous injection or IV injection)

Used to distinguish hypothalamic from pituitary lesions

Question 18

What are the indications of the use of gonadorelin analogues (goserelin, buserelin)? (4)

Answer 18

1. Endometriosis
2. Infertility
3. Breast cancer
4. Prostate cancer

Question 19

Administration of gonadorelin analogues produces an initial phase of (?); continued administration is followed by down-regulation of gonadotrophin-releasing hormone receptors, thereby reducing the release of gonadotrophins (follicle stimulating hormone and luteinising hormone) which in turn leads to inhibition of androgen and oestrogen production.

Answer 19

stimulation

Question 20

Administration of gonadorelin analogues produces an initial phase of stimulation; continued administration is followed by down-regulation of (?) receptors, thereby reducing the release of gonadotrophins (follicle stimulating hormone and luteinising hormone) which in turn leads to inhibition of androgen and oestrogen production.

Answer 20

gonadotrophin-releasing hormone

Question 21

Administration of gonadorelin analogues produces an initial phase of stimulation; continued administration is followed by down-regulation of gonadotrophin-releasing hormone receptors, thereby reducing the release of gonadotrophins ((?) and(?)) which in turn leads to inhibition of androgen and oestrogen production.

Answer 21

1. FSH

2. LH

Question 22

Administration of gonadorelin analogues produces an initial phase of stimulation; continued administration is followed by down-regulation of gonadotrophin-releasing hormone receptors, thereby reducing the release of gonadotrophins (follicle stimulating hormone and luteinising hormone) which in turn leads to inhibition of (?) and (?) production.

Answer 22

1. Androgen

2. Oestrogen

Question 23

How long can you use gonadorelin analogues (goserelin, buserelin) for the treatment of endometriosis?

Answer 23

No longer than 6 months (DO NOT repeat)