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Endo Repro Test 1 > Hypothalamic-Pituitary relationships > Flashcards

Hypothalamic-Pituitary relationships Flashcards

1
Q

where do cancers of pituitary expand?

A

into the brain & against the optic nerves
– increase in pituitary size often associated with dizziness &
vision problems, or both

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2
Q

what neuropeptide does SON secrete?

A

ADH

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3
Q

what neuropeptide does PVN secrete?

A

oxytocin

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4
Q

what hormones does ant. pituitary secrete?

A 
– ACTH
– TSH
– FSH
– LH
– GH
– Prolactin
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5
Q

how is the ant pituitary connected to hypothalamus?

A

• Connected to the hypothalamus
by hypothalamic-hypophysial
portal vessels

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6
Q

what does thehypothalamic-hypophysial

portal vessels allows?

A 
– Hypothalamic hormones
can be delivered to the
anterior pituitary
directly & in high
concentration
– The hypothalamic
hormones do not appear
in the systemic
circulation in high
concentration`
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7
Q

1 endocrine disorder:

A

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

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8
Q

2 endocrine disorder:

A

low or high levels of

hormone due to defect in the pituitary gland

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9
Q

3 endocrine disorder:

A

low or high levels of

hormone due to defect in the hypothalamus

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10
Q

Acromegaly

A

Caused by prolonged,
excessive secretion of
growth hormone (GH) in
adult life

• Characterized by excessive
growth of soft tissue,
cartilage, & bone in the
face, hands, & feet
• Develops very gradually;
may not be recognized until
it has been present for
many years
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11
Q

how do you diagnose acromegaly?

A

measure IGF-1

  • levels constant throughout day
  • should show increase IGF-1 and failure to suppress GH following oral glucose tolerance test
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12
Q

what are medications for acromegaly?

A

– Octreotide or lanreotide: Somatostatin analog
– Pegvisomant: GH receptor antagonist
– Bromocriptine or cabergoline: Dopamine receptor
agonists

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13
Q

in what manner is GH released?

A

secreted from

somatotrophs in a pulsatile manner

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14
Q

what are effects of GH

A

1) increase blood gluocse
(increases blood insulin)
2) increase protein syntheiss and organ growth (mediated by somatomedins)
3) increase linear growth (increase chondrocytes proliferation)
(mediated by somatomedins)

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15
Q

what does prolactin inhibit?

A

GnRH-> FSH and LH

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16
Q

what inhbits prolactin?

A

dopamine

17
Q

what does somatostatin inhibit?

A

GH

18
Q

what does TRH increase?

A

TSH and prolactin

19
Q

what are non functioning pituitary adenomas associated with?

A

FSH and LH

20
Q

causes of hypopituitarism

A

1) brain damage
2) pituitary tumors
3)non-pitutiary tumors
4)infections
5) infarction (sheehan syndrome)
– Autoimmune disorders
– Pituitary hypoplasia or aplasia
– Genetic causes

21
Q

Sheehan syndrome

A 
Postpartum
hypopituitarism due to
necrosis of the pituitary
gland
• Most patients present
with agalactorrhea &/or
difficulties in lactation
• Amenorrhea commonly
presented
• Some patients present
with hypothyroidism
22
Q

posterior lobe hormones

A

– ADH & oxytocin

23
Q

what triggers ADH secretion?

A

1) decrease BP
2) decrease arterial stretch due to low blood volume
3) increase osmolarity

24
Q

actions of ADH

A

1) V1 blood vessel receptors to vasoconstrict
2) V2 kidney receptors to reabsorb H20

overall goal= increase blood pressure and volume

25
Q

what is secretion of ADH most sensitive to

A

plasma osmolarity

changes!

26
Q

how does ADH increase H20- reabsorption

A

-V2 receptor= Gprotein
increase adenylate cyclase and camp
-aquoporin 2 channels inserted in membrane

27
Q

Diabetes insipidus (DI)

A
  • Lack of an effect of ADH on the renal collecting duct
  • Causes frequent urination
  • The large volume of urine is diluted
28
Q

Central DI

A 
• Lack of ADH (ê plasma ADH)
• Could result from:
- Damage to the pituitary
- Destruction of the
hypothalamus
29
Q

treatment for central DI

A

• Treatment: desmopressin (drug

that prevents water excretion)

30
Q

Nephrogenic DI

A 
• Kidneys unable to respond to
ADH (é plasma ADH)
• Causes:
- Drugs like lithium
- Chronic disorders (e.g.
polycystic kidney disease,
sickle cell anemia)
31
Q

what type of DI responds to desmopressin

A

central DI

32
Q

Syndrome of inappropriate ADH secretion (SIADH)

A
  • Excessive secretion of ADH
  • Excessive water retention
  • Hypoosmolarity fails to inhibit ADH release

Endo Repro Test 1 (3 decks)

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