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ENDO I > Hypothalamus CIS > Flashcards

Hypothalamus CIS Flashcards

1
Q

Major blood supply to ant pituitary is what

A

long portal vessels

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2
Q

minor blood supply to ant pituitary is what

A

short portal vessels

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3
Q

What type of hormones act on post pituitary

A

neuroendocrine

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4
Q

What type of hormones act on the anterior pituitary

A

tropic hormones from hypothalamus

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5
Q

How do pituitary adenomas affect vision

A

can press on optic chiasm

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6
Q

What hormones come from poist pituitary

A

oxytocin and ADH

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7
Q

What hormones come from ant pituitary

A

GH, prolactin, LH/FSH, TSH, ACTH

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8
Q

What groups of classes can cause hypopituitarism

A

pituitary diseases, hypothalamic disease, traumatic brain injury, stroke

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9
Q

What could be signs of postinfarction to anterior pituitary

A

fatgiue, unable to lactate, amenorrhea,, weight retention, skin a voice changes

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10
Q

What hormones explain fatigue? unable to lactate, amenorrhea, wight retention, skin and voice changes, BP

A

ACTH releases cortisol which maintains BP(so lack of)
TSH (weight control)
amenorrhea(lack of FSH and LH)
unable to lactate(porlactin)

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11
Q

If potassium levels are normal what hormone from pituitary can you expect is ok

A

aldosterone

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12
Q

Why would infarction to ant pituitary cause low blood glucose

A

no ACTH, no cortisol(helps maintain blood glucose)

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13
Q

Why are pregnant women susceptible to pituitary infarction?

A

The lactotrophs are enlarged due to pregnancy.

Also pregnant women have and enlarged pituitary

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14
Q

How come in Sheehan syndrome is the post pituitary relatively unaffected

A

blood from a different source- inferior hypophyseal a

does not enlarge during pregnancy

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15
Q

How is aldosterone level normal when ant pituitary infarcted

A

renin-angiotensin system

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16
Q

What are the physiologic causes of hyperprolactinemia

A

pregnancy, nipple stimulation, stress

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17
Q

What are the pathologic causes of hyperprolactinemia

A

lactotroph adenomas

decreased dopaminergic inhibition

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18
Q

What can cause decreased dopaminergic inhibition

A

hypothalamic and pituitary disease

drug use

19
Q

What are other causes of hyperprolactinemia

A

estrogen, hypothyroidism, chest wall injury, chronic renal failure, idiopathic hyperprolactinemia
macroprolactinmeia
genetic

20
Q

prolactin is inhibited by what

A

dopamine

21
Q

Increased prolactin levels affect what hormone

A

suppress GnRH

22
Q

how does central diabetes inspidus affect ADH levels

A

decreased released because suppresses secretions from posterior pituitary

23
Q

If every anterior pituitary hormone is low except high prolactin what could be the cause

A

decreased secretion of dopamine which usually inhibits prolactin
problem to hypothalamus
infundibulum could have been severed. hormones not transmitted from hypothalamus to anterior pituitary

24
Q

what would hormone levels look like in a pituitary adenoma

A

LH/FSH levels might be low because of feedback

prolactin levels would be high( inhibit gonadotropins)

25
Q

What is the most common cause of acromegaly

A

somatotroph adenoma of anterior pituitary

26
Q

What are the other causes of acromegaly

A

GHRH secretion from hypothalamic tumors or neuroendocrine tumors or ectopic GH secretion by neuroendocrine tumors

27
Q

What stimulates GH release

A

deep sleep, alpha adrenergic, fasten, Ach, sex steroids, stress, aa, hypoglycemia, ghrelin

28
Q

What are the supressors of GH release

A

obesity
beta adrenergics
glucocorticoids, high FFA, hyperglycemia, hypothyroidism, IGF-1

29
Q

What inhibits release of IGF, intrinsic growth factor

A

undernutrition, acute illness, chronic illness, GH receptor deficiency, GHR Ab, IGF-1 R deficiency

30
Q

describe the effects of protein intake, carb intake, and fasting on GH

A

protein intake increases somatomedin which increases GH
Carb intake causes no big change in somatomedin which decreases GH
fasting decreases somatomedin so increase in GH

31
Q

How come in fasting GH increases and growth decreases

A

because there is a decrease in growth from decreased insulin from decreased somatomedin

32
Q

What are the progressive changes in acromegaly

A

deepened skin creases, thickened skin, bulbous nose and lips, jaw appeared more prominent, hands were bulky

33
Q

Why are IGF levels more useful in diagnosing acromegaly

A

if GH elevated IGF elevated, IGF is more durable and easier to detect
GH is very pulsatile

34
Q

If there is a deficiency in hormones, what is the way to Dx

A

test it, try to activate it

35
Q

What is bitemporal hemianopsia

A

blindness in certain visual fields

36
Q

When are suppression tests used for hormone regulation testing

A

when it is suspected that there is over secretion

looking for normal regulation

37
Q

What metabolic disturbances result in physical changes seen in acromegaly

A

increased lipolysis
increased protein synthesis (lean body mass)
glucose- GH opposes insulin so can result in DM II

38
Q

How does the body compensate to the increased insulin insensitivity

A

hyperplasia of Beta cells

39
Q

What are Tx for acromegaly from GH secreting tumor on ant pituitary

A

surgical resection of neoplasm, stereotactic radiotherapy

lifelonge medicaly therapy with somatostatin analogue octeotide or GH R antagonist pegvisomant

40
Q

what is the effect of somatostatin on GH

A

inhibits further release through neg feedback loop

41
Q

How does GH lead to increased linear growth

A

actions of IGF-1

altered cartilage metabolism

42
Q

What is the effect of TRH on prolactin

A

increase amount released

43
Q

Why in hypothyroidism is TRH increased

A

not getting feedback since no TSH is actually being released

ENDO I (9 decks)

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