Hypothalamus-Pit-Adrenal axis Flashcards by Thomas Ems

name the 2 inhibitory hormones released by hypo

Somatostatin, PIH (dopamine)

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What is Ppit derived from? (2)

derived from neuroectoderm

downgrowth of 3rd ventricle

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What is Apit derived from? (2)

Oral ectoderm

Derived from Rathke’s pouch (roof of pharynx)

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What i slocated in sella turcica?

Apit

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Color of each on stain:
Chromophobes-
Acidophils
Basophils

Chromophobes- don’t stain (clear)
Acidophils (pink)
Basophils (purple)

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ACTH, MSH: cell type, stain

corticotroph, basophilic

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TSH: cell type, stain

thyrotroph, basolphilic

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FSH, LH: cell type, stain

gonadotroph, basophilic

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GH: cell type, stain

somatotroph, Acidophilic

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prolactin: cell type, stain

lactotroph, acidophilic

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mammosomatotroph: what homos (2)? stain?

GH, PRL, acidophilic

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ACTH: stimulated by, stimulates what gland to relaese what?

CRH –> ACTH –> adrenals to release Cortisol

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where are the homos from Ppit released?

directly into blood vessels

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2 functions of oxytocin

precipitates childbirth, lactation

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Define difference between primary and secondary endocrine disorders

Primary: target endocrine organ is fucked
Secondary: Pituitary itself is fucked

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Midline defect congenital cause of hypopituitarism

Septo-optic dysplasia

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two suprasellar tumor types that cuase hypopit

glioma, craniopharyngioma

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Cranio[haryngioma: derived from

rathke’s pouch

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Cranio[haryngioma: age ?

bimodal: 5-15, >65

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cp of cranioPharyngioma (2)

pit hypofunction, GH deficiency

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Histo of cranio[haryngioma

clacifications

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Cause of sheehan synd

Post-partum ischemic necrosis of pituitary

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presentation of sheehan

LH/FSH, ACTH, TSH deficiency

Pathoma- LH deficeincy –> poor lactation, pubic hair loss, fatigue

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Pituitary apoplexy:

cause, CP

cause: hemorrhage of adenoma
CP: hypopit

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cause of septo-optic dysplaisia

Genetic - (HESX1, SOX1 gene mutations)

What is wrong in septo-optic hypoplasia

optic nerve hypoplasia plus absence of septum pellucidum--. often blind

rathke's cleft pouch has what effect on pit?

fluid filled cyst in the posterior portion of Apit

Acquired hypopit follows what sequence of homo loss

GH --> LH/FSH --> TSH --> ACTH (least to most essential for life)

What happens to GH after relase? where?

GH gets conversted to IGF-1 in the liver

What inhibits GH release-3

malnutrition illness hyperclycemia

What stimulates GH release -4

deep sleep stress exercise hypoglycemia

IGF-1 has what 4 roles

1. bone turnover 2. linear growth promotion 3. Increased lipolysis 4. decreased Muscle glucose uptake (tries to increase BS)

Classic feature of pedriatric GH deficieincy

microphallus

How is GH stimulation test administered

insulin induces hypoglycemia which os normally met with a rise in GH.

Lack of GH leads to what (3)

increased CVD fatigue, anxiety, depresion premature death

MC cz of hyperpit

Pituitary Adenoma (

MC pituitary adenomas produce what 2 homos

PRL and GH are

age range of pit adenomas

35-60

Which type of tumor is most often non-functioning (hormone negative)? micro- or macro?

macroadenoma?

MC local mass effect of pit adenoma

bitemporal hemianopia

pit adenomas assc with what MEN syndrome

MEN1

**************MC type of hyperfunctioning adenoma

prolactinoma

imaging of prolactinoma

"pituitary stone" = calcification = dark space inside pituitary gland

************SX of prolactinemia (4)

Amenorrhea, galactorrhea, loss of libido and infertility

What is the Stalk Effect

mass in suprasellar area disturbs normal inhibitory influence of hypothalamus on prolactin

3 "other causes of prolactinemia

drugs renal failure hypothyroidism - lots of TRH stimulates prolactin release

What type and 2 examples of medications for hyperpit

dopamine receptor agonists: bromocriptine cabergoline

Gigantism is caused by

GH hypersecretion before closure of epiphyseal plate

Dx of GH adenoma (2)

^ serum GH and IGF1 | Failure to suppress GH in oral glucose test

What drug class treats GH adenoma

GHRH agonsists

Cushing disease: arises where, what imbalance

pituitary oversecretion of ACTH --> hypercortisol

WHat is cuase and mechanism of Nelson Syndrome

removal of adrenal glands--> increased CRH release --> hyperACTH (cortisol is not made)

2 signs of gonadotroph adenoma

Decreased libido, amennorhea

How is a pit CA diagnosed?

Must demonstrate metastasis to LN, liver, bone

If responds to ADH administration, what type os diabetes insipidus?

Central

Diagnosis of Diabetes insipidus

↓ urine osmolality and sp. gravity with ↑ serum sodium (dt relative water loss) and osmolality

electrolyte imbalance in SIADH

hyponatremia

MC cause of SIADH

small cell carcinoma of lung

Even Though total body water is increased, blood volume remains normal so what does not develop in SIADH

NO peripheral edema

oxytocin deficiency causes what 2 problems on pregancy

1. Prolonged labor | Difficulty with lactation