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Endo/Repro > Hypothalamus/Pit CIS > Flashcards

Hypothalamus/Pit CIS Flashcards

1
Q

Posterior Pituitary Hormones (2)

A
  1. Oxycontin

2. ADH

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2
Q

Anterior Pituitary Hormones (5)

A
  1. GH
  2. Prolactin
  3. LH/FHS
  4. TSH
  5. ACTH
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3
Q

Common Cause of Sheehan Syndrome

A

Postpartum Hemorrhage that required a blood transfusion

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4
Q

Hemorrhage in Sheehan Syndrome causes ______

A

Damage to the Anterior Pituitary

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5
Q

Increased levels of prolactin during lactation suppress ____

A

GnRH

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6
Q

Prolactin is inhibited by ___

A

Dopamine

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7
Q

Lab Values in Sheehan Syndrome

A

Overall decrease in anterior pituitary hormones

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8
Q

Symptoms in Sheehans (5)

A
  • inability to lactate
  • fatigue
  • amenorrhea
  • weight retention
  • Skin and voice changes
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9
Q

Blood Supply for the anterior pituitary

A

Superior Hypophyseal Artery

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10
Q

Blood Supply for the Posterior Pituitary

A

Inferior Hypophseal Artery

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11
Q

Pituitary Hormones can result in _____ problems

A

Vision

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12
Q

Why are pregnant women susceptible to Pituitary Infarction?

A
  • they produce increased amounts of estrogen, progesterone and prolactin
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13
Q

How does increased prolactin production put pregnant women at risk of developing Sheehan Sydrome?

A

Hyperplasia of lactotropes –> hyperplasia of pituitary –> increased blood demand/supply –> a hemorrhage during pregnancy can cause ischemic necrosis of the gland

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14
Q

Why can the posterior pituitary be spared in Sheehan’s?

A

Different blood supply from the anterior pituitary

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15
Q

Causes of Hyperprolactinemia (2)

A
  • loss of dopamine inhibition

- Hypothyroidism

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16
Q

How does hypothyroidism result in hyperprolactinemia?

A

TRH is a stimulus for prolactin release

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17
Q

Case:

  • Brain injury
  • low levels of LH, FSH, T4, T3, TSH, and Cortisol
  • high levels of prolactin
A

Hypothyroidism dt damage to the pituitary stalk (no Dopamine inhibition on prolactin)

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18
Q

In a Prolactinomaof the lactrotropes, _____ hormone levels should be normal while ___ and ___ levels should be low.

A
  • Thyroid hormone

- LH and FSH

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19
Q

In hypothyroidism you see very high levels of ____ and ____.

A

Prolactin and TSH

20
Q

Treatment of a Prolactinoma?

A

Dopamine agonist

21
Q

Prolactin Inhibits: (4)

A

-LH, FSH, GnRH, Testosterone

22
Q

Most common Cause of Acromegaly

A

Somatotroph adenoma of the anterior pituitary

23
Q

How does the body GH effect fat metabolism and blood glucose?

A
  • increases lipolysis

- increases blood glucose levels

24
Q

How does the body compensate for the increased glucose levels caused by increased GH?

A

pancreas secretes more insulin –> beta cell hypertrophy –> increase in C peptide levels –> death of beta cells (diabetes)

25
Q

High GH levels will cause insulin _____.

A

insensitivity

26
Q

Why doesn’t height increase in Post puberty acromegaly?

A

the epiphyseal plates have fused

27
Q

Post puberty effects of high levels of GH and IGF1 (6)

A
  • course facial features
  • insulin resistance
  • glucose intolerance
    increase in:
  • organ size
  • hand/foot size
  • tongue size
28
Q

Fat: GH causes increased ____ which results in ____.

A
  • lipolysis

- hyeperlipidemia

29
Q

Protein : GH causes increased ____ which increases ____.

A
  • protein synthesis

- lean body mass

30
Q

Glucose: GH ____ the effects of insulin which can result in _____.

A
  • opposes

- Type II diabetes

31
Q

In cases of stress, ____ release in increased but ____ is inhibited

A
  • GH

- IGF1

32
Q

Causes of GHRH release: (3)

A
  • fasting
  • stress
  • hypoglycemia
33
Q

Effects of protein intake on:

  • GH
  • IFG1
  • Insulin
  • Protein Synthesis
  • Growth
  • Caloric Storage
A
  • GH –> increased
  • IFG1 –> increased
  • Insulin –> increased
  • Protein Synthesis –> increased
  • Growth –> increased
  • Caloric Storage –> no change
34
Q

Effects of Carb intake on:

  • GH
  • IFG1
  • Insulin
  • Protein Synthesis
  • Growth
  • Caloric Storage
A
  • GH –> decreased
  • IFG1 –> no change
  • Insulin –> increased
  • Protein Synthesis –> no change
  • Growth –> no change
  • Caloric Storage –> increased
35
Q

Effects of fasting on:

  • GH
  • IFG1
  • Insulin
  • Protein Synthesis
  • Growth
  • Caloric metabolism
A
  • GH –> increased
  • IFG1 –> decresed
  • Insulin –> decreased
  • Protein Synthesis –> decreased
  • Growth –> decreased
  • Caloric metabolism–> increased
36
Q

Causes of GH inhibition (2)

A
  • Under-nutrition

- acute/chronic illness

37
Q

When there is an abundance of a hormone a ____ test is performed

A

suppression test

38
Q

When there is a deficiency of a hormone, a ____ test is performed

A

stimulation test

39
Q

Order of diagnostic tests ordered:

A
  1. hormone assays
  2. suppression/stimulation test
  3. imaging
40
Q

How is a GH supression test performed?

A

pt is given oral glucose

41
Q

What is octreotide and what is its mechanism of action?

A
  • acromegaly drug

- somatostatin analogue that inhibits the release of GH

42
Q

What is Pegvisomant?

A
  • acromegaly drug

- GH receptor antagonist

43
Q

Diabetogenic effect of GH

A
  • decreased glucose uptake
  • increased serum glucose
  • increased lipolysis
  • increased blood insulin levels
44
Q

Increased protein synthesis and organ growth (via IGF1) resulting from GH

A
  • increased aa uptake
  • increased DNA/RNA/protein synthesis
  • increased lean body mass and organ size
45
Q

An increase in organ size dt to GH can result in ______ dt increase in heart size.

A

Heart failure

46
Q

3 main actions of GH:

A
  1. Diabetogenic effect
  2. increased protein synthesis and organ size (dt IGF1)
  3. Increased linear growth before puberty

Endo/Repro (5 decks)

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