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Medical Physiology > Hypothalamus & Pituitary Hormones > Flashcards

Hypothalamus & Pituitary Hormones Flashcards

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USMLE® Step 1 flashcards
1
Q

where is the pituitary gland located?

A

sits in bony pocket at base of the skull, inferior to the hypothalamus

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2
Q

what are 4 notable structures of the pituitary gland?

A

hypophysial stalk
posterior pituitary
anterior pituitary
pars intermedia

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3
Q

what is the hypophysial stalk?

A

extension of the brain that attaches the pituitary gland to the brain

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4
Q

what is the posterior pituitary?

A

extension of the brain containing axons

neuronal secretion occurs here

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5
Q

what kind of cell makes up the anterior pituitary?

A

epithelial cells

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6
Q

what is the function of the pars intermedia?

A

separates anterior and posterior pituitary

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7
Q

what are the two major hormones secreted by the posterior pituitary?

A

vasopressin (antidiuretic hormone)

oxytocin

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8
Q

what is the function of ADH in the body?

A

conserves body water and regulates osmotic pressure of body fluids

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9
Q

how does ADH work to conserve body water?

A

acts on distal convoluted tubule and collecting ducts via cell surface receptors and cAMP formation, which enhances water permeability and rebabsoption

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10
Q

how does ADH get stimulated to conserve body water?

A

dehydration leads to an increase in osmolarity, which activates the osmoreceptor in brain and leads to ADH secretion

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11
Q

what condition arises when there is a deficiency in ADH?

A

central diabetes insipidus

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12
Q

what is central diabetes insipidus?

A

inability to retain water
excess thirst
frequent urination

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13
Q

what are some treatment options for central diabetes insipidus? how would they help?

A

drugs (clofibrate) to increase ADH secretion or to increase kidney response to ADH (chlorpropamide)
diuretics and dietary salt restriction to increase urine output

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14
Q

what happens when there is an excess of ADH?

A

excess water retention
headache
drowsiness
nausea

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15
Q

what are some treatment options for excess ADH and how do they help?

A

drugs (butorphanol) to decrease ADH secretion and reduce kidney response to ADH (demechlocycline)

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16
Q

what is the function of oxytocin in the body?

A

stimulates the contraction of smooth muscle cells (esp. mammary glands and uterus)

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17
Q

what two occasions causes oxytocin release and what results from this?

A

1) nursing - suckling reflex stimulates oxytocin release causing contraction of myoepithelial cells in breast to expel milk
2) child birth - oxytocin released during labour to stimulate rhythmic uterine contractions

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18
Q

what has oxytocin been used for clinically?

A

induce labour

therapeutically postpartum to decrease bleeding

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19
Q

what are 6 major hypothalamic hormones? what other hormones do they affect?

A

1) corticotropin releasing hormone (CRH) - increase ACTH
2) thyrotropin releasing hormone (TRH) - increase TSH and prolactin
3) gonadotropin releasing hormone (GnRH) - incr. LH and FSH
4) growth hormone releasing hormone (GHRH) - incr. GH
5) somatostatin - decrease GH
6) dopamine - decr. prolactin

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20
Q

what is the general feedback regulation of anterior pituitary hormones?

A

1) hypothalamus secretes releasing or inhibiting factor to pituitary gland (+ive or -ive)
2) pituitary gland releases hormone, which has positive impact on endocrine gland and negative impact on hypo.
3) endocrine gland releases tropic hormone, which positively impacts target tissue, negatively impacts hypo. and has a positive or negative effect on pit.

21
Q

when is pulsatile/rhythmic secretion of hypothalamic and pituitary hormones higher at?

A

night time

22
Q

what are 5 hormones released by ant. pituitary?

A 
prolactin
growth hormone
TSH
ACTH
gonadotropins (LH/FSH)
23
Q

where does prolactin work in the body?

A

breast to induce breast milk

24
Q

where does growth hormone work in the body?

A

goes to liver, leading to secretion of IGF-1 which affect bone, soft tissues, and ultimately growth

25
Q

where does TSH work in the body?

A

thyroid gland

releases T3 and T4 which affect many tissues and intermediary metabolism

26
Q

where does ACTH work in the body?

A

adrenal cortex

releases cortisol which affect many tissues and intermediary metabolism

27
Q

where do gonadotropins work in the body?

A

gonads

the affect sex steroids, gamete production, and ultimately sex characteristics/reproduction

28
Q

what does a release of growth hormone do, specifically? (5pts)

A 
decreases insulin sensitivity
increases lipolysis
increases IGF-1 secretion (affect protein synthesis and epiphyseal growth)
increase protein synthesis
increase bone growth
29
Q

what stimulates GH secretion? what inhibits it?

A

stimulated by GHRH, hypoglycemia, exercise, certain AAs, and sleep
inhibited by somatostatin, IGF-1 (negative feedback), hyperglycemia

30
Q

what is the feedback loop for GH secretion?

A

1) hypothalamus secretes somatostatin or GHRH, which have a negative impact and a positive impact on the pit. gland, respectively
2) pituitary gland releases GH (or inhibits it, depending on impact from hypo.)
3) GH has positive impact on liver and a +ive/-ive impact on body growth, lipolysis, glc uptake (depending on impact)
4) liver releases IGH-1 (impacts body growth, etc)
5) IGH-1 negatively impacts pit. gland and hypo.

31
Q

what happens when there is an excess of growth hormone present?

A

somatotrope tumour

32
Q

what condition occurs if GH excess occurs early in life?

A

gigantism (rare)

33
Q

what condition occurs if GH excess occurs after body growth stopped?

A

acromegaly (excess soft tissue hyperplasia)

34
Q

what are some treatment options for somatotrope tumour caused by excess GH?

A

tumour removal
SS analog
GH receptor antagonist

35
Q

what conditions occur when there is a GH deficiency?

A

hypothalamic and pituitary lesions

could be tumour, injury, infection, congenital/genetic defects, that lead to GH deficiency

36
Q

what does someone with GH deficiency look like?

A

proportional short stature, if it occurs early in life

37
Q

what are symptoms of adult hypopituitarism? (6pts)

A 
weakness
fine wrinkling
pale skin
loss of sex drive
genital atrophy
menstrual cycle cessation
38
Q

what are two other causes of retarded growth (GH is normal)?

A

GH receptor defect in target tissues (Laron Dwarfs)

IGF-1 deficiency (African pygmies)

39
Q

what are some treatment options for GH deficiency?

A

GH and IGF-1 replacement

40
Q

where is prolactin derived from?

A

lactotropes and somatomammotropes of ant. pit gland

41
Q

what are 3 actions of prolactin in the body?

A

1) promote growth and function of mammary gland to induce milk production (and suckling reflex)
2) increases maternal behaviour
3) inhibits gonadotropin secretion/action on glands to decrease steroidogenesis

42
Q

what controls the stimulation and inhibition of prolactin?

A

inhibited by dopamine

stimulated by oxytocin, TRH, VIP, and estrogen

43
Q

what are the hormone changes that occur during the suckling reflex?

A

1) infant suckling causes mechanoreceptors in nipple to stimulate hypothalamus
2) hypothalamus acts on in two pathways: post. pit. gland and dopamine
a) posterior pit. increases oxytocin, which increases contraction of myoepithelial cells, leading to increased milk ejection
b) dopamine levels decrease, acting on ant. pit gland to increase prolactin and increase milk production

44
Q

what condition occurs if there is an excess of prolactin?

A

hyperprolactinemia (most common form of pit. tumour)

45
Q

what could cause excess prolactin?

A

DA receptor blockers
stress
high physical activities
under weight

46
Q

what health consequences could occur to females due to excess prolactin?

A

anti-gonadal action causes secondary amenorrhea (Cessation of menstrual cycle) leading to infertility

47
Q

what is galactorrhea?

A

inappropriate milk production

48
Q

what health consequences could occur to males due to excess prolactin?

A

impotence
decreased sperm count
infertility

49
Q

what is a treatment option for excess prolactin? how does it help?

A

DA agonists

suppress prolactin secretion and shrink prolactinomas

Medical Physiology (15 decks)

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