Lecture 1 - Pituitary

Question 1

the anterior pituitary is derived from _____. the posterior pituitary is derived from _____;
the pituitary gland is located in the _____

Answer 1

oral ectoderm (Rathke's pouch);
neuroectoderm;

sella turcica

Question 2

TRH stimulates the release of what

Answer 2

TSH, prolactin

Question 3

dopamine _____ prolactin secretion. prolactin inhibits ______

Answer 3

inhibits;

GnRH secretion

Question 4

most common pituitary tumor>?

Answer 4

prolactinoma (diagnosed early);

GH tumor less common, diagnosed late

Question 5

mass effects of pituitary adenomas:

_____ (visual), ____pituitarism, headache

Answer 5

bitemporal hemianopia, hypo

Question 6

prolactin may be increased in response to _____ antagonists; they may also be increased in ___thyroidism

Answer 6

dopamine;

hypo (due to increased TRH)

Question 7

presentation of prolactinoma:

in women: ____, ____, ____ bone density due to ____ in estrogen

Answer 7

galactorrhea, amenorrhea, decreased;

inhibition

Question 8

prolactinoma in men:

_____ and _____

Answer 8

low libido, infertility

Question 9

treatment of prolactinoma: _____ is first line. examples = ?

Answer 9

dopamine agonists;

cabergoline, bromocriptine, pergolide

Question 10

GH is released in a ____ manner, usually at _____.

Answer 10

pulsatile, night

Question 11

what mediator is measured to look at GH levels?

this mediator causes ____, _____ resistance, and ____ growth

Answer 11

IGF1;

lipolysis, insulin, muscle

Question 12

GH excess:

____ in kids, ____ in adults; typically due to _____

Answer 12

gigantism, acromegaly;

pituitary adenoma (large )

Question 13

acromegaly:

large ____ and ____, frontal _____, excessive ____, impaired ____ tolerance

Answer 13

hands, feet;
blossing;
sweating;
glucose (2ndary type 2 DM)

Question 14

acromegaly diagnosis:

increased serum ____. failure to suppress serum ____ following oral _____

Answer 14

IGF1;

GH, glucose

Question 15

acromegaly treatment:
____ is first line.
if not cured, treat with _____, a somatostatin analog or _____, a GH receptor antagonist

Answer 15

surgery;

octreotide, pegvisomant

Question 16

acromegaly complications:
increased risk of ____ cancer.
death due to ____

Answer 16

colon;

HF

Question 17

posterior pit:
ADH is synthesised in the ____.
oxytocin is synthesized in the ____;
both are transported to the posterior pit via ____

Answer 17

supraoptic nuclei;
paraventricular nuclei;
neurophysins

Question 18

ADH release is stimulated by ____osmolality, ____volemia, and nausea

Answer 18

hyper, hypo

Question 19

SIADH:

characterized by ___volemic ___natremia with ____ urinary Na exretion

Answer 19

euvolemic hyponatremia;

continued

Question 20

in SIADH:
Urine osmolality is _____ than serum osmolality.
with water retention, aldosterone levels ____ and ____ levels increase

Answer 20

greater;

decrease, ANP/BNP

Question 21

treatment of SIADH:
first, _____;
_____ is a arginine vasopressin receptor antagonist. ____ is a selective V2 receptor antagonist

Answer 21

water restriction;

conivaptan, tolvaptan

Question 22

SIADH:
from ectopic ADH such as ____ cancer;
CNS disorders/trauma;
____ disease

Answer 22

small cell lung;

pulmonary

Question 23

DI:
urine osmolality is \_\_\_\_ than serum osmolality;
\_\_\_natremia, polyuria, polydipsia.
specific gravity is (low or high)
hyperosmotic volume \_\_\_\_\_

Answer 23

lower;
hyper;
low;
contraction

Question 24

DI:

with central DI, ADH levels are _____. with nephrogenic, ADH levels are ____, which responds to exogenous ADH?

Answer 24

low;
normal or high;
central