Pathology of HPA

Question 1

where is the hypothalamus

Answer 1

part of the diencephalon at base of brain
*major part of limbic system

Question 2

What is stored and released from the hypothalamus

Answer 2

hormonse to act on the pituitary

Question 3

Where is the pituitary

Answer 3

within the sella turcica

Question 4

What is the anterior part of the pituitary attached to the hypothalamus by

Answer 4

Via portal blood vessels

Question 5

What type of tissue makes up the anterior pituitary

Answer 5

glandular tissue

Question 6

What is the posterior pituitary made up of

Answer 6

neuroendocrine tissue

Question 7

What are the secretary cells in the pituitary

Answer 7

chromophils

Question 8

What controls the secretion of hormones from the pituitary

Answer 8

hypothalamus

Question 9

How does the posterior pituitary receive blood

Answer 9

a branch of the internal carotid

Question 10

What are herring bodies

Answer 10

Within the posterior pituitary at the end of the axons where the hormones are stored

Question 11

What does ADH do

Answer 11

increase water reabsorption within the kidney

Question 12

What will inhibit ADH secretion

Answer 12

alcohol

Question 13

What is TRH

Answer 13

Thyrotropin releasing hormones which stimulates TSH and inhibits prolactin

Question 14

What is GnRH

Answer 14

Gonadotropin releasing hormone stimulates FSH and LH

Question 15

What does somatostatin do

Answer 15

Inhibits TSH and growth hormone

Question 16

What does substance P do

Answer 16

Inhibits ACTH
stimulates GH, FSH, LH, Prolactin
involved with pain

Question 17

What is LH

Answer 17

Glycoprotein responsible for stimulating ovulation and progesterone production

and stimulate testicular growth and testosterone production

Question 18

What is FSH

Answer 18

Stimulates estrogen production and follicular maturation and spermatogenesis

Question 19

What does CRH do

Answer 19

Stimulate the release of ACTH

Question 20

What are the target cells for GH

Answer 20

Muscle
bone
liver

Question 21

What will stimulate prolactin release

Answer 21

Estrogen

Question 22

What stimulates oxytocin

Answer 22

stretch and suckling

Question 23

What stimulates ADH

Answer 23

Osmolarity, low BP

Question 24

Where is the pineal gland

Answer 24

in the central aspect of the brain

Question 25

What is the pineal gland made up of

Answer 25

Photoreceptor cells that secrete melatonin

Question 26

What is the pineal gland responsible for regulating

Answer 26

circadian rhythms

Question 27

what connects the pituitary to the hypothalamus

Answer 27

Hypophyseal stalk or infundibulum

Question 28

What is the associate genetic link for pituitary adenoma

Answer 28

MEN1

Question 29

What makes a pituitary adenoma aggressive

Answer 29

Mass effect

Question 30

What are pituitary adenomas characterized by

Answer 30

Microadenomas macroadenomas

Question 31

What are micro adenomas

Answer 31

Typically asymptomatic and generally hormonally silent

Question 32

What is a macro adenoma

Answer 32

alter hormone regulation or cause mass effect

Question 33

What are the common associated symptoms from pituitary ademoas

Answer 33

Hyperglycemia HTN Cardiomegaly LVH Increased prolactin

Question 34

What effect can a pituitary adenoma have on vision

Answer 34

bitemporal hemianopsia

Question 35

What is MEN syndrome

Answer 35

Autosomal dominant that predispose patients to endocrine tumors

Question 36

What is a prolactinoma

Answer 36

Most common type of pituitary adenoma inhibited by dopamine normally

Question 37

What are some causes of increased prolactin

Answer 37

prolactinomas decreased secretion (renal failure) primary hypothyroidism medications (lithium) Estrogen supps

Question 38

What are some of the effects of prolactinoma hyper secretion in women

Answer 38

Galactorrhea changes in menstrual cycle low estrogen hirsutism fractures

Question 39

What are some effects of prolactinoma hyper secretion in men

Answer 39

Gynecomastia hypogonadiam erectile dysfunction low testosterone

Question 40

What disease causes excessive growth hormone and IGF-1 in childhood

Answer 40

gigantism

Question 41

What is acromegaly

Answer 41

Excessive growth hormone during adulthood after growth plates have closed

Question 42

What does IGF manage

Answer 42

How GH affects the tissue *stimulates cellular hyperplasia and hypertrophy

Question 43

What is acromegaly associated with

Answer 43

Growth hormone secreting adenoma

Question 44

What is gigantism associated with

Answer 44

excess GHRH

Question 45

What does acromegaly cause

Answer 45

frontal bossing enlarged tongue Prognathism spade like hands enlarged feet

Question 46

What genetic factors are associated with Gigantism

Answer 46

MEN1 X-linked duplication error

Question 47

What is the main cation in blood

Answer 47

Sodium

Question 48

What is sodium responsible for in the blood

Answer 48

defines tonicity of intracellular and extracellular space to maintain homeostasis

Question 49

What happens as sodium levels increase

Answer 49

Osmolality increases ADH increases secretion Water retention occurs

Question 50

What is SIADH

Answer 50

Too much ADH Retained fluid hyponatremia/hypoosmolarity AMS

Question 51

what is diabetes insipidus

Answer 51

Not enough ADH or not working properly -dilute urine -hypernatremia/hyperosmolarity -polyuria/polydipsia

Question 52

What is central diabetes insipidus

Answer 52

not enough ADH production/ secretion from the pituitary

Question 53

What occurs in the brain with rapid hyperosmolarity

Answer 53

Osmotic demyelination

Question 54

What occurs in the brain with rapid hyponatremia

Answer 54

Brain herniation

Question 55

What is nephrogenic diabetes insipidus

Answer 55

Inability for the kidneys to respond appropriately to ADH

Question 56

What can occur in the brain with central diabetes insipidus

Answer 56

Hypernatremia

Question 57

How may a patient present with central diabetes insipidus

Answer 57

Polyuria (hydronephrosis etc) Polydipsia nocturia decrease urine sodium

Question 58

What does SIADH cause an increase in

Answer 58

ADH will increase the aquaporin proteins within the nephron

Question 59

How do patients typically present with SIADH

Answer 59

Thirst anorexia fatigue seizure neurologic damage

Question 60

What is panhypopituitarism

Answer 60

no hormones come from the pituitary

Question 61

What is the general cause of hypopituitarism

Answer 61

space occupying lesion such as pituitary adenoma

Question 62

What is Sheehan syndrome

Answer 62

ischemia of pituitary d/t postpartum hemorrhage

Question 63

What is pituitary apoplexy

Answer 63

Hemorrhage into pituitary

Question 64

What does ACTH deficiency cause

Answer 64

decreased cortisol

Question 65

What does TSH deficiency cause

Answer 65

hypothyroidism

Question 66

What does FSH / LH deficiency cause

Answer 66

Amenorrhea, vaginal/breast atrophy, testicular atrophy, decreased libido

Question 67

What does GH deficiency cause

Answer 67

Hypopituitary dwarfism