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2 Endocrine > Physiology of the Pituitary Gland > Flashcards

Physiology of the Pituitary Gland Flashcards

1
Q

what 2 chemicals are synthesised in the body of the nerve cells within the hypothalamus?

A

ADH

oxytocin

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2
Q

where are stimulating and inhibiting hormones released from?

A

body of the nerve cells of the hypothalamus

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3
Q

how many hormones does the anterior pituitary gland secrete?

A

5

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4
Q

what is thyrotropin?

A

TSH

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5
Q

what does cortisol do?

A

regulates BGLs
increases fat in the body
helps to defend the body against infection

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6
Q

what 2 hormones does gonadotropin releasing hormone stimulate the release of ?

A

luteinizing hormone

follicle stimulating hormone

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7
Q

what is the releasing hormone for GH?

A

growth hormone releasing hormone

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8
Q

what is the only hormone to be inhibited and not stimulated?

A

prolactin

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9
Q

what hormone from the pituitary inhibits the release of prolactin?

A

dopamine

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10
Q

what 2 hormones are released from the posterior pituitary?

A

vasopressin

oxytocin

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11
Q

is ACTH released from the pituitary or hypothalamus?

A

pituitary

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12
Q

what hormone stimulates production of ACTH?

A

CRH

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13
Q

peripheral sex hormones?

A

testosterone

oestradiol

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14
Q

which hormone has a direct effect on tissues?

A

GH

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15
Q

what can be affected when pituitary tumours grow up the way?

A

can hit optic chiasma

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16
Q

what happens when the optic chiasma is affected by a tumour

A

lose temporal vision

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17
Q

what can be hit if a pituitary tumour grows downwards?

A

sphenoid sinus

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18
Q

what is done in an insulin stress test?

A

make them go hypo to force the hypothalamus into secreting hormones

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19
Q

when would the patient have a positive insulin stress test?

A

in pituitary problems

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20
Q

when would you do a prolonged glucagon test instead of an insulin stress test?

A

epilepsy
over 60
heart disease

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21
Q

normal cortisol level?

A

over 500

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22
Q

normal GH level?

A

> 7ug/l

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23
Q

is the water deprivation test a stimulation or suppression test?

A

stimulation

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24
Q

what is a pituitary tumour <1cm called?

A

microadenoma

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25
Q

what is a pituitary tumour >1cm called?

A

macroadenoma

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26
Q

what can a pituitary tumour hit if it grows laterally?

A

cranial nerves 4, 3, 6

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27
Q

will a non functioning pituitary adenoma cause hypo or hyper hormone production?

A

hypo

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28
Q

name the 2 fields of the eye?

A

nasal

temporal

29
Q

non drug causes of a raised prolactin?

A 
breast feeding
pregnancy
stress
sleep
hypothyroidism
stalk lesion
prolactinoma
30
Q

does prolactinaemia present early in women or men?

A

women

31
Q

what do women get in prolactinoma that men dont get?

A

menstrual irregularity

leaking of milk from breast

32
Q

what do men get in prolactinoma that women dont get?

A

impotence
visual field problems
headache
anterior pit malfunction

33
Q

investigations for prolactinoma?

A
  1. MRI pituitary
  2. visual fields
  3. PFTs if other hormones affected
34
Q

best treatment for prolactinoma?

A

NOT surgery

cabergoline PO 2x pw

35
Q

cause of acromegaly?

A

GH excess

36
Q

clinical presentation of acromegaly?

A 
giant
thickened soft tissues
hypertension
CV problems
sleep apnoea
headaches
diabetes
colon cancer
37
Q

are the headaches in acromegaly caused by the tumour or vascular problems?

A

vascular problems

38
Q

how is acromegaly measured?

A

IGF1 levels

GTT

39
Q

why is GTT measured in acromegaly?

A

glucose inhibits GH

40
Q

is IGF1 elevated or low in acromegaly?

A

elevated

41
Q

1st line treatment for acromegaly?

A

pituitary surgery

42
Q

2nd line treatment for acromegaly?

A

radiotherapy

43
Q

3rd line treatment for acromegaly?

A

somatostatin analogue

44
Q

short term side effects of somatostatin analogues?

A

flatulence
diarrhoea
abdo pain

45
Q

cause of cushings syndrome?

A

excess cortisol

46
Q

what actually causes the symptoms of cushings syndrome?

A

protein loss from tissues

47
Q

what chemicals other than cortisol are in excess in cushings?

A

androgens

mineralocorticoid

48
Q

what condition causes frontal balding in women?

A

cushings

49
Q

what condition’s patients are described as a lemon on matchsticks?

A

cushings

50
Q

1st line screening test for cushings?

A

overnight 1mg dexamethasone suppression test PO

51
Q

what cortisol level in the morning would indicate a normal dexamethasone test?

A

<50

52
Q

what would you expect to happen when given dexamethasone test?

A

cortisol to lower

53
Q

definitive test for cushings?

A

2 day 2mg dexamethasone suppression test

54
Q

what form of steroid is the worst for causing cushings?

A

inhaled

topical

55
Q

where does ectopic cushings come from?

A

thymus
lungs
pancreas

56
Q

would you expect ACTH levels to be high, normal low in pituitary tumours?

A

high, around 300

57
Q

what cushings cause would cause the highest ACTH level?

A

> 300

58
Q

treatment for pituitary cushings?

A

hypophysectomy

bilateral adrenalectomy

59
Q

treatment for adrenal cushings?

A

adrenalectomy

60
Q

treatment for ectopic cushings?

A

remove source OR

bilateral adrenalectomy

61
Q

what drug treatment can be given for cushings if other treatment fails?

A

metyrapone
ketoconazole
somatostatin analogue

62
Q

causes of hypopituitarism?

A 
lung/breast mets
brain tu,oir
TB
sarcoidosis
polyarteritis
trauma
iatrogenic
infection
63
Q

clinical presentation of hyperpituitarism?

A 
menstrual irregularities
gynaecomastia
infertility
abdominal obesity
dry skin and hair
64
Q

how much thyroxine should you give in hypopituitarism?

A

100-150mcg

65
Q

what are all the drugs you need to give for hypopituitarism?

A 
thyroxine
hydrocortisone
ADH
GH
HRT/oest/prog pill OR testosterone
66
Q

causes of cranial diabetes insipidus?

A

DIDMOAD
trauma
tumour

67
Q

what is the only hormone that wont go down in hypopituitarism?

A

prolactin

68
Q

what test should you do for cranial diabetes insipidus?

A

water deprivation test

2 Endocrine (35 decks)

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