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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
what is a pituitary tumour >1cm called?
macroadenoma
26
what can a pituitary tumour hit if it grows laterally?
cranial nerves 4, 3, 6
27
will a non functioning pituitary adenoma cause hypo or hyper hormone production?
hypo
28
name the 2 fields of the eye?
nasal | temporal
29
non drug causes of a raised prolactin?
``` breast feeding pregnancy stress sleep hypothyroidism stalk lesion prolactinoma ```
30
does prolactinaemia present early in women or men?
women
31
what do women get in prolactinoma that men dont get?
menstrual irregularity | leaking of milk from breast
32
what do men get in prolactinoma that women dont get?
impotence visual field problems headache anterior pit malfunction
33
investigations for prolactinoma?
1. MRI pituitary 2. visual fields 3. PFTs if other hormones affected
34
best treatment for prolactinoma?
NOT surgery | cabergoline PO 2x pw
35
cause of acromegaly?
GH excess
36
clinical presentation of acromegaly?
``` giant thickened soft tissues hypertension CV problems sleep apnoea headaches diabetes colon cancer ```
37
are the headaches in acromegaly caused by the tumour or vascular problems?
vascular problems
38
how is acromegaly measured?
IGF1 levels | GTT
39
why is GTT measured in acromegaly?
glucose inhibits GH
40
is IGF1 elevated or low in acromegaly?
elevated
41
1st line treatment for acromegaly?
pituitary surgery
42
2nd line treatment for acromegaly?
radiotherapy
43
3rd line treatment for acromegaly?
somatostatin analogue
44
short term side effects of somatostatin analogues?
flatulence diarrhoea abdo pain
45
cause of cushings syndrome?
excess cortisol
46
what actually causes the symptoms of cushings syndrome?
protein loss from tissues
47
what chemicals other than cortisol are in excess in cushings?
androgens | mineralocorticoid
48
what condition causes frontal balding in women?
cushings
49
what condition's patients are described as a lemon on matchsticks?
cushings
50
1st line screening test for cushings?
overnight 1mg dexamethasone suppression test PO
51
what cortisol level in the morning would indicate a normal dexamethasone test?
<50
52
what would you expect to happen when given dexamethasone test?
cortisol to lower
53
definitive test for cushings?
2 day 2mg dexamethasone suppression test
54
what form of steroid is the worst for causing cushings?
inhaled | topical
55
where does ectopic cushings come from?
thymus lungs pancreas
56
would you expect ACTH levels to be high, normal low in pituitary tumours?
high, around 300
57
what cushings cause would cause the highest ACTH level?
>300
58
treatment for pituitary cushings?
hypophysectomy | bilateral adrenalectomy
59
treatment for adrenal cushings?
adrenalectomy
60
treatment for ectopic cushings?
remove source OR | bilateral adrenalectomy
61
what drug treatment can be given for cushings if other treatment fails?
metyrapone ketoconazole somatostatin analogue
62
causes of hypopituitarism?
``` lung/breast mets brain tu,oir TB sarcoidosis polyarteritis trauma iatrogenic infection ```
63
clinical presentation of hyperpituitarism?
``` menstrual irregularities gynaecomastia infertility abdominal obesity dry skin and hair ```
64
how much thyroxine should you give in hypopituitarism?
100-150mcg
65
what are all the drugs you need to give for hypopituitarism?
``` thyroxine hydrocortisone ADH GH HRT/oest/prog pill OR testosterone ```
66
causes of cranial diabetes insipidus?
DIDMOAD trauma tumour
67
what is the only hormone that wont go down in hypopituitarism?
prolactin
68
what test should you do for cranial diabetes insipidus?
water deprivation test

2 Endocrine (35 decks)

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