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2/ CEP: Cell communication > Pituitary > Flashcards

Pituitary Flashcards

1
Q

Where is the pituitary gland located?

A

In the sella turcica if the sphenoid bone

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2
Q

Name the 5 groups anterior pituitary hormones and the hypothalamal hormones by which it is regulated

A
  • GH regulated by GHRH and somatostatin- FSH and LH regulated by GnRH- ACTH regulated by CRH- TSH regulated by TRH- Prolactin inhibited by dopamine
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3
Q

What do are the full names of these hormones?:- GHRH- GnRH- CRH- ACTH- TRH- TSH

A
  • Growth Hormone Releasing Hormone- Gonadotropin Releasing Hormone - Corticotropin Releasing Hormone- Adrenocorticotrophic Hormone- Thyrotropin Releasing Hormone- Thyroid stimulating hormone
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4
Q

What stimulates the release of GH?What does it do?

A
  • hypoglycaemia, sleep, exercise- linear growth in children, acquisition of bone mass, stimulates protein synthesis, lipolysis, glucose metabolism, physiological wellbeing, regulation of body composition (abdominal fat when GH low)
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5
Q

When are prolactin levels highest?What are its effects?

A
  • during pregnancy and breastfeeding- essential for lactation, inhibits gonadal activity through suppression of GnRH (and thus FSH and LH)
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6
Q

What does ACTH do?When is it highest and why?What is its trophic affect?

A

Stimulates the release of cortisol from the kidneysIn the morning, helps to wake upIf high conc, adrenal glands increase in size

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7
Q

What does TSH do?

A

Stimulates thyroid glands to release T3 (active) and T4

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8
Q

What hormones does the posterior pituitary gland produce? Where are these hormones synthesised?

A

ADH and oxytocin In the hypothalamus

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9
Q

Where is ADH synthesised?How is it transported to the p pituitary

A

The supraoptic and paraventricular nuclei of the hypothalamus Secretory granules migrate down the axons of the supraoptichypophyseal tract into the posterior lobe

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10
Q

What does ADH do?What are the 2 major stimuli for secretion?

A

Augments the water permeability o f the lumbinal membrane of cortical and medullary collecting tubules, decreases urine outputHyperosmolality (concentrated blood) and effective circulating volume depletion

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11
Q

What does oxytocin do?

A

Stimulates contraction of smooth muscle of breast and uterus under positive feedback Roles in milk ejection reflex and birth

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12
Q

What are the main groupings of the mass effects of seller lesions? What is the other effect?

A
  • neurological - visual - hypopituitarism Hyper secretion by adenoma
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13
Q

What are the visual and neurological effects of a pituitary adenoma?

A

bitemporal hemianopia, loss of peripheral vision optic nerve damage headacheshypothalamic damage III, IV, V, VI nerve damage CFS leak

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14
Q

What is the embryological development of the pituitary gland?

A

anterior - ectoderm grows upward from roof of mouth, Rathke’s pouchposterior - diencephalon

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15
Q

How do you test for growth hormone deficiency?

A

GH stimulation test e.g. glucagon

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16
Q

How does FSH/LH deficiency manifest in each of the sexes and children?

A

children: delayed puberty
men: decreased libido, impotence, infertility, decreased muscle mass
women: decreased libido, infertility, dyspareunia, osteoporosis, menstrual disorders

17
Q

What are the symptoms of ACTH deficiency?

What is the diagnosis?

A

fatigue, weakness, anorexia, weight loss, hypoglycaemia, hypotension, anaemia
9.00am serum cortisol and ACTH
replace with steroids, approximate natural rhythm

18
Q

What is diabetes insipidus?

What are the possible causes?

A 
ADH deficiency 
idiopathic
familial
tumours
infections
ischaemia
19
Q

What are the symptoms of diabetes insipidus?

What is the treatment?

A

POLYURIA
polydipsia
nocturia
- ADH analogues

20
Q

What is the cause of acromegaly?
How is it diagnosed?
What is the treatment?

A

XS GH by a pituitary adenoma
Oral glucose tolerance test, GH normally is suppressed high blood sugar
- pituitary surgery
- dopamine agonists, somatostatin analogues, GH receptor antagonosts
- radiotherapy

21
Q

What are the manifestations of a proloctinoma?
What is the diagnosis?
What is the treatment?

A 
hypogonadism
galactorrhoea
mass effects
- exclude other causes of high prolactin
- pituitary imaging
Dopamine agonists, surgery, radiotherapy
22
Q

What are the two types of Cushings syndrome?

What are the causes of each?

A

ACTH dependent e.g. Cushing’s disease, ectopic secretion

ACTH independent e.g. iatrogenic due to steroid use, adrenal disease

23
Q

How is Cushing’s syndrome diagnosed?

A

midnight serum cortisol

overnight dexamethosone suppression test

2/ CEP: Cell communication (3 decks)

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