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endocrine > pituitary > Flashcards

pituitary Flashcards

1
Q

stimulates production and release of corticosteroids by adrenal glands

A

ACTH

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2
Q

anabolic hormone released from ant. pituitary

A

growth hormone

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3
Q

stimulates production and release of T4 by thyroid

A

TSH

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4
Q

key hormone controlling reproductive process and development

A

FSH

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5
Q

stimulates ovulation and development of corpus luteum as well as production of testosterone

A

LH

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6
Q

stimulates milk production and provides sexual gradification

A

prolactin

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7
Q

2 hormones from posterior pituitary

A

ADH and oxytocin

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8
Q

vasopressin increases water absorption in kidneys

A

ADH

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9
Q

increasing uterine contractions and milk release

A

oxytocin

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10
Q

which lobe secretes hormones by negative feedback to adrenals, thyroid, and gonads

A

anterior pituitary

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11
Q

which lobe does not produce its own hormones but stores

A

posterior

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12
Q

which hormones are made in the hypothalamus

A

ADH and oxytocin

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13
Q

what is intermediate pituitary lobe do

A

secretes melanocyte stimulating hormone to control skin pigmentation

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14
Q

Acromegaly is usually caused by a ___ ___ which secretes ___. Very rarely it may be caused by at an ___ location like a pancreatic cancer

A

Acromegaly is usually caused by a pituitary adenoma which secretes GH. Very rarely it may be caused by at an ectopic location like a pancreatic cancer

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15
Q 
Excessive growth of hands, feet, jaw and internal organs
Doughy moist handshake
Amenorrhea
Headaches
Weakness
HTN
Cardiomegaly
Arthralgias and arthritis
A

acromegaly

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16
Q

Gigantism

A

If excessive GH occurs in childhood before the epiphyses are closed

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17
Q

IGF-1 levels 5 times normal
Glucose tolerance test with a GH level taken at 1 hour
Elevated Prolactin
Fasting blood sugar or glucose tolerance test – patients will usually have an insulin resistance or DM 2

A

acromegaly blood work

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18
Q

IGF-1
from what organ
how is it stimuated

A

from liver

excess growth hormone stimulates release of this

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19
Q

acromegaly blood work

  • marked elevation of what
  • prolactin
  • glucose test when and result
A

IGF-1 levels 5 times normal
Elevated Prolactin
Glucose tolerance test with a GH level taken at 1 hour
Fasting blood sugar or glucose tolerance test – patients will usually have an insulin resistance or DM 2

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20
Q

acromegaly imaging

A

MRI will show pituitary adenoma in about 90% of patients and is better than CT
Radiographs: Thickened skull; Tufting of terminal phalanges, Increased thickness of heel pad

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21
Q

Radiographs: Thickened skull; Tufting of terminal phalanges, Increased thickness of heel pad

A

acromegaly imaging

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22
Q

acromegaly MRI or CT

A

MRI will show pituitary adenoma in about 90% of patients and is better than CT

23
Q

acromegaly onset and it does not affect what

A

30s

does not affect long bones

24
Q

doughy moist handshake, Carpel tunnel, deep course voice, HTN, insulin resistance, arthralgias, colon polyps, cystic acne, acanthosis nigricans, HA, spinal stenosis, temporal hemianopsia, decreased libido, ED, menstrual abnormalities, obstructive sleep apnea, macroglossia, cardiomegaly

A

acromegaly

25
Q

main acromegaly s/s

A

enlargement and elongation of hands, feet, jaw and internal organs

26
Q

at diagnosis of acromegaly, 10% will have what

A

overt heart failure with dilated left ventricle and reduced ejection fraction

27
Q

IGF-1 is elevated 5 fold

A

adenoma

28
Q

why measure prolactin levels

A

GH secreting tumors often co-secrete prolactin

29
Q

GH secreting tumors often co-secrete what

A

prolactin PRL

30
Q

describe glucose test for acromegaly

A

75 gm loading dose 1hr GTT will show failure of GH to decrease to less than 2

31
Q

Treatment of acromegaly

A

Transsphenoidal resection of the pituitary adenoma is the primary treatment.(no larger than 2cm)
Cyberknife or gamma knife if surgical and medical approaches unsuccessful
Dopamine agonist (Cabergoline) will help to normalize GH
Somatostatin analog (Octreotide, Lanreotide acetate)
GH receptor antagonist (Pegvisomant)

32
Q

what will normalize GH

A

cabergoline- dopamine agonist

33
Q

Somatostatin analog

A

Octreotide, Lanreotide acetate

34
Q

GH receptor antagonist

A

Pegvisomant

35
Q

Pegvisomant

A

GH receptor antagonist; blocks hepatic IGF-1 production, thereby providing symptomatic relief and normalization of IGF-1 in 90% of pts

36
Q

Octreotide, Lanreotide acetate

A

Somatostatin analog are inhibitory and may decrease tumor size

37
Q

cabergoline

A

Dopamine agonist (Cabergoline) will help to normalize GH; suppress GH levels in some pts with acromegaly that fail surgery

38
Q

what is the best measure of surgical success

A

normalization of GH and IGF-1 levels

39
Q

blocks hepatic IGF-1 production, thereby providing symptomatic relief and normalization of IGF-1 in 90% of pts

A

GH receptor antagonist (Pegvisomant)

40
Q

acromegalic pts have increased morbidity and mortality from what

A

cardiovascular disorders and progression of acromegalic symptoms

41
Q

what accounts for frequent visual involvement

A

pituitary gland has close proximity to the optic chiasma

42
Q

MRI shows a sellar lesion

A

acromegaly

43
Q

do not get what levels in acromegaly

A

GH. get IGF-1

44
Q

achondroplasia

A

dwarfism; non lethal type

45
Q

failure to ossify cartilage

A

dwarfism

46
Q

syndrome that affects 1 in 15,000-40,000 newborns

A

dwarfism

47
Q

most common type of short limbed dwarfism

A

achondroplastic dwarfs

48
Q

average height of an adult male and female with dwarfism

A

4’ 4” male; and 4’ 1” female

49
Q

dwarfism- describe limbs, trunks, head, face, brows

A

short limbs
long and narrow trunks
large heads with midface hypoplasia
prominent brows

50
Q

dwarfism
motor skills
intelligence
frequent what

A

delayed motor milestones
nml intelligence
frequent otitis media

51
Q

neurologic complications, bowing of legs, obesity, dental problems

A

dwarfism

52
Q

although not usually apparent at birth, pituitary dwarfism may present in male infants with what

A

hypoglycemia and micropenis

53
Q

achondroplasia group of disorders are all caused by what

A

mutations in the FGFR3 gene

endocrine (9 decks)

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