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Endocrine > Pituitary > Flashcards

Pituitary Flashcards

1
Q

The hypothalamus and pituitary gland form a unit that exerts control over what the endocrine glands?

A
  1. Thyroid
  2. Adrenals
  3. Gonads
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2
Q

What is considered the “master” gland?

A

Pituitary

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3
Q

What is responsible for the brain-endocrine interaction?

A

hypothalamic pituitary axis (HPA).

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4
Q

What gland delivers precise signals to the pituitary gland?

A

Hypothalamus

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5
Q

Where does the pituitary gland reside?

A

In the sphenoid bone in the area called the Sella tursica

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6
Q

What are the 4 divisions of the pituitary gland?

A
  1. Anterior pituitary (adenohypophysis)
  2. Pars intermedius
  3. Pars tubularis
  4. Neurohypophysis.
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7
Q

Which division is the largest? which is the most vascular?

A

largest=anterior pituitary (adenohypophysis)

Most vascular=Pars tubularis

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8
Q

Anterior or Posterior Pituitary: Responsible for regulation of the thyroid, adrenal, and mammary glands?

A

Anterior

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9
Q

Anterior or Posterior Pituitary: Produces only two hormones- oxytocin and ADH?

A

Posterior

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10
Q

Anterior or Posterior Pituitary: Regulates uterine contractions and water balance?

A

Posterior

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11
Q

Anterior or Posterior Pituitary: Highly vascularized?

A

Anterior

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12
Q

Anterior or Posterior Pituitary: Called the adenohypophysis?

A

Anterior

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13
Q

Anterior or Posterior Pituitary: Largely a collection of axonal projections from the hypothalamus?

A

Posterior

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14
Q

What 5 cell types are found in the anterior pituitary?

A
  1. Somatotropes
  2. Corticotropes
  3. Thryotropes
  4. Gonadotropes
  5. Lactotropes
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15
Q

Which cell type secretes TSH?

A

Thyrotropes

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16
Q

Which cell type secretes FSH/LH (luteinizing and Follicle stimulating hormone)?

A

Gonadotropes

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17
Q

Which cell type is most abundant?

A

Somatotropes

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18
Q

Which cell type secretes Prolactin (PRL)?

A

Lactotropes

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19
Q

Which cell type secretes Growth Hormone (GH)?

A

Somatotropes

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20
Q

What do corticotropes secrete?

A

Adrenocorticotropic Hormone (ACTH).

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21
Q

Another name for the posterior pituitary?

A

Neurohypophysis

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22
Q

What is the dominant site of ADH synthesis?

A

Supraoptic nucleus

23
Q

Which receptor is responsible for pressor effect of Vasopressin? Anti-diuretic effect of vasopressin?

A

Pressor= V1 receptor

Anti-diuretic effect=V2 receptor

24
Q

What stimulates release of ADH from hypothalamus?

A
  1. Plasma osmolality >290
  2. Stretch receptor activation
  3. Angiotensin II
  4. Nicotine
  5. Nausea
  6. Pain
  7. Stress
25
Q

What three things can depress the release of ADH?

A
  1. Decreased plasma osmolality
  2. Increased ECF volume
  3. Alcohol
26
Q

What is SIADH?

A

Autonomous release from pituitary (or tumor) cause water retention, hyponatremia.

27
Q

What is typically the cause of SIADH?

A

CNS disorders, cold stress, trauma, drug induced, squamous cell lung Cancers

28
Q

What is treatment of SIADH?

A

Find cause and limit fluid intake.

29
Q

What Serum Na+ is typically safe for elective procedures?

A

> 130mEq/l

30
Q

How does MAC change based on serum Na+?

A

<130mEq/l will result in decrease in MAC

31
Q

How rapid of a change in Na+ is associated with central pontine myelinolysis (CPM)?

A

> 0.5mEq/L/hour

32
Q

What are risk factors for CPM?

A
  1. Na <120 for more than 48hrs
  2. Aggresive IV fluid therapy with hypertonic saline solutions
  3. Development of hypernatremia during treatment
33
Q

What is pharmacological treatment of central diabetes insipidus (DI)?

A

ADH (desmopressin nasal spray)

34
Q

Renal diabetes insipidus is treated with what?

A

Demeclocycline

35
Q

Does hypovolemia require increased or decreased doses of IV agents?

A

Decreased

36
Q

At what level of hypernatremia should surgery be postponed?

A

> 150

37
Q

What is common cause of central DI?

A

Head injury/trauma

38
Q

What is common cause/causes of Renal (nephrogenic) DI?

A 
Chronic renal disease
Lithium toxicity
Hypercalcemia
Hypokalemia
Tubulointerstitial disease
Rare hereditary form
39
Q

Where is oxytocin secreted from?

A

Supraoptic (SO) Nucleus of the posterior pituitary

40
Q

What does oxytocin do?

A

Contraction of uterus during labor and lactating breasts

41
Q

What other use for pitocin is there other than to organize labor contractions during birth?

A

To decrease blood loss after birth

42
Q

What are complications of pitocin administration?

A

Fetal distress d/t hyperstimulation, uterine tetany, maternal water intoxication (ADH effects= very rare)

43
Q

T/F: Pitocin has to be given rapid IV push and why?

A

False; Slowly d/t side effects of hypertension, tachycardia, N/V, and rarely seizures

44
Q

How do you mix/dilute pitocin?

A

Usually 20-40units per 1L crystalloid and titrate to uterine contractions

45
Q

What can cause bitemporal hemianopsia?

A

Compression of the optic chiasm

46
Q

What is bitemporal hemianopsia?

A

Visual loss in the outer half of both eyes.

47
Q

T/F: Patients having pituitary resection should undergo evaluation of their hormonal function to detect either hypersecretion or panhypopituitarism?

A

True

48
Q

Which hormonal abnormality can result in acromegaly and difficult airway?

A

Growth Hormone

49
Q

TSH abnormality (high TSH) is typically associated with what?

A

Hyperthyroid, tachycardia, weight loss

50
Q

ACTH abnormality is associated with what?

A

Cushing’s disease- difficult airway and IV access

51
Q

What three medications are patients on with panhypopituitarism?

A

Cortisol
Desmopressin
Levothyroxine

52
Q

Though some may require craniotomy, most pituitary resections are done with what surgical approach?

A

Transsphenoidal

53
Q

Would you expect high or low urine output and high or low urine specific gravity with pituitary surgery?

A

Suspect high urine output and low urine specific gravity (<1.005)

54
Q

What is treatment for urine output/specific gravity with pituitary surgery?

A

DDAVP 0.5-1mcg IV or SQ

Endocrine (6 decks)

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