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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
What three things can depress the release of ADH?
1. Decreased plasma osmolality 2. Increased ECF volume 3. Alcohol
26
What is SIADH?
Autonomous release from pituitary (or tumor) cause water retention, hyponatremia.
27
What is typically the cause of SIADH?
CNS disorders, cold stress, trauma, drug induced, squamous cell lung Cancers
28
What is treatment of SIADH?
Find cause and limit fluid intake.
29
What Serum Na+ is typically safe for elective procedures?
>130mEq/l
30
How does MAC change based on serum Na+?
<130mEq/l will result in decrease in MAC
31
How rapid of a change in Na+ is associated with central pontine myelinolysis (CPM)?
>0.5mEq/L/hour
32
What are risk factors for CPM?
1. Na <120 for more than 48hrs 2. Aggresive IV fluid therapy with hypertonic saline solutions 3. Development of hypernatremia during treatment
33
What is pharmacological treatment of central diabetes insipidus (DI)?
ADH (desmopressin nasal spray)
34
Renal diabetes insipidus is treated with what?
Demeclocycline
35
Does hypovolemia require increased or decreased doses of IV agents?
Decreased
36
At what level of hypernatremia should surgery be postponed?
>150
37
What is common cause of central DI?
Head injury/trauma
38
What is common cause/causes of Renal (nephrogenic) DI?
``` Chronic renal disease Lithium toxicity Hypercalcemia Hypokalemia Tubulointerstitial disease Rare hereditary form ```
39
Where is oxytocin secreted from?
Supraoptic (SO) Nucleus of the posterior pituitary
40
What does oxytocin do?
Contraction of uterus during labor and lactating breasts
41
What other use for pitocin is there other than to organize labor contractions during birth?
To decrease blood loss after birth
42
What are complications of pitocin administration?
Fetal distress d/t hyperstimulation, uterine tetany, maternal water intoxication (ADH effects= very rare)
43
T/F: Pitocin has to be given rapid IV push and why?
False; Slowly d/t side effects of hypertension, tachycardia, N/V, and rarely seizures
44
How do you mix/dilute pitocin?
Usually 20-40units per 1L crystalloid and titrate to uterine contractions
45
What can cause bitemporal hemianopsia?
Compression of the optic chiasm
46
What is bitemporal hemianopsia?
Visual loss in the outer half of both eyes.
47
T/F: Patients having pituitary resection should undergo evaluation of their hormonal function to detect either hypersecretion or panhypopituitarism?
True
48
Which hormonal abnormality can result in acromegaly and difficult airway?
Growth Hormone
49
TSH abnormality (high TSH) is typically associated with what?
Hyperthyroid, tachycardia, weight loss
50
ACTH abnormality is associated with what?
Cushing's disease- difficult airway and IV access
51
What three medications are patients on with panhypopituitarism?
Cortisol Desmopressin Levothyroxine
52
Though some may require craniotomy, most pituitary resections are done with what surgical approach?
Transsphenoidal
53
Would you expect high or low urine output and high or low urine specific gravity with pituitary surgery?
Suspect high urine output and low urine specific gravity (<1.005)
54
What is treatment for urine output/specific gravity with pituitary surgery?
DDAVP 0.5-1mcg IV or SQ

Endocrine (6 decks)

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