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My Endocrinology > Pituitary > Flashcards

Pituitary Flashcards

1
Q

What are the hormones secreted by the anterior pituitary?

A
  • MSH
  • FSH
  • TSH
  • GH
  • LH
  • ACTH
  • PRL
    (mish. fish.tish, gh.lh, acth.prl)
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2
Q

What are the hormones secreted by the posterior pituitary?

A
  • ADH

- OXT

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3
Q

What does cold exposure do to the thyroid?

A

cold –> TRH (hypothalamus) –> TSH (anterior pituitary) –> free T4 (thyroid) which then downregulates TSH from anterior pituitary
(‘hip auntie’)

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4
Q

What causes testosterone to be released?

A

LH

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5
Q

What causes oestrogen and progesterone to be released?

A

FSH

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6
Q

What action does cortisol have?

A

down regulates the production of CRH and ACTH (its precursors)

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7
Q

How is cortisol made?

A

CRH from the hypothalamus –> ACTH from the pituitary –> cortisol

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8
Q

How is thyroxine made?

A

TRH from hypothalamus –> TSH from pituitary –> thyroxine

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9
Q

How are testosterone and E2 (oestradiol) made?

A

GnRh from hypothalamus –> LH/FSH from pituitary –> E2/TEST

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10
Q

How is growth hormone made?

A

GHRH from hypothalamus –> GH from the pituitary

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11
Q

How is prolactin made?

A

DA from hypothalamus DOWNREGULATES prolactin production from the pituitary

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12
Q

Where are vasopressin and OXT stored?

A

in the posterior pituitary from the hypothalamus

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13
Q

Where do all the hormones from the pituitary go?

A

muscle, liver, fat, breast tissue, gonads, brain, bones etc

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14
Q

What is the best test for pituitary disease?

A

MRI

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15
Q

What is the most common direction for a pituitary tumour to grow?

A

upwards as there is bone on either side

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16
Q

What are the types of dynamic testing?

A
  • suppress hormone to check if there is too much still being made
  • stimulate hormone to check if there is too little made
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17
Q

What is the insulin stress test?

A

causes a hypo so the hypothalamus will make cortisol and GH due to stress

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18
Q

What is the synacthen test?

A

synthetic ACTH is given to test cortisol levels

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19
Q

What is the water deprivation test?

A

check for ADH production using urine concentration to test for diabetes insipidus

20
Q

What is the difference between a pituitary microadenoma and a macroadenoma?

A

Microadenoma is smaller than or equal to 1cm

Macroadenoma is bigger than 1cm

21
Q

What can pituitary tumours cause?

A

they can compression other structures so less production from normal tissue

  • hypoadrenalism
  • hypothyroid
  • hypogonad
  • GH deficiency
  • DI (less common as tumours usually affect anterior pit)
22
Q

What is the treatment for a tumour causing bitemporal hemianopia?

A
  • transphenoidal surgery

- hormone replacement

23
Q

What are the causes of raised prolactin?

A
  • physiological: breast feeding, pregnancy, stress and sleep
  • pharmacological: dopamine antagonists, antipsychotic
  • pathological: hypothyroid, stalk blocking (RTA or iatrogenic) or prolactinoma
24
Q

What are the differentials for excess sweating?

A
  • post-menopausal
  • acromegaly
  • hyperthyroidism
  • Cushing’s
  • Phaeochromocytoma (increased adrenaline and noradrenaline)
25
Q

What are the differentials for galactorrhea?

A
  • drugs eg dopamine antagonists
  • prolactin-secreting tumour
  • physiological eg post-partum
  • stalk lesions so dopamine movement inhibited
26
Q

What does the cavernous sinus contain?

A

the internal carotid artery and nerves 3,4,6 and parts of V1 and V2

27
Q

What are the two sub-categories of the anterior pituitary hormones?

A
  • trophic: TSH, LH, ACTH, FSH

- non-trophic: GH and PRL

28
Q

What are the main problems in the anterior pituitary?

A
  • hyperfunction: adenoma or carcinoma

- hypofunction: surgery, sudden haemorrhage or ischaemic necrosis

29
Q

What are the main problems in the posterior pituitary?

A

DI or SIADH

30
Q

What are the main features of pituitary adenomas?

A
  • from cells in the anterior pituitary
  • associated with MEN1
  • classified by type of hormone they secrete
31
Q

What can large pituitary adenomas do?

A

cause visual issues or pressure atrophy so there is panhypopituitarism

32
Q

What are the main types of pituitary adenomas?

A
  • prolactioma
  • GH secreting so acromegaly
  • ACTH secreting so Cushing’s
33
Q

What is panhypopituitarism caused by?

A
  • sarcoidosis
  • Sheehan’s syndrome
  • primary/metastatic tumours
34
Q

What are the features of a craniopharyngioma?

A
  • brain tumour near pituitary gland
  • suprasellar
  • can calcify
  • presents as headaches and visual disturbances
35
Q

What is SIADH?

A

arises from ectopic production of ADH such as from a paraneoplastic syndrome

36
Q

What does ADH do?

A

causes the patient to pee less and reabsorb more water

37
Q

What does high ADH cause?

A

small volume of concentrated urine (high osmolality)

38
Q

What does low ADH cause?

A

large volume of dilute urine (low osmolality)

39
Q

What is sodium balance controlled by?

A

steroids from the adrenals which is called mineralocorticoid activity

40
Q

How does sodium balance occur?

A
  • Na+ reabsorption in exchange for K+/H+

- this is done by aldosterone and cortisol

41
Q

How does the amount of mineralocorticoid activity change the amount of sodium?

A
  • too much activity is sodium gain

- too little activity is sodium loss

42
Q

What are the causes of a low sodium?

A
  • too little sodium = skin, gut, adrenal/kidney

- too much water = compulsive drinking, SIADH

43
Q

What are the causes of a high sodium?

A
  • too much sodium = near-drowning, IV meds

- too little water = too little to drink, DI

44
Q

What is the difference between sodium and water loss?

A
  • sodium loss is just from the ECF as it is confined here (water follows sodium)
  • water loss is from the whole body
45
Q

What is does SIADH cause?

A

high urine osmolality

low plasma osmolality

My Endocrinology (12 decks)

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