Pituitary gland

Question 1

What is the pituitary gland?

Answer 1

small, pea-sized gland located at the base of the brain, responsible for secreting several hormones that regulate various bodily functions.

Question 2

What are the two main parts of the pituitary gland?

Answer 2

The pituitary gland is divided into two main parts: the anterior pituitary (adenohypophysis) and the posterior pituitary (neurohypophysis).

Question 3

What hormones are secreted by the anterior pituitary?

Answer 3

growth hormone GH
prolactin
follicle-stimulating hormone
luteinizing hormone
adrenocorticotropic hormone ACTH
thyroid-stimulating hormone TSH

Question 4

What hormones are secreted by the posterior pituitary?

Answer 4

oxytocin and vasopressin (also known as antidiuretic hormone).

Question 5

What is the hypothalamus-pituitary axis?

Answer 5

feedback loop that controls the release of hormones from the pituitary gland. The hypothalamus produces hormones that stimulate or inhibit the release of pituitary hormones.

Question 6

function of growth hormone?

Answer 6

promotes growth and development of bone and muscle, and helps regulate metabolism and body composition.

Question 7

function of prolactin?

Answer 7

stimulates milk production in lactating females and may also have a role in reproductive function and behavior.

Question 8

What is the function of adrenocorticotropic hormone (ACTH)?

Answer 8

ACTH stimulates the adrenal gland to produce cortisol, which helps regulate metabolism and the body’s response to stress.

Question 9

What is the function of thyroid-stimulating hormone (TSH)?

Answer 9

TSH stimulates the thyroid gland to produce thyroid hormones, which help regulate metabolism, growth, and development.

Question 10

What is the function of oxytocin?

Answer 10

Oxytocin plays a role in social bonding and attachment, and stimulates contractions of the uterus during childbirth and milk ejection during breastfeeding.

Question 11

What is the function of vasopressin (antidiuretic hormone)? ADH

Answer 11

Vasopressin regulates water balance in the body by promoting water reabsorption in the kidneys, and also plays a role in regulating blood pressure and social behavior.

Question 12

acromegaly

Answer 12

disorder caused by excess production of growth hormone in adulthood

Question 13

acromegaly symptoms

Answer 13

enlargement of the hands and feet
protruding jaw and forehead
deepening of the voice
excessive sweating
spade like hands
wide feet
thick lips and tongue
carpal tunnel

Question 14

prolactinoma

Answer 14

benign tumor of the pituitary gland that produces excessive amounts of prolactin, leading to abnormal milk production, menstrual irregularities, and decreased sex drive in women and men.

Question 15

Cushing’s disease

Answer 15

disorder caused by excessive production of cortisol by the adrenal glands, due to a pituitary tumour that produces excess adrenocorticotropic hormone (ACTH).

Question 16

cushings disease symptoms

Answer 16

weight gain
moon face
buffalo hump
high blood pressure
menstrual irregularities
increased risk of infections and fractures
easy bruising
stretch marks
central obesity
hirsutism
hyperpigmentation

Question 17

acromegaly complications

Answer 17

headache
chiasmal compression
diabetes
sleep apnoea
colon caner
osteoarthritis

Question 18

acromegaly investigations

Answer 18

clinical features
IGF1 elevated levels
GH
MRI and CT to locate tumour
OGTT

Question 19

acromegaly is caused by

Answer 19

benign tumour of pituitary gland or tumours in other parts of body that produce GHRH

Question 20

management of acromegaly

Answer 20

remove the tumour primary choice
somatostatin analogues SSA or growth hormone receptor antagonists GHRA
radiotherapy in some cases
monitor GH and IGF1 levels

Question 21

what is IGF1

Answer 21

Insulin-like Growth Factor 1, which is a hormone that is mainly produced by the liver in response to growth hormone (GH) stimulation
promotes cell growth and proliferation, particularly in bone and muscle tissues. IGF1 also plays a role in regulating metabolism, blood sugar levels, and insulin sensitivity.
key regulators of growth and development in the body

Question 22

cushings disease causes

Answer 22

pituitary tumour

Question 23

cushings disease investigations

Answer 23

elevated levels of cortisol and ACTH in blood-
low dose dexamethasone :
low cortisol- normal, high/ normal cortisol- cushings syndrome

then high dose:
low cortisol- cushings disease, high/normal- ectopic or adrenal (low ACTH)

then CRH test

Question 24

management cushings syndrome

Answer 24

pituitary surgery through nose- transphenoidal
surgical removal of adrenal tumour
surgical removal of ectopic ACTH tumour

or remove adrenal glands and give replacement steroid hormones

Question 25

cushings syndrome

Answer 25

prolonged high levels of glucocorticoids in body

broader term that encompasses any condition that results in excess cortisol production in the body caused by many factors for example:

C cushings disease (pituitary adenoma releasing excessive ACTH)
A adrenal adenoma (an adrenal tumour secreting excess cortisol)
P paraneoplastic syndrome (ACTH released from tumour other than pituitary gland eg small cell lung cancer)
E exogenous steroids

Question 26

diabetes insipidus

Answer 26

rare condition that is characterised by excessive thirst and passing of large volumes of dilute urine

Question 27

causes of diabetes insipidus

Answer 27

idiopathic
post head trauma or operation
metastatic carcinoma
brain tumours
autoimmune diseases
deficiency in production of ADH

Question 28

diagnosis investigations DI

Answer 28

excessive thirst and polyuria
copeptin test
urine osmolality
U&Es
plasma ADH levels
CT or MRI

Question 29

treatment DI

Answer 29

administer ADH, if Uosm increases by 50% following ADH then indicates central DI

desmopressin (synthetic form of ADH)- orally 100mg-200mg 6-8h 1h before or 2h after meal
can be nasal or IV
monitor urine output and electrolytes

Question 30

AVP is another name for what

Answer 30

ADH

Question 31

two types of corticosteroids

Answer 31

glucocorticoids - cortisol
mineralocorticoids- aldosterone

Question 32

gigantism

Answer 32

excess GH due to pituitary tumour before epiphyseal growth plates of long bones close