Pituitary gland and its disorders Flashcards

1
Q

What hormones does the anterior pituitary produce?

A
→ ACTH 
→ TSH
→ GH 
→ LH/FSH
→ Prolactin
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2
Q

What hormones does the posterior pituitary produce?

A

→ oxytocin

→ ADH

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3
Q

What does oxytocin do?

A

→ uterine contractions

→ breast milk expression

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4
Q

What are the three layers of the endocrine system?

A

→ end organ is the primary layer
→ the secondary layer is the pituitary
→ third layer is the hypothalamus

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5
Q

What are the 2 functions of the hypothalamus?

A

→ it takes sensory input - electrical signal

→ and produces hormones to adapt to the physical state - chemical signal

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6
Q

In what blood vessel do the hormones get released into?

A

→ hypophyseal portal blood vessel

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7
Q

What is the negative feedback system in endocrinology?

A

→ The production of the end hormone stops the pituitary and hypothalamus producing more

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8
Q

What happens when you get pituitary tumors?

A

→ Hormone hypersecretion
→ Space occupying lesion- visual loss
→ Hormone deficiency states

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9
Q

What is excess growth hormone?

A

→ acromegaly

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10
Q

What is too much ACTH?

A

→ Cushings disease

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11
Q

What is excess TSH?

A

→ secondary thyrotoxicosis

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12
Q

What is excess LH and FSH?

A

→ Non functioning pituitary tumor

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13
Q

What is excess prolactin?

A

→ prolactinoma

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14
Q

Describe the growth hormone circulation

A

→ GF acts on the liver to produce IGF
→ IGF acts on bones to stimulate chondrocytes to grow which form new bone
→ it reduces body fat

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15
Q

What are symptoms of acromegaly?

A

→ hands grow
→ Macroglossia
→ Carpal tunnel
→ Change of appearance

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16
Q

Why do people with acromegaly get polyps or cancer?

A

→ skin and bowel tissue turns over a lot

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17
Q

What are the actions of cortisol?

A
→ increases plasma glucose levels 
→ increases lipolysis 
→ Proteins are catabolized 
→ Na+ and H2O retention to maintain BP 
→ increase glycogenolysis
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18
Q

What are visible changes in cushings?

A
→ change body shape
→ central obesity 
→ moon face
→ thin skin 
→ excess hair growth
→ irregular periods 
→ High BP
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19
Q

How is prolactin controlled?

A

→ The stimulus to production of milk is an external signal
→ Intrinsic high production of prolactin from the pituitary
→ Tonic inhibitory dopamine signal from the hypothalamus to the pituitary

20
Q

How does lactation occur?

A

→ mechanical stimulation of the nipple sends a neuronal signal to the brain
→ goes to the hypothalamus
→ switches off dopamine production

21
Q

What happens if you have excess prolactin?

A

→ Infertility

→ No periods - amenorrhoea

22
Q

What drugs would interfere with prolactin formation?

A

→ drugs that interfere with dopamine such as antiemetics and antipsychotics

23
Q

What is the treatment for excess prolactin?

A

→ Dopamine agonists
→ bromocriptine
→ Cabergoline

24
Q

Why do non functioning pituitary tumors cause problems?

A

→ Pressure on the surrounding structures
→ no syndromes
→ headache - visual field defects

25
Q

Why do we have front facing eyes?

A

→ Humans are predators

→ Gives depth vision

26
Q

What is homologous vision?

A

→ Nasal fibres from the same side cross and line up with temporal fibres on the other side
→ Go into one piece back to the brain for interpretation

27
Q

Where is the optic chiasm?

A

→ Above the pituitary

28
Q

What is bitemporal hemianopia?

A

→ Partial blindness

→ Vision is missing in the outer half of both right and left visual field

29
Q

In what order are the hormones lost in when the tumor grows?

A

1) sex hormones
2) growth hormones
3) metabolic
4) Survival

30
Q

What rises when a tumor is made?

A

→ prolactin

→ obstructs the pituitary and stops dopamine coming in the brain

31
Q

What are the treatments for pituitary adenomas?

A

→ Transsphenoidal surgery
→ Radiotherapy
→ Drugs - block hormone production, stops hormone release

32
Q

What are the causes of pituitary failure?

A
→ Tumor 
→ Trauma
→ Infection
→ Inflammation - sarcoidosis 
→ Iatrogenic
33
Q

What happens if you don’t produce enough thyroid hormone?

A
→ Bradycardia
→ Weight gain
→ Cold intolerance
→ Hypothermia
→ Constipation
34
Q

What happens when you don’t produce enough sex steroids?

A

→ Oligomenorrhoea
→ Reduced libido
→ Hot flushes
→ Less body hair

35
Q

What happens if you have reduced cortisol?

A
→ Tiredness
→ Weakness
→ Anorexia
→ Postural hypotension
→ Myalgia
36
Q

What happens if you have reduced GH?

A

→ Tiredness

→ Central weight gain

37
Q

What is the treatment for underproduction of thyroid hormone?

A

→ Thyroxine

38
Q

What is the treatment for underproduction of sex steroids?

A

→ Testosterone

→ Estrogen

39
Q

What is the treatment for reduced hydrocortisol?

A

→ Hydrocortisone

40
Q

What is the treatment for reduced GH?

A

→ Growth hormone

41
Q

What is the action of ADH?

A

→ Collecting ducts
→ Increases permeability for H2O
→ Reabsorption of free water
→ Vasoconstriction

42
Q

How is ADH stimulated?

A

→ Increased osmolality
→ Decreased blood pressure
→ Decrease in O2
→ Increase in CO2

43
Q

What is the cause of syndrome of inappropriate ADH production?

A

→ Brain injury
→ Lung cancer
→ Metabolic - hypothyroidism, Addisons

44
Q

How do you diagnose SIADH?

A

→ Dilute plasma

→ Concentrated urine

45
Q

What happens during diabetes insipidus?

A

→ Cranial
→ Lack of production of ADH

→ Nephrogenic
- receptor doesnt respond to it

46
Q

What is a symptom of SIADH?

A

→ Urinating a lot

47
Q

What is the water deprivation test?

A

→ Checking if someone is dehydrated when depriving them of water