Pituitary Hormone regulation and disease

Question 1

The anterior pituitary has no arterial blood supply but receives blood through a _____ _____ circulation from the hypothalamus

Answer 1

portal venous

Question 2

Secondary hypothyroidism

Answer 2

Thyroid capable of making T3 and T4 but not stimulated as pituitary not working properly so not releasing TSH. Therefore, levels of T3, T4 and TSH will all be low

Question 3

Primary hypothyroidism

Answer 3

Thyroid not functioning properly so not releasing T4 and T3. Pituitary recognises low levels of T3 and T4 so produces more TSH. High levels of TSH, low levels T3 and T4

Question 4

True or false: presence of cortisol inhibits hypothalamus releasing CRH and pituitary releasing ACTH

Answer 4

True

Question 5

Prolactin is inhibited by ______ from hypothalamus down the stalk to the anterior pituitary

Answer 5

dopamine

Question 6

If hypothalamus is impaired so no dopamine released to anterior pituitary then what happens to prolactin levels released by pituitary?

Answer 6

Increases. Dopamine inhibits prolactin secretion.

Question 7

What are the different chemicals that the hypothalamus secrete to the pituitary?

Answer 7

GHRH and SMS
GnRH
CRH
TRH
Dopamine

Question 8

What are the different hormones that the anterior pituitary releases?

Answer 8

GH
LH and FSH
ACTH
TSH
Prolactin

Question 9

What are the 3 things that tumours near the pituitary gland can cause?

Answer 9

Pressure on local structures (optic nerve)
Pressure on normal pituitary
Functioning tumour

Question 10

What does pressure on optic nerve cause?

Answer 10

Bitemporal hemianopia

Question 11

What can pressure on normal pituitary cause?

Answer 11

Hypopituitarism

Question 12

What can functioning tumour cause?

Answer 12

Prolactinoma
Acromegaly
Cushing’s Disease

Question 13

When does a micro tumour become a macro tumour?

Answer 13

at 1cm and bigger

Question 14

Prolactinomas are more common in women and present with…

Answer 14

Galactorrhoea / amenorrhoea / infertility
Loss of libido
Visual field defect

Question 15

How do you treat Prolactinomas?

Answer 15

Dopamine agonist eg Cabergoline or bromocriptine

Question 16

Cushing’s Syndrome

Answer 16

Too much of a hormone over time?

Question 17

Cushing’s Disease

Answer 17

Cushing’s syndrome particularly causing ACTH pituitary secreting adenoma

Question 18

True or false: don’t normally get benign pituitary adenoma with diabetes insipidus

Answer 18

True