Posterior Pituitary Flashcards

1
Q

What does the posterior piruitary originate from?

A

Neuro tissue - large numbers of glial-type cells

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2
Q

What are 2 hormones that the posterior pituitary secretes?

A

Vasopressin (ADH, primarily from supraoptic nuclei)

Oxytocin (expression of milk from glands of breasts to nipples, promotes onset of labour. Primarily paraventricular nuclei)

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3
Q

What happens when you have a water deficit?

A

The plasma osmolality increases (less water so increased conc of solutes)

Therefore, cellular hydration decreases (water moves into plasma)

You become thirsty and vasopressin is released

Renal water excretion decreases due to vasopressin and you drink water

Total body water increases

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4
Q

Mechanism of vasopressin

A

1) ADH binds to membrane receptor of collecting duct cell

2) Receptor activate cAMP second messenger system

3) Cell inserts AQP2 water pores into apical membrane (collecting tubule lumen side)

4) Water is absorbed by osmosis into the blood

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5
Q

What type of cells are responsible for regulating ADH release?

A

Osmoreceptors and baroreceptors

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6
Q

What is ANP?

A

Atrial-natriuretic peptide

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7
Q

In the kidney, ANP _____ diuresis and natriureis

A

stimulates

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8
Q

True or false - ANP causes vasodilation of the afferent arteriole and contraction of the efferent arteriole so increases GFR.

A

True

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9
Q

ANP is made and secreted in the cardiac ___ cells in the walls of the ___ in the heart which contain volume receptors.

A

muscle
atria

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10
Q

What is osmolality

A

Concentration of particles per kilogram of fluid.

(Size of particle doesn’t matter just number of particles)

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11
Q

T or F - drinking rapidly suppresses vasopressin release and thirst

A

True

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12
Q

T or F - in pregnancy osmotic threshold for VP release and thirst is increased

A

False
It is decreased

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13
Q

T or F - plasma VP concentration increase with age

A

True

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14
Q

Diabetes insipidus

A

Syndrome of inappropriate antidiuretic hormone secretion - SIADH

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15
Q

What does polyuria mean?

A

Large volume of urine

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16
Q

What does polydypsia mean?

A

Large volume of drinking

17
Q

What happens in Diabetes insipidus?

A

Patient is drinking loads (polydypsia) but also has large volume of water (polyuria) without any glucose and potassium present.

The urine is too dilute for the osmolality of the water. Not reabsorbing enough water.
Inability to concentrate urine.

Hyponatraemia
Plasma hypo-osmolality
Urine osmolality

18
Q

The 2 types of Diabetes Insipidus

A

Cranial DI - lack of ADH (therefore low levels in plasma)

Nephrogenic DI - resistance to ADH (therefore higher levels in plasma)

19
Q

Causes of Cranial DI (lack of ADH)

A

Destruction of hypothalamus

Interruption of connection between hypothalamus and pituitary

eg tumours, trauma, infections, granuloma (small area of inflammation)

20
Q

Causes of Nephrogenic Diabetes insipidus (resistance to ADH)

A

Osmotic diuresis (diabetes mellitus)
drugs
Chronic renal failure
Metabolic

21
Q

How can a water deprivation test differentiate cranial DI to nephrogenic DI?

A

When desmopressin is give:

CDI - plasma osmolality starts decreasing. Urine osmolality starts increasing.

NDI - plasma osmolality keeps increasing
Urine osmolality remains low

22
Q

Management of Cranial DI

A

desmopressin

(for nephrogenic DI needed very high dose desmopressin)