SECRETS Endo - Pituitary

Question 1

Sheehan syndrome

Answer 1

postpartum necrosis

infarct of anterior pituitary

Question 2

susceptibility of pituitary to hemorrhage postpartum

Answer 2

during pregnancy = hyperplasia of lactotrophs without increase in blood supply

Question 3

sparing of posterior pituitary in Sheehan

Answer 3

posterior pituitary has alternate blood supply

Question 4

embryo anterior pituitary

Answer 4

Rathke’s pouch

Question 5

embryo post pituitary

Answer 5

ventral outgrowth from primitive hypothalamus

Question 6

anterior pit hormones

Answer 6

FSH
LH
ACTH
TSH
prolactin
GH

Question 7

post pit

Answer 7

oxytocin

ADH

Question 8

dopamine - prolactin

Answer 8

dopamine inhibits prolactin secretion

Question 9

prolactinoma

Answer 9

most common type of hypersecreting pituitary adenomas

situated in sella turcica

Question 10

prolactin levels before, during, after pregnancy

Answer 10

before = normal, tonic inhibition by depamine

during = elevated 2/2 high estrogen, but lactation is inhibited by high estrogen & progesterone

after = elevated due to suckling
inhibit GnRH = anovulatory infertility while nursing

Question 11

prolactinoma sx

Answer 11

galactorrhea, infertility, malaise, depression

in men - impotence, lack of libido

Question 12

prolactin - FSH/LH

Answer 12

prolactin inhibits GnRH –> decrease FSH, LH

infertility, amenorrhea

Question 13

tx hyperprolactinemia

Answer 13

dopa agonists

bromocriptine

Question 14

tuberoinfundibular tract disruption

Answer 14

• all ant pituitary hormones except prolactin++

Question 15

causes hyperprolactinemia

Answer 15

prolactinoma, antipsychotics, hypothyroidism, breast feeding/excessive nipple stimulation

Question 16

acromegaly

Answer 16

++ GH

GH-secreting tumor

middle aged adults

Question 17

hyperglycemia in acromegaly

Answer 17

GH –> + serum glucose –> diabetes

body’s mechanism to prevent serious hypoglycemia

Question 18

GH secretion times

Answer 18

nighttime

Question 19

GH inhibition

Answer 19

somatostatin, glucose, emotional stress, malnutrition, obesity, glucocorticoids, decreased thyroid hormone

Question 20

acromegaly sx

Answer 20

gradually enlarging hands, feet, coarsening face

prominent jaw, organomegaly

Question 21

IGF-1

Answer 21

anabolic effect on bones
metabolic effects

secreted by liver

Question 22

tx acromegaly

Answer 22

somatostatin
analog octreotide

secreted by hypothalamus, pancreatic islets, gastric mucosa

(inhibits stuff)

Question 23

++ GH in kids

Answer 23

gigantism

epiphyseal plates have not closed yet

Question 24

pituitary dwarfism

Answer 24

deficient GH, proportional

Question 25

achondroplasia

Answer 25

dwarfism that is not proportional mutation in FBFR3 = inhibit bone growth

Question 26

GH effects

Answer 26

anabolic on skeletal muscle, bone lipolysis in adipose tissue stimulate gluconeogenesis antagonizes insulin