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MEH A > Session 8 Lecture 2 > Flashcards

Session 8 Lecture 2 Flashcards

1
Q

What happens if you have growth hormones deficiency?

A

In childhood - results in pituitary dwarfism. Proportionate type dwarfism

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2
Q

What are the symptoms of GH defunct in adults?

A

Dec tolerance to exercise, dec muscle strength, inc body fat and reduced sense of well’being

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3
Q

What is GH defence in adults usually due to?

A

Mass effect from a pituitary adenoma

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4
Q

What is GH deficiency in children usually due to?

A

Idiopathic (of unknown cause) but specific gene mutations and autoimmune inflammation have been identified

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5
Q

What are the symptoms of GH deficiency in children?

A

Poor growth, short stature

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6
Q

What are the treatments of GH deficiency?

A

Human GH manufactured by recombinant DNA technology

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7
Q

What is the most common cause of pituitary malfunction?

A

Benign tumour (adenoma)

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8
Q

What affect can benign pituitary tumour have?

A

Cause inadequate reduction is pituitary hormones due to physical pressure form the tumour

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9
Q

Clinical presentation of pituitary tumours?

A

Visual loss, headache (due to pressure on the optic nerve), hyper or hyposecretion

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10
Q

What are the clinical symptom of hypersecreting tumours?

A

Symptoms usually correspond to the systemic effects of the over-secreted hormone

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11
Q

What do the investigations of a suspected pituitary tumour involve?

A

Delineation of the anatomy, size and topographical location of the pituitary,
Assessment of visual field and defects
Assessment of endocrine function

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12
Q

How do you measure hormone levels?

A

FBC or staining sections from a biopsy of the tumour with antibodies for the relevant hormone

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13
Q

What is hypopituitarism?

A

Insufficient pituitary hormone production

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14
Q

What is the most common result of pituitary adenoma?

A

Hypopituitarism

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15
Q

What are the rarer causes of hypopituitarism?

A

Radiation therapy, inflammatory disease and head injury

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16
Q

Which hormones are the first to be affected in hypopituitarism?

A

GH ad LH/FSH

17
Q

What is defunct in all anterior pituitary hormones referred to as?

A

Pan hypopituitarism

18
Q

When is secretion of ADH and oxytocin from posterior pituitary affected?

A

If tumour affects hypothalamic function or an inflammatory response involved

19
Q

What happens if you have gonadotropin deficiency?

A

Lack of libido, infertility and oligomenorrhea/amenorrhea

20
Q

What is gonadotropin deficiency usually due to?

A

Mass effect from pituitary adenoma

21
Q

What happens in TSH deficiency?

A

Low thyroid hormones, weight gain, tiredness, slow pulse

22
Q

What happens in ACTH deficiency?

A

Low cortisol, tired, dizzy Ess., low sodium

23
Q

What happens in ADH deficiency?

A

Excess excretion of dilute urine resulting in dehydration and an inc sensation of thirst (DIABETES INSIPIDUS)

24
Q

What are the three main conditions caused by excess pituitary hormone production?

A

Prolactin excess, growth hormone excess and ACTH excess

25
Q

What is the normal physiological function of prolactin?

A

Initiate and maintain lactation

26
Q

What is another name for dopamine?

A

PIH - prolactin release inhibiting hormone

27
Q

What is prolactin section regulated by?

A

PRH and PIH (dopamine)

28
Q

What are the symptoms of hyperprolactinaemia?

A

Galactorrhea, gynecomastia, hypogonadism, anemorrhea and erectile dysfunction

29
Q

What does hypogonadism due to hyperprolactinaemia result from?

A

Higher levels of opine in the hypothalamus which inhibits GnRH therefore inhibits FSH and LH.

30
Q

What is the most common cause of hyperprolactinaemia?

A

Prolactinoma - pituitary adenoma that secretes prolactin

31
Q

What is the first line of treatment for someone with prolactin excess?

A

Cabergoline - dopamine receptor agonist

32
Q

What happens if you have a growth hormone excess in children?

A

Leads to gigantism

33
Q

What are the systemic effects of growth hormone excess?

A

Direct causes of GH itself and through stimulation of IGF1 production

34
Q

Why does it take a long time to diagnose someone with GH excess?

A

The effects of increased activation of GH and IGF receptors take several years to manifest as a change in physical appearance

35
Q

How does excess growth hormones in adults present as?

A

ACROMEGALY - large extremities - hands, feet and lower jaw. Can also be seeping of the voice

36
Q

Describe some more complex effects of GH excess

A

GH antagonises the actions of insulin therefore several metabolic complications may also manifest inc diabetes mellitus and inc serum IGF (linked to cancer)

37
Q

What treatments are available to people with acromegaly?

A

Surgery to remove adenoma, radiation therapy and drug therapy

38
Q

What happens with excess ACTH?

A

Cushing’s syndrome

MEH A (19 decks)

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