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Physiology 1 > The Pituitary Gland And Its Disorders > Flashcards

The Pituitary Gland And Its Disorders Flashcards

1
Q

What is another name for the anterior lobe of the pituitary gland?

A

Adenohypophysis

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2
Q

What is another name for the posterior lobe of the pituitary gland?

A

Neurohypophysis

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3
Q

What is the dual blood supply to the pituitary gland?

A

Pituitary arteries and the hypophysial portal circulation

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4
Q

What does the hypophysial portal circulation begin as?

A

A capillary plexus round the arc

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5
Q

What are the three layers of the endocrine system?

A

Primary- end organ
Secondary - pituitary
Tertiary - hypothalamus

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6
Q

What is the role of the hypothalamus?

A

Takes inputs from the brainstem and senses and higher centres and converts them into hormones that give a particular state

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7
Q

How does the hypothalamus work in conjunction with the pituitary gland?

A

Hypothalamus secretes small amount of hormone into hypophysial vein which runs into the pituitary which amplifies the hormone to the rest of the body

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8
Q

What are the clinical features of pituitary tumours?

A

Hormone hypersecretion, space occupying lesion, hormone deficiency states

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9
Q

What do the space occupying lesions cause?

A

Headaches, visual loss and cavernous sinus invasion

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10
Q

What does excess TSH lead to?

A

Secondary thyrotoxicosis

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11
Q

What does excess LH/FSH lead to?

A

Non functioning pituitary tumour

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12
Q

What does excess PRL lead to?

A

Prolactinoma

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13
Q

What is the function of GH on liver?

A

Stimulates liver to produce IGF-1 -> acts on chondrocytes in long bones to promote linear growth

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14
Q

What does acral enlargement involve?

A

Spade like hands, increased shoe size, macroglossia (big tongue), carpal tunnel syndrome

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15
Q

Give some external effects of GH excess (acromegaly)

A

Increased skin thickness, sweating, skin tags and increased interdental spacing

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16
Q

Give the systemic effects of acromegaly

A

Impaired fasting glucose and glucose tolerance, diabetes mellitus, insulin resistance, reduced cholesterol, increased TGs and nitrogen retention

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17
Q

What are the actions of cortisol?

A

Increases plasma glucose levels and lipolysis, protein catabolis, sodium and water retention, anti-inflammatory and increased gastric acid production

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18
Q

What processes increase when cortisol increases plasma glucose levels?

A

Gluconeogenesis, glycogenesis and glycogen storage

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19
Q

Why does cortisol increases lipolysis?

A

Conserve glucose by using broken down fats as energy

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20
Q

What are the external symptoms of Cushing’s syndrome?

A

Change in body shape, central obesity, moon face, thin skin and easy bruising

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21
Q

What does the change in sex hormones in cushings lead to?

A

Excess hair growth, irregular periods, problems conceiving and impotence (ED)

22
Q

What does prolactin inhibit?

A

LH and FSH

23
Q

What feedback mechanism controls prolactinomas?

A

Positive

24
Q

What does tonic release of DA inhibit?

A

PRL release

25
Q

What drugs interfere with DA and PRL secretion?

A

Antiemetics, antipsychotics and OCP/HRT

26
Q

What is the name for the condition where a patient has PRL excess?

A

Hypogonadism

27
Q

What are the symptoms of hypogonadism?

A

Infertility, amenorrhoea, reduced libido, oligoamenorrhoea, galactorrhoea and ED

28
Q

What is amenorrhoea?

A

Complete stop of periods

29
Q

What is galactorrhoea?

A

Milk release from breast

30
Q

What is the treatment for hypogonadism?

A

Dopamine agonists like bromocriptine and cabergoline

31
Q

What percentage of all pituitary tumours are non-functioning?

A

30%

32
Q

What is the treatment for pituitary tumours?

A

Surgery

33
Q

What is the optic chiasm?

A

Bit just above the pituitary where the signals from the two optic nerves meet

34
Q

Why is the top of the field of vision lost first with a pituitary tumour?

A

Tumours will grow up from the bottom and the lens is inverted

35
Q

What is the order of the loss of pituitary function with an expanding tumour?

A

LH and FSH -> GH -> TSH-> ACTH-> increased prolactin

36
Q

What are the three treatments of pituitary adenomas?

A

Surgery, radiotherapy and drugs

37
Q

What do the drugs do with pituitary adenomas?

A

Block hormone production or stop their release

38
Q

What can cause pituitary failure?

A

Tumour, trauma, infection, inflammation or iatrogenic

39
Q

What is iatrogenic?

A

Caused by medical treatment

40
Q

What are the consequences of hypopituitarism on the thyroid?

A

Bradycardia, weight gain, cold intolerance, hypothermia, constipation

41
Q

What are the consequences of hypopituitarism on the sex steroids?

A

Oligomenorrhoea, reduced libido, hot flushes and reduced body hair

42
Q

What are the consequences of hypopituitarism on reduced cortisol?

A

Tiredness, weakness, anorexia, postural hypotension and myalgia

43
Q

What is myalgia?

A

Muscle pain

44
Q

When does excess ADH release happen?

A

In brain injury or infection where altered brain stimulus increases hypothalamic ADH production

45
Q

What controls vasopressin release?

A

Increased plasma osmolality, decreased blood pressure

46
Q

What is the action of ADH?

A

Increase the collecting ducts permeability for water and also vasoconstriction

47
Q

What is the treatment for the syndrome of inappropriate ADH secretion?

A

Fluid restriction, demeclocycline and ADH antagonists

48
Q

What causes diabetes insipidus?

A

Underproduction of ADH

49
Q

What is the water deprivation test?

A

Body can tolerate 3% loss of body mass due to fluid loss - dont give them water for 8 hrs to see the changes in urine conc

50
Q

What is a diabetic persons reaction to being given an ADH injection after the water deprivation test?

A

Plasma becomes concentrated - in cranial DI it goes back to normal but in nephrogenic DI, ADH conc stays the same

51
Q

What is the difference between cranial and nephrogenic DI?

A

Cranial = lack of production and nephrogenic = receptor resistance

52
Q

What is the treatment for DI?

A

ADH drugs

Physiology 1 (65 decks)

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