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Clinical medicine A > triggers and extra stuff for anterior pituitary > Flashcards

triggers and extra stuff for anterior pituitary Flashcards

1
Q

what neuroendocrine cell stimulates ACTH to be released

A

CRH

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2
Q

what neuroendocrine cell stimulates TSH to be released

A

TRH

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3
Q

what neuroendocrine cell stimulates LH and FSH to be released? what neuroendocrine cell inhibits their release?

A

GnRH sitmulates

GnIH inhibits

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4
Q

what neuroendocrine cell sitmulates prolactin to be released? what inhibits it?

A

prolactin releasing peptide releases

prolactin inhibiting factor (dopamine) inhibits

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5
Q

what neuroendocrine cell
stimulates GH to be released? what inhibits it?

A

somatocrinin stimulates

somatostaitin inhibits

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6
Q

what inherited disorders cause inadequate production of anterior pituitary hormones

A

Pituitary dysplasia/aplasia
congenital CNS mass
Congenital hypothalmic disorders

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7
Q

what traumatic disorders cause inadequate production of anterior pituitary hormones

A

surgical resection
radiation
head injury

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8
Q

what tumor disorders cause inadequate production of anterior pituitary hormones

A

pituitary adenoma
pituitary metastisis

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9
Q

what inflammatory disorders cause inadequate production of anterior pituitary hormones

A

hemochromatosis
sacoidosis

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10
Q

what vascular disorders cause inadequate production of anterior pituitary hormones

A

arteritis
sickle cell

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11
Q

what infections cause inadequate production of anterior pituitary hormones

A

fungal
parasitic
TB

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12
Q

what congenital disorders cause hypopituitarism

A

gene mutations
prader willi
kallmann syndrome

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13
Q

what acquired disorders cause hypopituitarism

A

radiation
TBI
chemotherapy
ischemic stroke

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14
Q

what are functional causes of hypopituitarism

A

opioid use
normal aging
malnutrition
CKD

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15
Q

where is prolactin snthesized

A

lactotrophs

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16
Q

what causes a mild rise in PRL levels

A

exericse, meals, sex
breast exam, chest wall injury
minor surgeries, general anesthesia
stress of any kind.

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17
Q

in the ovary, PRL leads to _______ and _________

A

hypoestrogenism and anovulation

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18
Q

how is prolactin cleared

A

renally

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19
Q

ammenorrhea, galactorrhea, infetrility

A

hallmarks for hyperprolactinemia

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20
Q

what is galactorrhea

A

inappropriate discharge of milk-containing fluid from the breast (present in 80% of hyperprolactinemic women)

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21
Q

how does hypogonadotropic hypogonadism manifest:

A

Decreased libido
impotence/ED
infertility
gynecomastia
galactorrhea (less common)

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22
Q

If a mass lesion is in the region of sella turcica, what else should be evaluated

A

secretion of other pituitary hormones

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23
Q

if MRI is normal and there is not another cause identifiable for the hyperprolactinemia what is it diagnosed as?
what could be occurring here.

A

idiopathic hyperprolactinemia

can be due to microadenomas too small to be seen on imaging

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24
Q

can be treated with estrogen, estrogen/progesterone, or testosterone as well as dopamine agonists

A

hyperprolactinemia

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25
Q

risk of cardiac valve insufficiency in parkinsons

A

SE of cabergoline

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26
Q

sheenans syndrome, dopamine agonists, tumors

A

causes of hypoprolactinemia

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27
Q

treatement w dopamine antagonists

A

hypoprolactinemia

28
Q

TSH/FT4 to r/o hypothyroidism
hCG
CMP
Men: serum total and free testosterone, LH, and FSH.
Women: serum estradiol, LH, and FSH

the above were done to rule out differential diagnoses.

what is the suspected diagnosis of the patient

A

hyperprolactinemia

29
Q

what releases IGF-1

A

liver

30
Q

increased w sleep, exercise, stress and Low BG levels

A

GH

31
Q

virtigo, insomnia, constipation, nightmares, dry mouth, nasal congestion.

A

SE of dopamine agonists

32
Q

trauma, infection or cranial irradiation

A

etiologies for aqcuired GH deficiency

33
Q

micropenis, high pitched voice, short stature

A

presentation of isolated GH deficiency

also includes:
increased fat
hypoglycemia

34
Q

increased fat, hypoglycemia,

A

presentation of isolated GH deficiency

also include:
micropenis
short stature
high pitched voice

35
Q

inheritance through autosomal dominant or recessive, or through x linked gene

A

GH deficiency

36
Q

defects in receptor structure or signaling

A

GH insensitivity

37
Q

Normal/high GH levels
Low IGF-1 levels

diagnosis is….

A

GH insensitivity

38
Q

turner syndrome, chronic systemic disease, skeletal disorders and hypothyroidism

A

other causes of growth failure besides GH deficiency

39
Q

giving a physiologic or pharmacologic stimuli after a night of fasting and measuring ______ levels afterward is the test used when suspecting what disease

A

this is a GH stimulation test, used to test GH deficiency

40
Q

used for what:
MRI to visualize the hypothalamus and pituitary.
CT of brain w/ contrast can screen for pituitary tumor.

A

GH deficency evaluation

41
Q

What is the treatment for GH deficiency?

A

Recombinant GH (0.02-0.05mg/kg/day)) SC

42
Q

hypothalmic or pituitary somatotrope damage

A

MCC of GH deficiency in adults

43
Q

HLD, LV dysfunction, HTN, increased fractures

A

Adult GH deficiency

44
Q

Active neoplasm
Intracranial hypertension
Uncontrolled diabetes + retinopathy

A

contraindications for treatment of AGHD

45
Q

somatotroph lesions

A

acromegaly/gigantism

46
Q

chest or andominal carcinoid tumor

A

MCC of excess GHRH-mediated acromegaly

47
Q

coarse facial features

A

acromegaly/gigantism d/t soft tissue swelling

48
Q

clinical concern of cardiomyopathy w arrhythmias

A

acromegaly/gigantism

also has:
LVH
HTN
decreased diastolic function

49
Q

LVH, HTN, decreased diastolic function

A

clinical concerns for acromegaly/gigantism

also has:
cardiomyopathy w arrhythmias

50
Q

sleep apnea, DM, colon polyps

A

complications of acromegaly/gigantism

51
Q

giving oral glucose load of 75mg is used in what test to confirm the presence of what diagnosis

A

GH suppression test
confirms/rules out acromegaly/giganstism

52
Q

Transsphenoidal surgical resection for both micro and macroadenomas.

A

primary treatment for acromegaly/gigantism

53
Q

External radiation therapy or high-energy stereotactic techniques

A

secondary/adjuvant therapy for acromegaly/gigantism

54
Q

somatostatin analogues, dopamine agonists

A

acromegaly pharmacotherapy

55
Q

suppression of gallbladder contractility and delayment of emptying

A

octreotide (somatostatin analogue)

56
Q

amenorrhea, infertility, osteoporosis, deceased libido, oligomenorrhea

A

hypogonadism (hypopituitarism)

could also be describing hyperprolactinemia! look for presence of galactorrhea

57
Q

High GnRH, LH and FSH

A

PRIMARY hypogonadism (issue is in gonads)

58
Q

Low GnRH, LH and FSH

A

secondary hypogonadism (issue is in hypothalamus/pituitary)

59
Q

serum and free testosterone, serm LH and PRL

A

used to evaluate hypogonadism in males

60
Q

serum, TSH, FSH, LH and PRL as well as hCG

A

female lab evaluation of hypogonadism

very similar to hyperprolactinemia! but hyperprolactinemia also has estradiol, FT4 and CMP

61
Q

leuprolide

A

used in males w hypogonadism and intact pituitary function

62
Q

human menopausal gonadotropin

A

used for female hypogonadism for ovulation

63
Q

pulsatile GnRH

A

used for hypothalamic infertility in females w hypogonadism

64
Q

clomiphene

A

used in male hypogonadism to stimulate pituitary gonadotrophs

65
Q

CV dysfunction and altered lipid metabolism

A

AGHD

Clinical medicine A (32 decks)

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