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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
risk of cardiac valve insufficiency in parkinsons
SE of cabergoline
26
sheenans syndrome, dopamine agonists, tumors
causes of hypoprolactinemia
27
treatement w dopamine antagonists
hypoprolactinemia
28
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
hyperprolactinemia
29
what releases IGF-1
liver
30
increased w sleep, exercise, stress and Low BG levels
GH
31
virtigo, insomnia, constipation, nightmares, dry mouth, nasal congestion.
SE of dopamine agonists
32
trauma, infection or cranial irradiation
etiologies for aqcuired GH deficiency
33
micropenis, high pitched voice, short stature
presentation of isolated GH deficiency also includes: increased fat hypoglycemia
34
increased fat, hypoglycemia,
presentation of isolated GH deficiency also include: micropenis short stature high pitched voice
35
inheritance through autosomal dominant or recessive, or through x linked gene
GH deficiency
36
defects in receptor structure or signaling
GH insensitivity
37
Normal/high GH levels Low IGF-1 levels diagnosis is....
GH insensitivity
38
turner syndrome, chronic systemic disease, skeletal disorders and hypothyroidism
other causes of growth failure besides GH deficiency
39
giving a physiologic or pharmacologic stimuli after a night of fasting and measuring ______ levels afterward is the test used when suspecting what disease
this is a GH stimulation test, used to test GH deficiency
40
used for what: MRI to visualize the hypothalamus and pituitary. CT of brain w/ contrast can screen for pituitary tumor.
GH deficency evaluation
41
What is the treatment for GH deficiency?
Recombinant GH (0.02-0.05mg/kg/day)) SC
42
hypothalmic or pituitary somatotrope damage
MCC of GH deficiency in adults
43
HLD, LV dysfunction, HTN, increased fractures
Adult GH deficiency
44
Active neoplasm Intracranial hypertension Uncontrolled diabetes + retinopathy
contraindications for treatment of AGHD
45
somatotroph lesions
acromegaly/gigantism
46
chest or andominal carcinoid tumor
MCC of excess GHRH-mediated acromegaly
47
coarse facial features
acromegaly/gigantism d/t soft tissue swelling
48
clinical concern of cardiomyopathy w arrhythmias
acromegaly/gigantism also has: LVH HTN decreased diastolic function
49
LVH, HTN, decreased diastolic function
clinical concerns for acromegaly/gigantism also has: cardiomyopathy w arrhythmias
50
sleep apnea, DM, colon polyps
complications of acromegaly/gigantism
51
giving oral glucose load of 75mg is used in what test to confirm the presence of what diagnosis
GH suppression test confirms/rules out acromegaly/giganstism
52
Transsphenoidal surgical resection for both micro and macroadenomas.
primary treatment for acromegaly/gigantism
53
External radiation therapy or high-energy stereotactic techniques
secondary/adjuvant therapy for acromegaly/gigantism
54
somatostatin analogues, dopamine agonists
acromegaly pharmacotherapy
55
suppression of gallbladder contractility and delayment of emptying
octreotide (somatostatin analogue)
56
amenorrhea, infertility, osteoporosis, deceased libido, oligomenorrhea
hypogonadism (hypopituitarism) could also be describing hyperprolactinemia! look for presence of galactorrhea
57
High GnRH, LH and FSH
PRIMARY hypogonadism (issue is in gonads)
58
Low GnRH, LH and FSH
secondary hypogonadism (issue is in hypothalamus/pituitary)
59
serum and free testosterone, serm LH and PRL
used to evaluate hypogonadism in males
60
serum, TSH, FSH, LH and PRL as well as hCG
female lab evaluation of hypogonadism very similar to hyperprolactinemia! but hyperprolactinemia also has estradiol, FT4 and CMP
61
leuprolide
used in males w hypogonadism and intact pituitary function
62
human menopausal gonadotropin
used for female hypogonadism for ovulation
63
pulsatile GnRH
used for hypothalamic infertility in females w hypogonadism
64
clomiphene
used in male hypogonadism to stimulate pituitary gonadotrophs
65
CV dysfunction and altered lipid metabolism
AGHD

Clinical medicine A (32 decks)

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