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Endocrine Troutman > Week 2 Pituitary > Flashcards

Week 2 Pituitary Flashcards

1
Q

What is known as the “master gland?”

A

The pituitary gland

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2
Q

What is known as “the coordinating center of the endocrine system?”

A

the hypothalamus

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3
Q

What 4 areas does the hypothalamus consolidate signals from?

A
  1. Upper cortical limits
  2. Autonomic Function
  3. Environmental cues
  4. Peripheral endocrine feedback
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4
Q

The _________ delivers precise signals to the _________ which releases ________ that that influence other endocrine systems

A
  1. Hypothalamus
  2. Pituitary
  3. Hormones
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5
Q

Which area of the pituitary is highly vascularized?

A

The anterior or adenohypophysis

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6
Q

Which type of cell secretes thyroid stimulating hormone (TSH)?

A

Thyrotropes

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7
Q

What is the posterior pituitary mainly consisted of?

A

Axonal projections from the hypothalamus

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8
Q

What 2 main things does ADH do? What 4 things does it lead to?

A

Increases permeability of the collecting ducts —> increasing free water absorption

  1. Increased urine osmolality
  2. Decreased plasma osmolality
  3. Increased ECF

Also causes smooth muscle contraction = vasoconstriction

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9
Q

What happens to plasma osmolality with dehydration?

A

It increases

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10
Q

What does decreased ECF volume activate?

A

Stretch receptors in the great veins, atria & pulmonary vessels —> trigger ADH release

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11
Q

Name all the stimulus for ADH release (8)?

A

Angiotensin II, nicotine, nausea, pain, stress, stretch receptors, baroreceptors (carotids & aortic arch), osmoreceptor in hypothalamus

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12
Q

What depresses the release of ADH(3)? What does this cause?

A
  1. Decreased plasma osmolality
  2. Increased ECF volume
  3. Alcohol
    — increased urine output
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13
Q

What is the treatment for SIADH?

A

Find the cause & limit fluid intake

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14
Q

What is SIADH and what does it cause?

A

Autonomous release of ADH from pituitary — water retention, hyponatremia, concentrated urine, hyperosmolar (dilute) plasma

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15
Q

What can cause SIADH? (5)

A
  1. CSN disorders
  2. cold stress
  3. trauma
  4. drug induced
  5. squamous cell lung CA
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16
Q

What does now sodium reflect? (2)

A
  1. Absolute increase in total body water (TBW)

2. Na+ loss in excess of water

17
Q

What are the risk factors of CPM in the hyponatremia patient? (3)

A
  1. Serum Na+ < 120 mEq/L for > 48 hours
  2. Aggressive IVF therapy with hypertonic saline solutions
  3. Development of hypernatremia during treatment
18
Q

What is Central Diabetes Insipidus? How is it treated?

A

ADH deficiency caused by pituitary’s inability to release ADH
MOST COMMON
— exogenous ADH (desmopressin nasal spray)

19
Q

What is renal Diabetes Insipidus? Treatment?

A

The inability of the kidneys to respond to ADH

— demeclocycline (decreases responsiveness of collecting tubules) & ADH

20
Q

What is the most common cause of central DI?

A

Transient post head injury or surgery

21
Q

What are causes of Nephrogenic DI?

A
  1. Chronic renal disease
  2. Lithium toxicity
  3. Hypercalcemia
  4. Hypokalemia
  5. Tubulointerstitial disease (drugs)
  6. Heredity (rare)
22
Q

What are anesthetic implications of diabetes insipidus?

A

Hypernatremia & hypovolemia =

  • increased MAC - b/c of decreased uptake of inhalation agent and decreased CO
  • decreased IV agents due to hypovolemia
23
Q

What Na+ level would you postpone an elective surgery?

A

Na+ >150

24
Q

What are symptoms of hypernatremia (6)?

A
  1. Restlessness
  2. Lethargy
  3. Hyperreflexia
  4. Seizures
  5. Coma
  6. Death
25
Q

What does oxytocin do (2)?

A
  1. Uterine contractions

2. Myoepithelial cell contraction (milk ejection)

26
Q

What are complications during labor of too much pitocin (7)?

A
  1. Fetal distress (d/t hyperstimulation)
  2. Uterine tetany
  3. Maternal water intoxication (ADH effects rare)
  4. Hypertension
  5. Tachycardia
  6. N/V
  7. Seizures (rare)
27
Q

What is commonly compressed with pituitary tumors and what does this cause?

A

Compression of OPTIC CHASM —> Bitemporal hemianopsia (blindness over half field of vision)

28
Q

What approach is used for most pituitary resection?

A

Transsphenoidal approach

29
Q

What is often a symptom following pituitary surgery?

A

May develop DI due to loss of ADH - temporary or permanent

Endocrine Troutman (1 decks)

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