Term
| Anterior Pituitary: Peptide Hormones |
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Definition
Growth Hormone
Prolactin
ACTH |
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Term
| Anterior Pituitary: Glycoprotein Hormones |
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Definition
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Term
| Effects of Growth Hormone: Direct and Indirect |
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Definition
Direct: Fat cell break down triglyceride
Indirect: Liver releases IGF-1, stimulates bone/muscle growth |
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Term
| Embryological Origin of Pituitary |
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Definition
Anterior lobe: Rathke's Pouch
Posterior Lobe: Diencephalon (NT from Hypothalamus) |
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Term
| Factors Regulating GH secretion |
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Definition
Stimulating Factors: GHRH from Hypothalamus, Ghrelin from stomach.
Inhibiting Factors: Somatostatin (multiple sources), IGF-1 from liver (feedback inhibition) |
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Term
| Control of Prolactin Secretion |
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Definition
Hypothalamus tonically inhibits PRL secretion
TRH, Estrogen, and Stimulation of the nipples promote PRL release. |
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Term
Which Hypothalamic Factor Stimulates the Release of:
1. ACTH
2. TSH
3. LH
4. FSH |
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Definition
1. CRH
2. TRH
3. GnRH
4. GnRH |
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Term
| What are the Effects of Oxytocin Release? |
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Definition
1. Milk Letdown
2. Uterine Contraction
3. Maternal Behavior
4. Sperm Transport |
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Term
| What Factors Stimulate AVP secretion? |
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Definition
1. High Blood Osmolarity (detected in hypothalamus)
2. Decreased BP or Blood Volume
3. Nausea/Vomiting |
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Term
| What is the Disorder for Growth Hormone Hypersecretion, and how is it tested for? |
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Definition
| Acromegaly is tested for with the glucose tolerance test or by checking IGF-1 levels (elevated in acromegaly). |
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Term
| Treatment of Hyperprolactinemia |
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Definition
| Dopamine agonists: bromocryiptine, cabergoline |
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Term
| What is the definition, and what are the causes of diabetes insipidus? |
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Definition
Definition: Excretion of dilute urine; inability of the kidneys to concentrate urine.
1. Hypothalamic- lack of ADH
2. Nephrogenic- kidney's don't respond to ADH
3. Psychogenic Polydipsia: Excessive ingestion of water. |
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Term
| How is Diabetes Insipidus treated? |
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Definition
| Manage water intake, DDAVP. |
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Term
1. What is the initial treatment of Acromegaly?
2. What are the alternatives? |
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Definition
1. Transphenoidal Adenectomy
2. Irradiation (slower) or Octreotide/Pegvisomant treatment |
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Term
| What is the effect of Hyperprolactinemia on men? |
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Definition
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Term
| When should a prolactinoma be suspected? |
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Definition
PRL level >200: definite prolactinoma
PRL level 100-200: probable prolactinoma |
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Term
| What hormone secreting pituitary tumor is unique in being treated medically as an initial approach? |
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Definition
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Term
| What comprises the clinical presentation of a pituitary adenoma? |
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Definition
1. Mass effects (i.e. headache, visual disturbance)
2. Hypopituitarism (anything but PRL can be deficient)
3. Hormone excess- PRL, GH, ACTH, TSH
4. Can be found incidentally when doing head imaging studies |
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Term
| What are the top 3 pituitary tumors? |
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Definition
1. Prolactinoma
2. Null cell (no hormone)
3. Gonadotroph |
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Term
| Comorbidities in Acromegaly |
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Definition
Sleep Apnea
Diabetes
LVH/CHF
Colonic Polyps/Malignancy
HTN |
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Term
| What causes 75% of all cases of Cushing's syndrome? |
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Definition
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Term
| Why are gonadotroph tumors in the same category as null sell adenomas? |
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Definition
| Because neither produces a distinct clinical syndrome. |
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