10: Hypothalamic-pituitary axis physiology, pituitary tumours, prolactinomas and acromegaly Flashcards Preview

Endocrine Week 3 2017/18 > 10: Hypothalamic-pituitary axis physiology, pituitary tumours, prolactinomas and acromegaly > Flashcards

Flashcards in 10: Hypothalamic-pituitary axis physiology, pituitary tumours, prolactinomas and acromegaly Deck (51)
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1

What is found superior to the pituitary gland?

Optic chiasm

2

The pituitary gland is split into which parts?

Anterior and posterior pituitary gland

3

What hormones are produced by the posterior pituitary?

ADH

Oxytocin

4

Which hormones are produced by the anterior pituitary gland?

ACTH

TSH

FSH

LH

PRL

Growth hormone

5

Which gland itself controls the pituitary gland?

Hypothalamus

6

What are the effects of cortisol?

Increases blood glucose level

Increased lipogenesis

Increases immune response

7

What is the main difference between prolactin release from the anterior pituitary and all the other hormones?

Dopamine inhibits constant prolactin secretion by the anterior pituitary

8

What are the three clinical presentations you see in endocrinology?

Too much hormone

Not enough hormone

Gland is too big

9

In which direction do pituitary tumours usually grow?

Superiorly

because inferiorly and laterally there are bones

10

What structure tends to be compressed by pituitary tumours?

Optic chiasm

11

If a pituitary tumour grows around the internal carotid artery, can it be cured surgically?

No, risk of rupturing artery too high

12

What ENT symptom may patients present with if a pituitary tumour breaches the sphenoid sinus?

CSF leak from nose

13

What dynamic tests would you do in the case of

a) too much hormone

b) too little hormone?

a) Too much > Suppression test

b) Too little > Stimuation test

14

Diabetes insipidus involves a deficiency of what?

ADH

15

What is the stimulation test for diabetes insipidus?

Water deprivation test

should stimulate the release of ADH

16

What name is given to pituitary tumours

a) < 1cm

b) > 1cm

in diameter?

< or equal to 1cm diameter MICROADENOMA

> 1cm diameter - MACROADENOMA

17

What is a non-functioning pituitary adenoma?

A pituitary adenoma which doesn't produce any hormone

18

What can non-functioning pituitary adenomas compress?

Optic chiasm

CN III, IV & VI (optic, trochlear, abducent nerves)

19

What endocrine conditions do non-functioning pituitary adenomas produce?

Not producing hormone, so deficiencies:

hypoadrenalism

hypothyroidism

hypogonadism

GH deficiency

20

If a non-functioning pituitary adenoma affects the posterior pituitary, what endocrine condition can you get?

Diabetes insipidus

21

At the optic chiasm, which optic nerves cross over and which ones stay on the unilateral side?

Temporal nerves stay on the same side

Nasal nerves cross over

22

Which type of vision is lost in optic chiasm compression?

Temporal vision on both sides

bitemporal hemianopia

23

What is the physiological function of prolactin?

Production of breast milk

24

What are physiological causes for a raised prolactin?

Breastfeeding

Pregnancy

Stress

Sleep

25

Which drugs cause raised prolactin?

Dopamine antagonists

Antipsychotic drugs

26

What is an example of a dopamine antagonist which raises prolactin?

Metoclopramide

27

How do dopamine agonists affect prolactin levels?

Suppress prolactin

28

Which thyroid-related hormone causes prolactin levels to rise?

Thyrotropin releasing hormone (TRH)

so PRL is raised in hypothyroidism

29

Which thyroid disease causes raised prolactin levels?

Hypothyroidism

as TRH levels are raised to compensate

30

What is a functioning adenoma which can cause raised prolactin?

Prolactinoma