Anterior Pituitary (pathophys)

Question 1

what’s the anterior pituitary made of?

Answer 1

red vascular glandular tissue

Question 2

Hormones inhibited by somatostatin (17)

Answer 2

Acetylcholine
Arginine vasopressin 
Cholecystokinin
Epidermal growth hormone 
Glucagon
Gastrin
Gastric inhibitory polypeptide 
Growth hormone
Insulin
Motilin
Neurotensin 
Pancreatic polypeptide 
Secretin
Serotonin
Substance P
Thyrotropin
Vasoactive intestinal polypeptide

Question 3

Results of pitutitary hormone deficiency of GH

Answer 3

short stature

Question 4

Results of pitutitary hormone deficiency of FSH

Answer 4

infertility

Question 5

Results of pitutitary hormone deficiency of LH

Answer 5

men: hypogonadism, reduced sperm count
women: hypogonadism, amenorrhea, oligomenorrhea

Question 6

Results of pitutitary hormone deficiency of TSH

Answer 6

hypothyroidism

Question 7

Results of pitutitary hormone deficiency of ACTH

Answer 7

hypoadrenalism, loss of pigmentation

Question 8

Results of pitutitary hormone deficiency of prolactin

Answer 8

sheehan’s syndrome

Question 9

Results of pitutitary hormone deficiency of ADH

Answer 9

diabetes insipidus

Question 10

other name for ADH

Answer 10

vasopressin

Question 11

Results of pitutitary hormone deficiency of oxytocin

Answer 11

failure of milk letdown, post-partum uterine bleeding?

Question 12

secretary pituitary tumors can release which hormones? (5)

Answer 12

prolacting
ACTH
GH
gonadotropins (rare)
TSH (rare)

Question 13

effect of prolactin excess (females, 5 items)

Answer 13

AMENORRHEA 
OLIGOMENORRHEA 
GALACTORRHEA  (30-80%)
INFERTILITY 
OSTEOPENIA

Question 14

effect of prolactin excess (males, 4 items)

Answer 14

HYPOGONADISM
DECREASED LIBIDO
GALACTORRHEA (RARE <30%)
PITUITARY DEFICIENCIES

Question 15

effect of ACTH excess

Answer 15

cushing’s disease

Question 16

effect of GH excess (2)

Answer 16

acromegaly

gigantism

Question 17

effect of gonadotropins (3 + frequency)

Answer 17

visual disturbances
headaches
hypogonadism

rare

Question 18

effect of TSH excess (+frequency)

Answer 18

hyperthyroidism

rare

Question 19

feedback system of GH

Answer 19

hypothalamus releases GHRH (+GH) and somostatin (-GH) which regulate GH output.

GH (+somotostatin?) –> liver
–> IGF-1 (feeds back to pituitary & hypothalamus)

Question 20

98% of acromegaly due to

Answer 20

pituitary disorders releasing GH

Question 21

60% of pituitary acromegaly due to

Answer 21

GH - cell adenoma releasing GH

Question 22

25% of pituitary acromegaly due to

Answer 22

mixed GH-cell and prolactin-cell adenoma releasing GH

Question 23

extripituitary cause of acromegaly

Answer 23

pancreatic islet-cell tumor (very rare) releasing GH

Question 24

excess GHRH secreting types of acromegaly (2)

Answer 24

central ectopic (<1%)
peripheral ectopic (1%)

Question 25

risks of long-term GH conc elevation

Answer 25

malignancy:colon, esophagus, melanoma, stomach ~3x risk ``` arthropathy hypertension neuropathy respiratory disease CV disease carbohydrate intolerence (DM) ```

Question 26

From where could GHRH come from that would cause gigantism? (2)

Answer 26

lung carcinoid tumors | islet cell tumors

Question 26

From where could GHRH come from that would cause gigantism? (2)

Answer 26

lung carcinoid tumors | islet cell tumors

Question 27

Manifestations of GH excess see in >40% of patients

Answer 27

``` Acral enlargement 100% Soft Tissue overgrowth 88% Hyperhidrosis 87% Lethargy of fatigue 73% Paresthesias 70% Joint Pain 69% Photophobia 46% Papillomas 45% ```

Question 27

Manifestations of GH excess see in >40% of patients

Answer 27

``` Acral enlargement 100% Soft Tissue overgrowth 88% Hyperhidrosis 87% Lethargy of fatigue 73% Paresthesias 70% Joint Pain 69% Photophobia 46% Papillomas 45% ```