Endo 2

Question 1

Is the anterior pituitary gland a true endocrine organ?

Answer 1

yes

Question 2

is the posterior pituitary gland a true endocrine organ?

Answer 2

no
-contains axon terminals of hypothalamic neurons

Question 3

Where is the pituitary gland located?

Answer 3

in the sella turcica

Question 4

What hormones are released from the anterior pituitary?

Answer 4

growth hormone
ACTH
TSH
FSH
LH
prolactin

Question 5

What hormones are released from posterior pituitary?

Answer 5

ADH/vasopressin
oxytocin

Question 6

What type of cells secrete GH?

Answer 6

somatotrophs

Question 7

What type of cells secrete ACTH?

Answer 7

corticotrophs

Question 8

What type of cells secrete TSH?

Answer 8

thyrotrophs

Question 9

What type of cells secrete LH nad FSH?

Answer 9

gonadotrophs

Question 10

What type of cells secrete prolactin?

Answer 10

mammotrophs

Question 11

Where are hypothalamic hormones released into?

Answer 11

primary capillary plexus in the median eminence

Question 12

What carries the hypothalamic hormones to the sinuses of the anterior pituitaryt?

Answer 12

hypothalamic-hypophyseal portal blood vessels

Question 13

How does GH function?

Answer 13

it can act directly on the tissue or act as a tropic hormone to the liver
-causes the release of insulin like growth factor in the liver

Question 14

How is GH released?

Answer 14

in a pulsatile manner
-lower during the day with highest levels a few hours after sleep

Question 15

What stimulates the release of GH?

Answer 15

starvation, fasting, stress, exercise, and excitement

Question 16

How does the secretion of GH change throughout life?

Answer 16

-high during neonatal period
-decreases in childhood
-peaks during puberty
-declines with age after puberty

Question 17

Where is IGF-1 made?

Answer 17

in most tissues and act as a neighboring cells in a paracrine manner
-major site of synthesis is in the liver

Question 18

What is the mechanism of action in GH and IGF-1?

Answer 18

-growth in nearly all tissues in the body (increase organ size, increase organ function, increase in linear growth)
-amino acid uptake and protein synthesis in most cells (increase lean body mass)
-reduce glucose utilization (decrease uptake, increase hepatic glucose production, and increase insulin secretion)
-mobilization of fatty acids from adipose tissue resulting in increases FFA in blood and use of FFA for energy

Question 19

What does GH and IGF-1 do in bone deposition prior to the fusing of epiphyseal plates?

Answer 19

stimulates chondrogenesis and widening of epiphyseal plates, following by bone matrix depositions (linear growth)

Question 20

How does GH and IGF-1 do to bones in an adult?

Answer 20

increases bone formation by activating osteoblasts and osteoclasts

Question 21

What is excess growth hormone called in children?

Answer 21

gigantism

Question 22

What is excess GH called in adults?

Answer 22

acromegaly

Question 23

What is the cause of 90% of acromegaly?

Answer 23

pituitary tumor

Question 24

What are some symptoms of excess GH?

Answer 24

-coarse facial features, large fleshy nose, frontal bossing, jaw malocclusion
-coronary heart disease
-diabetes mellitus
-kyphosis
-paresthesias
-hyperhidrosis and oily skin

Question 25

What is the treatment for pituitary microadenoma?:

Answer 25

surgical resection of tumor via transsphenoidal approach followed by treatment in GHIH

Question 26

What are the oral manifestations of GH excess?

Answer 26

-thick, rubbery skin, enlarged nose, and thick lips -macrocephaly -macrognathia -mandibular prognathism -generalized diastemata -anterior open bite and malocclusion -macroglossia, dyspnea, dysphagia, dysphonia, sialorrhea -hypertrophy of pharyngeal and laryngeal tissues -> sleep apnea

Question 27

What can cause a deficiency of GH?

Answer 27

-hypothalamic disorders -mutations in GHRH receptor, GH gene, GH receptor, IGF-1 receptor -combined pituitary hormone deficiencies -radiation -psychosocial deprivation (causes an increase in GHIH)

Question 28

What are the clinical manifestations of complete GH deficiency?

Answer 28

-slow linear growth rates -normal skeletal proportions -pudgy, youthful appearance (decreased lipolysis) -in the setting of cortisol deficiency (hypoglycemia)

Question 29

What is the most common form of dwarfism?

Answer 29

achondroplasia

Question 30

What causes achondroplasia?

Answer 30

mutation in FGF-3 receptors in cartilage and brain -makes receptor over active and inhibits cartilage growth at growth plates

Question 31

What are the oral manifestations of GH deficiency?

Answer 31

-disproportionate delayed growth of skull and facial skeleton -tooth formation and growth of alveolar regions in the jaw are abnormal (tooth crowding and malocclusion, high tendency for plaque accumulation, difficulty maintaining good oral hygiene, and prone to gingivitis and periodontal disease) -solitary median maxillary central incisor -delayed eruption of primary and secondary dentition

Question 32

What is solitary median maxillary central incisor?

Answer 32

when an individual only has one maxillary central incisor

Question 33

How does vasopressin effect blood vessels?

Answer 33

contraction of vascular smooth muscle via V1 receptors -raise blood pressure

Question 34

How does vasopressin effect renal tubules?

Answer 34

-bind to V2 receptors in late distal tubules and collecting duct -aquaporin-2 proteins are inserted into the apical membrane of tubular epithelial cells -allow more water resopriton

Question 35

What stimulates ADH secretion?

Answer 35

-decreased blood volume (isotonic) -increased osmolarity (isovolemic) -decreases blood pressure

Question 36

What is hypodipsia?

Answer 36

decreases or absent feeling of thirst which results in reduced intake of water

Question 37

What does neurogenic diabetes insipidus do to ADH?

Answer 37

decrease levels

Question 38

What does nephrogenic diabetes insipidus do to ADH?

Answer 38

increase levels

Question 39

What is syndrome of inappropriate ADH?

Answer 39

increases and uncontrolled of ADH that causes volume expansion and hyponatremia -decrease Na -decrease nerve and muscle excitability -can result from surgery, pain, stress, temperature changes, tumor, etc

Question 40

What are the actions of oxytonic?

Answer 40

released from posterior pituitary -stimulate contraction of uterus toward the end of gestation -cause milk ejection from breasts in lactation

Question 41

What is pitocin?:

Answer 41

synthetic oxytocin that is given to induce labor

Question 42

What is a sign of a disease?

Answer 42

objective evidence of disease that can be seen or measured

Question 43

What is a symptom of a disease?

Answer 43

something that cannot be measured but are reported by the person