Endocrine- pituitary

Question 1

Endocrine System Consists of tissues that orchestrate ______ (homeostasis)

Answer 1

metabolic equilibrium

Question 2

Means of communication mediated by secreted molecules (______) released by endocrine tissue (gland) and carried through the blood to a distant tissue (target cell/tissue)

Answer 2

hormones

Question 3

Target tissue often secretes factors that down-regulate the activity of the gland (______)

Answer 3

feedback inhibition

Question 4

Pathology occurs when there is:

Answer 4

Underproduction or overproduction of hormones

Mass lesions of hyperplastic glandular tissue

Question 5

Lesions may be _____ (don’t produce hormones)

Answer 5

nonfunctional

Question 6

Lesions may be _____ (produce hormones)

Answer 6

functional

Question 7

Mass lesions of hyperplastic glandular tissue

may be __________ and can ________.

Answer 7

Benign or malignant

compress other tissues (e.g., vasculature, nerves)

Question 8

Anterior lobe (adenohypophysis) 
is what percent of pituitary gland

Answer 8

80%

Question 9

Hypothalamus releasing factors (positive) are carried to the anterior pituitary by the______.

Answer 9

portal vascular system

Question 10

Hypothalamus releasing factors (positive) are carried to the anterior pituitary by the portal vascular system, Except for _____.

Answer 10

Prolactin secretion inhibited by hypothalamic dopamine (not stimulated)

Growth hormone secretion stimulated by GHRH and inhibited by somatostatin (both from the hypothalamus)

Question 11

Prolactin secretion inhibited by hypothalamic ______(not stimulated)

Answer 11

dopamine

Question 12

Growth hormone secretion stimulated by ___ and inhibited by somatostatin (both from the hypothalamus)

Answer 12

GHRH

Question 13

Growth hormone secretion stimulated by GHRH and inhibited by______ (both from the hypothalamus)

Answer 13

somatostatin

Question 14

in posterior pituitary, Modified glial cells and axonal processes from the hypothalamus, pass through the _____ to the posterior lobe (axon terminals)

Answer 14

pituitary stalk

Question 15

Pre-formed hormones produced in the _____, stored in the axon terminals in the posterior pituitary, released directly into the systemic circulation

Answer 15

hypothalamus

Question 16

Posterior pituitary hormones

Answer 16

Oxytocin
 Antidiuretic hormone (ADH or vasopressin)

Question 17

what causes release of oxytocin or ADH

Answer 17

Direct CNS stimulation causes release

Question 18

Dilatation of the cervix (pregnancy) and nipple stimulation (suckling) results in ____ release (also “happy” times!)

Answer 18

oxytocin

Question 19

Decreased blood pressure (cardiac atria and carotid baroreceptors), increase in plasma osmotic pressure detected by CNS osmoreceptors stimulates ____ release (opposite effects inhibit)

Answer 19

ADH

Question 20

Diseases of the posterior pituitary often noticed quickly because of increased or decreased secretion of ___

Answer 20

ADH

Question 21

what is Hyperpituitarism

Answer 21

Excess secretion of pituitary hormones

Question 22

causes of hyperpituitarism

Answer 22

Functional pituitary adenoma
Hyperplasia or carcinoma of the anterior pituitary
Ectopic secretion of hormones by non-pituitary tumors
Over-secretion of hypothalamic releasing factors

Question 23

causes of Hypopituitarism

Answer 23

Pituitary or hypothalamic injury

• Ischemic injury (including compression injury, thrombolic / embolic injury)
• Surgery or radiation
• Inflammatory reactions

Nonfunctional pituitary adenomas (replaces functional tissue)

Question 24

what is Hypopituitarism

Answer 24

Under-secretion of pituitary hormones

Question 25

examples of Pituitary or hypothalamic injury

Answer 25

- Ischemic injury (including compression injury, thrombolic / embolic injury) - Surgery or radiation - Inflammatory reactions

Question 26

Sellar expansion, bony erosion, and | disruption of the diaphragma sella can cause pituitary _____.

Answer 26

Local mass effects

Question 27

Expanding pituitary lesions often compress the _____(visual field abnormalities, classically bitemporal hemianopsia)

Answer 27

optic chiasm

Question 28

pituitary mass effects May produce signs and symptoms of elevated ____(headache, nausea, and vomiting)

Answer 28

intracranial pressure

Question 29

Acute hemorrhage into an adenoma causes rapid enlargement of the lesion, called pituitary ____ (i.e., pituitary stroke, a neurosurgical emergency)

Answer 29

apoplexy

Question 30

Most common cause of hyperpituitarism is an ______.

Answer 30

anterior lobe adenoma

Question 31

anterior lobe adenoma Can be _____(hormone excess and clinical manifestations) or _____(without clinical symptoms of hormone excess, present late)

Answer 31

functional non functioning

Question 32

Less common causes of _____include pituitary carcinomas and some hypothalamic disorders (unregulated secretion of releasing factors)

Answer 32

hyperpituitarism

Question 33

anterior lobe adenomas are | Usually found in adults ___ years

Answer 33

35 to 60

Question 34

Pituitary adenomas are well-circumscribed lesions usually confined to the _____(may extend superiorly through the diaphragm sella into the suprasellar region, where they may compress the optic chiasm and cranial nerves.

Answer 34

sella turcica

Question 35

_______ tend to be more invasive and contain areas of hemorrhage and necrosis.

Answer 35

Macroadenomas

Question 36

headaches occur when there is inflammation/irritation to the ____.

Answer 36

dura

Question 37

if there is disruption of bony sella, CSF can be released and pt will have ___.

Answer 37

rhinorrea

Question 38

most common pituitary adenoma

Answer 38

prolactinoma

Question 39

associated symptoms with ACTH

Answer 39

``` Cushing syndrome (hypercortisolism) Nelson syndrome (reactive adenoma after adrenalectomy) ```

Question 40

associated symptoms with GH (IGF-1)

Answer 40

Gigantism (children) | Acromegaly (adults)

Question 41

associated symptoms with Prolactin

Answer 41

Galactorrhea and amenorrhea (in females) Reduced libido, infertility Most common manifestation

Question 42

associated symptoms with Prolactin, GH

Answer 42

Combined features of GH and prolactin excess

Question 43

associated symptoms with TSH

Answer 43

hyperthyroidism

Question 44

______ refers to the loss of one or more pituitary hormones

Answer 44

Hypopituitarism

Question 45

______ results from complete loss of all pituitary hormone secretion

Answer 45

Panhypopituitarism

Question 46

Causes | of Panhypopituitarism

Answer 46

Ischemic necrosis (head injury, vascular, postpartum) Sella turcica neoplasms (nonfunctioning adenoma) Intrasellar cysts Chronic inflammatory lesions (TB, syphillis, sarcoidosis) Infiltrative disorders (amyloidosis, hemochromatosis) Genetic mutations

Question 47

A syndrome of polyuria resulting from the inability to concentrate urine and to conserve water due to inadequate ADH

Answer 47

Diabetes Insipidus

Question 48

diabetes insipidus causes

Answer 48

Reduced pituitary production of ADH (central diabetes insipidus) Reduced renal response to ADH (nephrogenic diabetes insipidus) Pregnancy increases metabolic clearance of ADH (so it lasts longer), decrease water reabsorption

Question 49

____ is Due to secretion of more ADH than is appropriate for the blood sodium concentration or volume

Answer 49

SIADH

Question 50

Associated with dilutional hyponatremia without edema

Answer 50

SIADH

Question 51

SIADH- About 30% cases are _________ (hyperpituitarism), remainder are other CNS disorders, neoplastic, pulmonary, drug effects

Answer 51

posterior pituitary oversecretion

Question 52

Neurologic consequences of _____include confusion, lethargy and weakness, myoclonus, asterixis, generalized seizures, and coma

Answer 52

hyponatremia