EXAM #1: HYPOTHALAMUS & PITUITARY Flashcards Preview

Endocrine > EXAM #1: HYPOTHALAMUS & PITUITARY > Flashcards

Flashcards in EXAM #1: HYPOTHALAMUS & PITUITARY Deck (23):
1

What are the two essential anterior pituitary hormones?

1) TSH
2) ACTH

2

What is hypopituitarism?

Insufficient secretion of pituitary hormones resulting from diseases of the hypothalamus or the pituitary.

3

What are the major causes of hypopituitarism?

1) Tumors, such as nonfunctional pituitary adenomas or craniopharyngiomas (exert pressure on adjacent pituitary cells)
2) Pituitary surgery or radiation
3) Traumatic brain injury and subarachnoid hemorrhage
4) Pituitary apoplexy (sudden hemorrhage into the pituitary gland)
5) Sheehan syndrome
6) Empty sella syndrome

4

What two anterior pituitary hormones do NOT have simple feedback loops?

1) GH
2) Prolactin

5

What is the clinical consequence of GH and Prolactin not having simple feedback loops?

These hormones are most likely to be in EXCESS

6

What are the manifestations of excess prolactin?

1) Galactorrhea
2) Hypogonadism

*Elevated prolactin inhibits GnRH

7

What are the manifestations of excess GH?

1) Giantism
2) Acromegaly

8

What is prolactin essential for?

Lactation

9

What causes hypogonadism in hyperprolactinemia?

Inhibition of GnRH release from hypothalamus

10

What are the manifestations of hyperprolactinemia in women?

1) Irregular menses
2) Infertility
3) Osteoporosis

11

What are the clinical manifestations of hyperprolactinemia in men?

1) Impotence
2) Infertility

12

What is the differential diagnosis for hyperprolactinemia?

1) Pituitary adenoma (overproduction)
2) Decreased dopamine inhibitiory action
3) Decreased renal clearance of prolactin
4) Unknown
- Cirrhosis
- Primary amyloidosis

13

What serum concentration of prolactin is diagnostic for a pituitary adenoma?

300

*Less than 30 is stress, greater than 100 and NOT pregnant is also an adenoma

14

What drugs most commonly cause hyperporlactinemia?

- Verapamil
- Methyldopa
- Reglan
- Resperidone
- Haldol

15

What is the most common type of pituitary adenoma?

Prolactinoma

16

What is the treatment for a micro-prolactinoma?

Bromocriptine (DA agonist)

*Dopamine decreases prolactin

17

What is the treatment for a macro-prolactinoma?

1) Bromocriptine + Tamoxifen
2) Radiation
3) Transsphenodial resection

18

What is the hallmark symptom of hypoprolactinemia?

Failure to lactate

19

What is the difference in the outcome of excessive GH secretion occurs in childhood vs adulthood?

Childhood= gigantism

Adulthood= acromegaly

20

How is growth hormone excess diagnosed?

- Increased insulin-like growth factor
- MRI/CT imaging of a pituitary neoplasm.
- Growth hormone suppression test with glucose load*

*Dr. Horner, this is a MUST

21

In a patient with acromegaly, what screening test should be done more frequently?

Colonoscopy

22

How is growth hormone excess treated?

Surgery or radiation* + medication adjuncts

*FIRECRACKER:
- Octreotide, a somatostatin analogue that inhibits GH release from the anterior pituitary and
- Pegvisomant, a GH receptor antagonist which effectively blocks IGF-1 production.

23

What type of hypothalamic tumor is more common, slow or rapid growing? Which is more destructive?

More common= slow growing

More destructive= rapid growing