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Flashcards in Lecture 98 Deck (38):
1

Name the hormones secreted by the anterior pituitary gland

TSH, ACTH, GH, LSH, FSH, PRL

2

Name the hormones secreted by the posterior pituitary gland

ADH (AVP) and oxytocin

3

describe the basic neuroendocrine axis (H-P-A)

hypothalamus-pituitary-peripheral gland. the pituitary gland has negative feedback on the hypothalamus and the peripheral gland has negative feedback on the pituitary and hypothalamus

4

describe the 4 basic laboratory abnormalities of the neuroendocrine axis

overactive peripheral gland (peripheral gland hormone is up/pituitary trophic hormone is down)
under active peripheral gland (peripheral gland hormone down/pituitary trophic hormone up)
increased pituitary stimulation (both up)
decreased pituitary stimulation (both down)

5

What other peptide hormones belong to the same superfamily as prolactin?

GH and hCS

6

What superfamily is prolactin in? What two other hormones belong in this family?

Peptide hormone. included GH and hCS (aka hPL)-all derived from same ancestral gene

7

What are lactotrophs what do they secrete and where are they found? What inhibits secretion from lactortrophs? What increases it?

cell that secrete prolactin. widely distributed in anterior pituitary make up 25% of a. pituitary vol.
secretion inhibited by dopamine, increased by TRH.

8

What is the prime function of prolactin?

to initiate and maintain lactation

9

Name a physiologic (2), pathologic (6), and pharmacologic (2) factors that influences prolactin secretion.

-pregnancy-up, nursing-up
-prolactinomas-up, pituitary stalk compression-up, hypopituitarism-down, pituitary tumors-down, surgery-down, and radiation-down
-anti-psychotics-up, and dopamine agnonists-down

10

state the signs/Sx/lab results of prolactinoma? hypopituitarism?

prolactinoma-amenrrhea,galactorrhea (in women)l, loss of libio (in men), increase in prolactin levels
hypopituitarism-failure to lactate, decrease in prolactin levels

11

describe the prolactin endocrine axis

hypothalamus releases TRH (activates) or dopamine (inhibits) which acts on pituitary lactrotropes to secrete or not secrete prolactin which acts on breasts, liver, adrenals,ovaries, testis, prostate, pancreatic islets, lymphoid tissue, and peripheral mononuclear cells

12

what is the role of TRH? where is it made? what inhibits its secretion?

(thyroid releasing hormone) synthesized in supraoptic and paraventricular nuclei of the hypothalamus, stimulates TSH secretion and prolactin secretion, inhibited by T3 and T4

13

what molecules regulate TSH secretion? what is its function?

TRH increases secretion and T3/T4 stop secretion. function is to promote follicular cell growth and thyroid hormone production

14

describe the thyroid endocrine axis

TRH is released from the hypothalamus and causes TSH release from pituitary thyrotropes. TSH serves two functions 1)inhibits its release from pituitary thyrotropes (negative feedback) and 2) stimulate T4,T3 production from the thyroid. T4/T3 have negative feedback on the primary thyrotropes and hypothalamus

15

Name the physiological (2), pathological (1), and pharmacological (1) factors that influence TSH secretion

-primary hypothyriodism (Hashimoto Disease)-up, primary hyperthyriodism (Graves Disease)-down
-TSH-secreting pituitary adenomas-up
-Leveothyroxine (LT4) (Synthroid)-down

16

state the signs/Sx/lab results of TSH-secreting pituitary tumor? hypopituitarism?

TSH-secreting pituitary tumor-hyperthyroidism (tremor, palpitations, heat, intolerance, weight loss, anxiety), goiter
hypopituitarism-hypothyroidism (fatigue, cold intolerance, weight gain, constipation, edema, dry har/skin)

17

what is the role of CRH, where it is made, what is it inhibited by?

corticotropin releasing hormone stimulates ACTH secretion, made in paraventricular nucleus of the hypothalamus (note these neurons also make ADH), it's inhibited by cortisol

18

what is the role of ACTH, where is it made, what is it inhibited by what is is stimulated by?

corticotropin promotes growth of adrenocortical cells and production of steroid hormones (cortisol/DHEA), made in the corticotrophs (found in center of a. pituitary gland), CRH increases secretion and high cortisol levels inhibit secretion

19

describe the adrenal endocrine axis

the hypothalamus secretes CRH which acts on the coticotropes to release ACTH which acts on the hypothalamus to inhibit CRH production and acts on the adrenal cortex to release cortisol. cortisol then had negative feedback on a. pituitary and hypothalamus

20

Name the physiological (3), pathological (2), and pharmacological (1) factors that influence ACTH secretion

-primary hypoadrenalism-up, primary hypoglycemia-up, non-ACTH mediated cushing's syndrome "adrenal Cushing"-down
-cushing disease, hypopituitarism
-glucocorticoids-down

21

state the signs/Sx/lab results of Cushing Disease? Hypopituitarism?

Cushing disease-weight gain, DM, hypertension, hirsutism, abdominal striae, bruising, edema, weakness, depression
fatigue,weakness, hyponatremia, hypotension, nausea

22

What is the name the disease states that correspond to 1-4 in the context of the thyroid H-P axis.
1) Overactive peripheral gland
2) Underactive peripheral gland
3) Increased pituitary stimulation
4) Decreased pituitary stimulation

1) primary hypERthyriodism (Grave's)
2) primary hypOthyroididsm (Hashimoto's Disease)
3) secondary or central hypERthyriodism
4) secondary or central hypOthyriodism

23

What is the name the disease states that correspond to 1-4 in the context of the adrenal H-P axis.
1) Overactive peripheral gland
2) Underactive peripheral gland
3) Increased pituitary stimulation
4) Decreased pituitary stimulation

1) Adrenal Cushing Syndrome
2) Primary Hypoadrenalism (Addison's)
3) Pituitary Cushing Disease
4) Secondary or central hypoadrenalism

24

what is the role of GHRH where is it made, what is it inhibited by what is is stimulated by?

Growth Hormone releasing hormone stimulates GH secretion, it is made by neurons in the paraventricular nucleus of the hypothalamus, is it inhibited by GH, IGF-I and stimulated by estrogen and glucocorticoids

25

what is the role of GH, what family is it apart of, where is it made, what is it's secretion pattern, which sex has higher levels, what is it inhibited by what is is stimulated by?

growth hormone stimulates systemic IGF-I production in liver and local production ("paracrine" factor) this mechanism allows for potent anabolic, counter-regulatory, and lipolytic actions. is apart of a peptide hormone superfamily that contains prolactin and chorionic somatotropin, made in somatotropes (50% of a. pituitary vol), secreted in a pulsatile manner (most burst during sleep) also increasing secretion levels until adolescence and then decreases with aging. women have higher levels, stimulated by GHRH, inhibited by somatostatin and IGF-I

26

Name the physiological (3), pathological (3), and pharmacological (3) factors that influence GH secretion

-childhood/puberty-up, hypoglycemia-up, aging-down
-acromegaly-up, gigantism-up, hypopituitarism-down
-GHRH-up, glucose-down, somatostatin-down

27

state the signs/Sx/lab results of acromegaly? Hypopituitarism?

skeletal growth, coarsening of face, thickening of skin, sweating
growth failure, decreased muscle mass, hypoglycemia, fatigue

28

What is the name the disease states that correspond to 1-2 in the context of the adrenal H-P axis.
1) Increased pituitary stimulation
2) Decreased pituitary stimulation

1) acromegaly
2) hypopituitarism

29

what is the role of GnRH where is it made, how is it secreted, what is it inhibited by, what is is stimulated by?

role is to increase pituitary secretion of LH and FSH, made in neurons in 3 areas of hypothalamus, it's secreted in a pulsatile fashion (critical for function 1 pulse/90mins), inhibited by gonadal sex steroids and inhibin

30

what is the role of LH where is it made, what family is it in?

promotes ovulation and luteinization of ovarian follicle and estrogen production in women/promotes testosterone production in men, produced by gonadotrophs, in a family of glycoprotein hormones (LH, FSH, hCG) that all share a common alpha subunit

31

what is the role of FSH where is it made, what family is it in, what is it stimulated by, what inhibits it?

stimulates ovarian follicular growth in women and stimulates testicular growth and spermagenesis in men, belongs to a glycoprotein hormone family that shares a common alpha subunit (LH,FSH,hCG), stimulated by GnRH, and inhibited by inhibin and estradiol/testosterone

32

Name the physiological (6), pathological (2), and pharmacological (1) factors that influence LH/FSH secretion

-puberty-up, mid-menstrual cycle-up, menopause-up, stress-down severe medical illness-down, psychiatric illness-down
-hyperprolactinemia-down, hypopituitarism-down
-oral contraceptives-down

33

state the signs/Sx/lab results of FSH(LH)-secreting pituitary adenoma? Hypopituitarism?

precocious puberty
amenorrhea, decreased libido, infertility

34

What is the name the disease states that correspond to 1-4 in the context of the ovarian H-P axis.
1) Overactive peripheral gland
2) Underactive peripheral gland
3) Increased pituitary stimulation
4) Decreased pituitary stimulation

1)ovarian or adrenal neoplasm
2)primary hypogonadism (menopause)
3) female precocious puberty
4)hypogonadotropic hypogonadism

35

What is the name the disease states that correspond to 1-3 in the context of the testicular H-P axis.
1) Underactive peripheral gland
2) Increased pituitary stimulation
3) Decreased pituitary stimulation

1) primary hypogonadism
2) male precocious puberty
3) hypogonadotropic hypogonadism

36

what is the role of ADH, where is made, what stimulates it what inhibits it?

stimulate aquaporin channels in renal collecting duct to decrease urine flow, and increase osmolarity and free wate excretion (also vasoconstriction, platelet aggregation, stimulate thirst), made in the supraoptic/paraventricular nuclei, stimulated and inhibited by osmoreceptors (more sensitive) and baroreceptors (less sensitive)

37

Name the physiological (2), pathological (2), and pharmacological (1) factors that influence LH/FSH secretion

-hyperosmolality (hypernatremia)-up hypoosmolality-down
-SIADH-up diabetes insipidus-down
-opiates-up and carbamazepine-up

38

What is the name the disease states that correspond to 1-3 in the context of the ADH H-P axis.
1) decrease plasma osmolarity/increased ADH
2) increased plasma osm/decreased ADH
3) Increased plasma osm/increased ADH

1) SIADH
2) central diabetes insipidus
3) nephrogenic diabetes insipidus (absent or decreased responsiveness to ADH by kidney)