Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endo > Pituitary DO > Flashcards

Pituitary DO Flashcards

1
Q

HPA Axis hormones functions

A
  1. respond to stress
  2. thyroid stim, growth, reproduction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which pituitary gland is the producer? which is the storer?

A

Anterior - Producer
Posterior - Storer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Anterior and Posterior Pituitary glands secrete which hormones?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Growth hormone excess is referred to as _____
Growth hormone deficiency is referred to as _____

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what stim and inhibits Growth hormone secretion?

A

GHRH stim
Somatostatin inhibits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

High levels of growth hormone are usually caused by ____

A

a GH-secreting tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what increases growth hormone secretion?

think big picture

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What decreases growth hormone secretion?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Giantism vs Acromegaly
Which occurs during childhood?

A

Giantism = during childhood (b4 growth plates close)
Acromegaly = Adulthood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

genetic causes of Giantism

A
  • familial isolated pituitary adenoma
    multiple endocrine neoplasia type 1 (MEN1)
  • McCune-Albright syndrome (MAS)
  • Carney complex with onset during
  • prepubescence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Giantism SS

A
  • Longitudinal acceleration of linear growth secondary to insulinlike growth factor I (IGF-I) excess
  • Tumor mass may cause headaches, visual changes due to optic nerve compression, and hypopituitarism
  • Hyperprolactinemia is a common finding; it results from pituitary growth hormone (GH) excess,
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Acromegaly WU

A
  • Two baseline GH levels are obtained prior to ingestion of 75 or 100 g of oral glucose, and additional GH measurements are made at 30, 60, 90, and 120 minutes following the oral glucose load. A rise, or no suppression is diagnostic.
  • Measure serum GH 1 hour after oral administration of 100 g of glucose. Clearly elevated GH levels (>10 ng/mL) after oral glucose, combined with the clinical picture, secure the diagnosis of acromegaly, while a normal GH level (< 5 ng/mL) after oral glucose essentially excludes the diagnosis.

GnRH can be measured
IGF-I can be measured
Prolactin is often also measured since it can be co-secreted in 20% of tumors
Imaging: MRI of brain
CT scans of abdomen/pelvis or chest if brain is negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Acromegaly Complications

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Acromegaly Trmnt

A
  • # 1 Trnassphenoidal Sx
  • Radiation
  • Octreotide -
  • Bromocriptine -
  • Pegvisomant (Somavert) -
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

MC pituitary hormone deficiency in children

A

Growth Hormone Deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

2 main ways you get pituitary dwarfism

A
  1. Isolated LOW growth hormone
  2. Generalized - ALL pituitary hormones are LOW
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pituitary Dwarfism WU

A
  • IGF-1 levels
  • XR of LT Hand to determine bone age
  • MRI to r/o calcifications, tumors, structural anomalies
  • ACTH, 8 am serum cortisol level, LH, FSH, Prolactin levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Dx Criteria for Pituitary Dwarfism

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Dwarfism Trmnt

A
  • recombinant Growth Hormone
  • +/- other pituitary hormone replacement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which HPA hormones should be eval for deficiencies?

A

ALL
Cortisol
Thyroid
ADH
Sex hormone around time of puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why do new moms need to try breastfeeding ASAP

A

Stim Prolactin -> breastfeeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What stim prolactin secretion

A
  • sleep
  • stress
  • pregnancy
  • chest wall stimulation or trauma
  • TRH, dopamine receptor antagonists, primary hypothyroidism
  • prolactinomas (tumor)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Approximately 75% of patients presenting with galactorrhea and amenorrhea have _____.

A

hyperprolactinemia

24
Q

Drugs that can cause Hyperprolactinemia

A

Dopamine-receptor antagonists (phenothiazines, butyrophenones, thioxanthenes, metoclopramide, sulpiride, pimozide)
Conventional and atypical antipsychotics (Haloperidol, risperidone{70-100%}, olanzapine, quetiapine, amisulpride)
Dopamine-depleting agents (methyldopa, reserpine)
Others (isoniazid, danazol, tricyclic antidepressants, monoamine antihypertensives, verapamil, estrogens, antiandrogens, cyproheptadine, opiates, H2-blockers [cimetidine], cocaine)

25
Q

Prolactin levels >_______ req brain imaging

A

100-250ng/mL

Med induced will be high but under 100 usually

26
Q

why may you need a DEXA scan if you have Hyperprolactinemia?

A

persistent low estrogen/testosterone can lead to osteoporosis

27
Q

Initial drug of choice if hyperprolactinemia ET is pituitary in orgin

A

Bromocriptine (Dopamone AGONIST)

28
Q

Prolactin Deficiency is MC assosiated with post-partum _____ Syndrome

A

Sheehan

postpartum pituitary necrosis
necrosis of cells of the anterior pituitary gland following significant post-partum bleeding, hypovolemia, and shock.

29
Q

Mom lost a lot of blood during birth and is having trouble starting breastfeeding. Concern for?

A

Sheehan syndrome (postpartum pituitary necrosis)
Prolactin deficiency

Lose blood flow to anterior pituitary -> ischemia

30
Q

WU for prolactin deficiency

A
31
Q

Prolactin Deficiency trmnt

A

Lifelong replacement of pituitary hormones:
Hypothyroidism can be treated with levothyroxine
Cortisol deficiency can be treated with prednisone or hydrocortisone.
Gonadotropin deficiency should be treated with estrogen if the uterus has been removed with a combination of estrogen and progesterone if a uterus is present.
The growth hormone is probably the most common hormone that needs replacing, and the dosage must be individualized to the patient’s need.
For patients who develop diabetes insipidus, desmopressin (DDAVP)

32
Q

Excess ADH is ____

A

SIADH

33
Q

ADH deficiency is ____

A

Diabetes insipidus

34
Q

what does ADH do?

A

dont pee
save water at collecting duct
Vasoconstricts at high levels

35
Q

What incr and decr ADH secretion?

A
36
Q

Central Diabetes Insipidus (ADH Deficiency)

A
37
Q

Primary vs Secondary Central Diabetes Inspidus

A
38
Q

Non-central Diabetes Insipidus

A
  • Nephrogenic Diabetes Insipidus - tubule receptors dont respond correctly to ADH
  • Psychogenic Polydipsia - drinking too much water -> kidney becomes insensitive to ADH (>6L)
39
Q

Water Deprivation Test

A
40
Q

Pt does water deprivation test. No urine concentration increase is seen. What may this be?

A

Diabetes insipidus

41
Q

Are those with psychogenic polydipsia able to concentrate their urine during water deprivation test?

A

YEs

42
Q

Tx for water deprivation test?

A

restrict fluid intake to ≤ 2 L/day
Norm concentrating ability will return within several weeks

43
Q

Central Diabetes Insipidus (ADH Deficiency) Trmnt

A

Desmopressin (DDA VP)

mimics endogenous vasopressin

44
Q

3 non-hormonal drugs that reduce polyuria?

A
  1. Diuretics, primarily thiazides
  2. Vasopressin-releasing drugs (eg, chlorpropamide, carbamazepine, clofibrate)
  3. Prostaglandin inhibitors(NSAIDs)
45
Q

Chlorpropamide, carbamazepine, and clofibrate stimulates increased renal tubular water reabsorption (pee less). This is effective on which type(s) of diabetes Insipidus?

A

ONLY central diabetes insipidus. May even eliminate need for vasopressin!

WONT work for nephrogenic diabetes insipidus bc their receptors are shot

46
Q

Nephrogenic Diabetes Insipidus Trmnt

A

Indomethacin (NSAIDs make you pee less)
Na+ intake restriction
Thiazide Diuretic

47
Q

ADH excess is referred to as ____

A

SIADH
Syndrome of Innapropriate AntiDiuretic Hormone Secretion

48
Q

SIADH definition

A

Dilute serum (hyposmolarity)
concentrated urine

NO other physiological cause of vasopressin secretion
Normally, low plasma osmolality inhibits vasopressin secretion, allowing the kidneys to produce dilute urine.

49
Q

Euvolemic vs Hypervolemic vs Hypovolemic Hyponatremia

A
  • Euvolemic - norm water gain and loss (equalized free water)
  • Hypervolemic - water retention is greater (CHF, Cirrhosis)
  • Hypovolemic - Na+ loss is greater (MCC by renal diuretic like thiazide or extra renal causes)
50
Q

Which type of hyponatremia is SIADH?

A

Euvolemic Hyponatremia

51
Q

SIADH etiology

A
52
Q

SIADH WU

A
53
Q

SIADH Trmnt

A

Treatment of cause
Fluid restriction
Sometimes a vasopressin receptor antagonist Sometimes NS

54
Q

SIADH Fluid Restriction

only drink ____ L a day

A

250-500L

Also give loop diuretic combo with IV 0.9% saline to slowly correct severe Na+ deficits without inducing vol overload

55
Q

If pt with SIADH cannot tolerate water restriction, giving ____ will unconcentrate the urine. However, it can cause acute kidney injury (AKI)

A

Demeclocycline

Endo (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions