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Metabolism, Endocrinology and Haematology > Session 8 - HPA, Growth Hormone And Pituitary Disorders > Flashcards

Session 8 - HPA, Growth Hormone And Pituitary Disorders Flashcards

1
Q

What is the relationship between the hypothalamus and the posterior pituitary gland?

A

Axons from hypothalamus passes down the infundibulum and terminates in posterior pituitary

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2
Q

What is the relationship between the anterior pituitary and the hypothalamus?

A

Hypothalamus releases tropic hormones into hypophyseal portal system supplying anterior pituitary to control its hormonal secretions

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3
Q

What are the 8 hormones produced by the hypothalamus?

A 
Oxytocin 
Antidiuretic hormone
Thyrotropin releasing hormone
Corticotropin releasing hormone
Gonadotropin releasing hormone
Growth hormone releasing hormone
Growth hormone inhibiting hormone
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4
Q

What is the 2 roles of oxytocin?

A

Milk let-down reflex

Uterus contractions during birth

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5
Q

What is the role of antidiuretic hormone?

A

Regulation of body water volume

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6
Q

What is the role of thyrotropin releasing hormone?

A

Stimulate release of thyroid stimulating hormone from anterior pituitary, which stimulates thyroid gland to secrete T3&4 and increase metabolic rate

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7
Q

What is the role of prolactin release-inhibiting hormone?

A

Inhibit release of prolactin from anterior pituitary, inhibit breast growth and milk secretion

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8
Q

What is the role of corticotropin releasing hormone?

A

Stimulate release of adrenocorticotropic hormone from anterior pituitary, stimulates adrenal gland to secrete cortisol and increase stress response and metabolic actions

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9
Q

What is the role of gonadotropin releasing hormone?

A

Stimulate release of follicle-stimulating hormone and luteinizing hormone which stimulates ovaries and testes to secrete sex hormones and gamete production respectively

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10
Q

What is the role of growth hormone releasing hormone?

A

Stimulate release of growth hormone to increase growth

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11
Q

What is the role of growth hormone inhibiting hormone?

A

Inhibit release of growth hormone, inhibit growth

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12
Q

What are the 6 hormones produced by anterior pituitary?

A 
Thyroid stimulating hormone
Adrenocorticotropic hormone
Luteinizing hormone
Follicle stimulating hormone
Prolactin
Growth hormone
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13
Q

What is the role of thyroid stimulating hormone?

A

Secretion of thyroid hormone from thyroid gland

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14
Q

What is the role of adrenocorticotropic hormone?

A

Secretion of hormones from adrenal cortex

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15
Q

What is the role of luteinizing hormone?

A

Ovulation and secretion of sex hormones

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16
Q

What is the role of follicle stimulating hormone?

A

Development of eggs and sperm

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17
Q

What is the role of prolactin?

A

Mammary gland development and milk secretion

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18
Q

What is the role of growth hormone?

A

Growth and energy metabolism, stimulates insulin-like growth factors

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19
Q

What are 2 ways that growth hormone secretion is regulated?

A

Long loop and short loop negative feedback

20
Q

What is the long loop negative feedback to regulate growth hormone secretion?

A

Insulin-like growth factors

inhibit release of growth hormone releasing hormone
stimulates release of somatostatin / growth hormone inhibiting hormone
Inhibit release of growth hormone

21
Q

What is the short loop negative feedback to regulate growth hormone secretion?

A

Growth hormone stimulates somatostatin release

22
Q

What are the 2 ways growth hormones exert effects on cells?

A

Directly through growth hormone receptors

Indirectly through insulin-like growth factor-I

23
Q

How does growth hormone exert its effects directly?

A

Growth hormone binds to growth hormone receptors (cytokines receptors) coupled to Janus Kinases (JAKs) which phosphorylate target proteins, altering their functions, and also results in signalling cascades that activate transcription factors to increase production of IGFs

24
Q

How does growth hormone exert its effects on cells indirectly?

A

Produce insulin-like growth factors which circulate in blood bound to specific binding proteins which modulate their availability to activate IGF receptors (tyrosine kinase) to cause hypertrophy, hyperplasia, increased protein synthesis and lipolysis

25
Q

What is the most common cause of pituitary malfunction?

A

Benign tumor / adenoma

26
Q

How do pituitary tumors cause problems?

A

Puts physical pressure on other local structure or secrete substances

27
Q

What are 5 problems that a non functioning tumor can cause?

A 
Inadequate production of hormones
Headache
Visual problems
Nausea
Vomiting
28
Q

What is a problem that a hypersecreting tumor can cause?

A

Systemic effects of over secreted hormone

29
Q

What are the 3 steps of investigating a suspected pituitary tumor?

A

MRI scan to see anatomy, size and location
Assessment of visual field defects
Assessment of endocrine function to determine excess or deficiency through biopsy or blood test

30
Q

What are 4 possible causes of hypopituitarism?

A

Adenoma
Radiation
Head injury
Inflammatory disease

31
Q

What happens during hypopituitarism?

A

Progressive loss of anterior pituitary function with GH and LH first to be affected

32
Q

What is panhypopituitarism?

A

Deficiency of all anterior pituitary hormones

33
Q

What are symptoms of growth hormone deficiency?

A

Decreased tolerance to exercise
Decreased muscle strength
Increased body fat
Reduced sense of well being

34
Q

What is the common cause of GH deficiency in adults and children?

A

Pituitary adenoma in adults

Idiopathic but maybe gene mutations and autoimmmune condition in children

35
Q

What are 4 symptoms of gonadotropin deficiency?

A

Decreased libido
Infertility
Oligomenorrhea
Impotence

36
Q

What are 4 causes of ADH deficiency?

A

Hypothalamic tumor
Pituitary tumor extended up into hypothalamus
Cranial radiotherapy
Infections

37
Q

What are 3 symptoms of ADH deficiency?

A

Polyuria
Polydipsia
Dehydration

38
Q

What are 3 main conditions caused by hyperpituitarism?

A

Prolactin excess
Growth hormone excess
ACTH excess

39
Q

What is the normal function of prolactin?

A

Initiate and maintain lactation

40
Q

What is prolactin inhibited by?

A

Dopamine

41
Q

What are 5 symptoms of hyperprolactinanemia?

A 
Galactorrhea - unexplained milk production 
Gynecomastia - hard breast 
Hypogonadism - lower sexual activity 
Amenorrhea - ceased menstruation 
Erectile dysfunction
42
Q

What is the common cause of hyperprolactinaemia?

A

Prolactinoma

43
Q

How to treat hyperprolactinaemia?

A

Dopamine receptor agonists like cabergoline

44
Q

What are 8 symptoms of growth hormone excess?

A 
Broad nose
Coarse facial features
Thick lips
Prominent supraorbital ridge
Enlargement of hands and feet
Excessive sweating
Deeper voice
Gigantism (if in childhood)
45
Q

What are 3 treatment options for acromegaly?

A

Surgery to remove adenoma
Radiation
Drug therapy

46
Q

What are 3 drugs to treat acromegaly?

A

Dopamine receptor agonists to reduce GH
Somatostatin to limit GH secretion
GH receptor antagonist - Pegvisomant

47
Q

What does ACTH excess cause?

A

Cushing’s syndrome

Metabolism, Endocrinology and Haematology (8 decks)

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