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110 Cards in this Set
- Front
- Back
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Prolactin, growth hormone, and lutenizing hormone are produed where?
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Anterior pituitary
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Oxytocin and vasopressin are stored where?
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Posterior pituitary
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Which area of the pituitary is associated with hormones that have direct targets?
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Posterior pituitary
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What type of hormone is ACTH?
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Amino acid peptide
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What type of hormone is prolactin?
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Single-chain polypeptide
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What is the source of prolactin?
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Lactotrophs (pituitary)
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What is the target of prolactin?
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Mammary glands
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What is the function of prolactin?
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Stimulate lactation
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What is the target of ACTH?
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Adrenal gland
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What is the function of ACTH?
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Cortisol stimulation
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What is the target of growth hormone?
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Liver - IGF1
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What is the target of TSH?
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Thyroid
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What type of hormone is TSH?
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Two-piece glycoprotein
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What is the source of TSH?
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Thyrotropes (pituitary)
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What is the function of TSH?
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Stimulates thyroid hormone release
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What type of hormone is FSH?
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Two-type GP
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What type of hormone is oxytocin?
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Peptide hormone
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What is the synthetic oxytocin given to women to induce labor?
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Pitocin
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What is the function of oxytocin?
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Milk ejection and uterine contraction
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What type of hormone is vasopressin?
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Peptide
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What type of hormone is FSH?
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Two-type GP
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What type of hormone is oxytocin?
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Peptide hormone
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What is the synthetic oxytocin given to women to induce labor?
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Pitocin
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What is the function of oxytocin?
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Milk ejection and uterine contraction
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What type of hormone is vasopressin?
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Peptide
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What is the function of vasopressin?
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Conservation of water
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What is the source of growth hormone?
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Somatotrophs (pituitary)
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What is the HT releasing hormone for growth hormone?
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GHRH
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What is the HT inhibiting factor for growth hormone?
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Somatostatin
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What is the source of ACTH?
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Corticotropes (pituitary)
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What are the HT releasing hormones for ACTH?
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CRH
AVP |
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What is the HT releasing hormone for prolactin?
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TRH
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What is the HT inhibiting factor for prolactin?
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Dopamine
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What is the HT releasing hormone for TSH?
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TRH
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What are the HT inhibiting factors for TSH?
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Somatostatin
Dopamine |
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Acromegaly occurs as a result of what?
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Growth hormone excess after growth plates are closed
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Gigantism occurs as a result of what?
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Growth hormone excess before growth plates are closed
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What is an excess of growth hormone usually due to?
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Pituitary adenoma
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Amenorrhea, headaches, visual field loss, and muscular weakness can be symptoms of what?
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Acromegaly/gigantism
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What are the clinical points of acromegaly/gigantism?
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Head, hands, heart, high sugar
(all enlarged/elevated) |
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What tests should be run in suspicion of acromegaly/gigantism?
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IGF-1
Prolactin Glucose TSH Free T4 Calcium Phosphorus |
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A positive glucose challenge test will show no difference in glucose levels after how long?
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60 minutes
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Glucose inhibits or stimulates release of growth hormone?
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Inhibits
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What percentage of patients with acromegaly/gigantism will have hypertension?
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50%
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What percentage of patients with acromegaly/gigantism experience heart failure?
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10%
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What percentage of patients with acromegaly/gigantism will have diabetes?
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30%
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What percentage of patients with a pituitary adenoma reach remission with treatment?
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70%
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What is the primary approach for a pituitary adenoma?
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Surgery
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What is the surgical approach for a pituitary adenoma?
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Endoscopic transphenoidal approach
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What are the possible complications of surgery for pituitary adenoma?
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CSF leaks
Hyponatremia Infection |
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Cabergoline is what?
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Medication for pituitary adenoma
Dopamine agonist |
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Which drugs are somatostatin analogs?
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Octreotide
Lanreotide |
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Pegvisomant is what?
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Medication for pituitary adenoma
GH receptor antagonist |
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Which pituitary adenoma drug does not shrink the tumor?
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Pegvisomant
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What would be the 3rd line treatment for pituitary adenoma?
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Stereotactic radiation
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What symptoms persist after treatment for pituitary adenoma?
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Bony changes
Hypertension |
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What level of GH indicates a likely recurrence of a pituitary adenoma?
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Over 5 ng/ml
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What levels must be measured for life in a patient in remission from pituitary adenoma?
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GH
IGF-1 |
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Chronic circulating glucocorticoids are associated with what?
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Cushing's syndrome
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What are the two main types of Cushing's syndrome?
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Spontaneous
Iatrogenic |
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What is the prevalence of Cushing's syndrome in the US?
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2-4 per million
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Cushing's Syndrome is much more common in females or males?
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Females
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What are the two types of spontaneous Cushing's syndrome?
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ACTH dependent
ACTH independent |
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What causes 68% of ACTH dependent spontaneous Cushing's?
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Primary pituitary adenoma
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What causes 15% of ACTH dependent spontaneous Cushing's?
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Ectopic ACTH secretion
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What generally causes ACTH independent spontaneous Cushing's?
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Adrenal cortisol-secreting tumor
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What is the usual age range for diagnosis of Cushing's syndrome?
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20-40
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Central/truncal obesity and peripheral wasting are indicative of what?
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Cushing's syndrome
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Moon facies, easy bruising, delayed healing, thin skin, and striae are indicative of what?
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Cushing's syndrome
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What percentage of Cushing's syndrome patients experience depression?
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50-80%
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What are the tests for Cushing's syndrome?
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24 hr free urine cortisol
Dexamethasone suppression test |
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What will happen to the cortisol level in a normal patient undergoing the dexamethasone suppression test?
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Morning cortisol surge will be suppressed
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Pituitary ACTH-secreting adenomas arise from where?
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Basophilic corticotroph cells
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What is the usual size for pituitary ACTH-secreting adenomas?
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Less than 10 mm in diameter
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What leads to diffuse hyperplasia of the adrenal cortices?
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Excess ACTH
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What are the hormonal effects of microadenomas?
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Galactorrhea
Menstrual irregularities Infertility Decreased bone density |
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What are the mass effects of macroadenomas?
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Visual disturbances
Headaches Cranial nerve troubles |
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Dopamine inhibits what?
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Release of PRL from anterior pituitary
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Hypothalamic tumors, lactation, acromegaly, and Cushing's syndrome are causes of what?
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Hyperprolactinemia
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What drugs can cause hyperprolactinemia?
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Dopamine receptor antagonists
SSRIs Verapamil Opioids |
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What are 3 dopamine agonists?
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Cabergoline
Bromocriptine Pergolide |
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What are the first line treatments for hyperprolactinemia?
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Stop meds known to cause elevated PRL
Oral contraceptives for women Testosterone for infertile men Dopamine agonists |
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What percentage of patients with hyperprolactinemia treated with dopamine agonists show return to normal PRL levels?
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90%
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What are the 2nd & 3rd line treatments for hyperprolactinemia?
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Surgery
Radiation |
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Diabetes insipidus is characterized by what?
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Deficient ADH (AVP)
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What are the two main types of diabetes insipidus?
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Central
Nephrogenic |
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What are the prominent symptoms of diabetes insipidus?
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Polyuria
Polydipsia (ice water) |
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What is the hallmark of diabetes insipidus?
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Dilute urine
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How would you determine dilute urine?
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Specific gravity is very low
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Causes of excessive thirst/urination can be what (other than diabetes insipidus)?
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DM I or II
Primary polydipsia Lithium Nocturia of Parkinson's disease |
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What hormone conserves water in the kidney?
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ADH
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What will serum sodium be in diabetes insipidus?
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Normal or high
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Why are sodium levels sometimes high in diabetes insipidus?
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ADH enables patient to lose water through activated aquaporins without losing other solutes
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What is the treatment for diabetes insipidus?
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Replacement with Desmopressin
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What is diabetes insipidus' opposing disorder?
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SIADH
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What kind of traits are MEN1 and MEN2?
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Inherited, autosomal dominant traits
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MEN1 and MEN2 convey predisposition to develop what?
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Endocrine tumors
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MEN I is what syndrome?
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Werner's syndrome
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MEN 2a is what syndrome?
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Sipple's syndrome
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Werner's syndrome arises from mutations in what?
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Menin gene on chromosome 11
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67% of Werner's syndrome patients have what?
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Hyperparathyroidism
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What percentage of Werner's syndrome patients have enteropancreatic tumors?
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90%
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What percentage of Werner's syndrome patients have gastrinomas?
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35%
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What cancer is present in over 90% of MEN 2a & 2b patients?
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Medullary thyroid cancer
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Bilateral pheochromocytomas are present in what percentage of MEN 2a & 2b patients?
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About 30%
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What percentage of MEN 2b patients have mucosal neuromas?
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over 90%
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Prophylactic total thyroidectomies are often necessary in what disease?
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MEN
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What is the most common pituitary disorder?
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Prolactinoma
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What is the most common anterior pituitary disorder?
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Hyperprolactinemia
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Why is hypogonadism a common feature of acromegaly/gigantism?
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Overproduction of ACTH inhibits GnRH, so you don't get GnRH's effects
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