Anterior pituitary

Acidophils --> produce ?

Prolactin and GH-secreting cells

" drink lactic acid to grow"

Posterior pituitary

Which hormones

Prolactinomas

~ microadenomas <1cm

Impinging: Nonsecretory pituitary adenomas, Craniopharyngeomas

Infarction: Sheehan syndrome, Sickle cell anemia

Histiocytosis X, hemochromatosis, irradiation, Autoimmune destruction

Prolactin-sparing hypopituitarism

cause?

Hypothalamic disorders/interruption of the pituitary stalk => decreased anterior pituitary hormones*

*except prolactin --> lack of inhibition (dopamin)

Stress, hypoglycemia, icreased [AA] (arginine)

Exercise, sleep (first 2 hrs)

oral clonidine

Insulin tolerance test--> hypoglycemia-->

GH> 20ng/mL (normal)

IGF-1*--> no diurnal variation

--> consistently elevated in GH excess

*only for ages >5 yrs

Other:1.random blood sample--> markedly [GH]_elevated

2.[GH]_nml--> fails to supress w Glucose

inhibitory

eg GNRH agonists

young woman < 45 presenting with possible early menopause

FSH >40IU/L on 2 separate occasions > 4weeks apart

Dx?

Pro-opio melanocortin --> translational cleavage =

ACTH + MSH + b - endorphin

Pt with hypernatremia

Low urine osmolarity

DDx

Diabetes insipidus

1.central--> inadequate ADH secretion

2.nephrogenic--> unresponsive renal tubules

Overnight H₂O deprivation test¹ + ADH²(vasopressin)

Nm=¹ [Osmol]_urine increases, ²No effect

central DI = ¹fail, ²[Osmol]_urine increases

nephrogenic DI = ^1,2 fail

relatively normovolemic Pt with hyponatremia

high [Na⁺]_urine /[Osmol]_urine

SIADH <--Lung-small cell ca, pancreatic adenoca, Intracranial tm,Interstitial lung disease,cerebral trauma,

Drugs: chlorpropamide