Term
| What are the six major hormones produced by the anterior pituitary? |
|
Definition
| Follicule-Stimulating Hormone, Luteinizing Hormone, Adrenocorticotrophic Hormone, Thyroid Stimulating Hormone, Prolactin, Growth Hormone |
|
|
Term
| Is the posterior pituitary a gland? |
|
Definition
| the posterior pituitary gland is not a gland, per se; rather, it is largely a collection of axonal projections from the hypothalamus that terminate behind the anterior pituitary gland. These axons release peptide hormones into the capillaries of the hypophyseal circulation. |
|
|
Term
| What hormones are secreted from the posterior pituitary? |
|
Definition
Oxytocin and Vasopressin
Hormones known classically as posterior pituitary hormones are synthesized by the hypothalamus. They are then stored and secreted by the posterior pituitary into the bloodstream. |
|
|
Term
| Insufficient secretion of vasopressin causes? |
|
Definition
| diabetes insipidus, a condition in which the body loses the capacity to concentrate urine. |
|
|
Term
| Oversecretion of vasopressin causes? |
|
Definition
| the syndrome of inappropriate antidiuretic hormone (SIADH). |
|
|
Term
| another name for the posterior pituitary? |
|
Definition
|
|
Term
| Where is Prolactin produced? |
|
Definition
| in the anterior pituitary by lactotrophs |
|
|
Term
| What is the most common form of pituitary hormone hypersecretion? |
|
Definition
|
|
Term
| Name 5 major etiologies of hyperprolactinemia |
|
Definition
| Neoplastic, Iatrogenic, Traumatic, Metabolic and Physiologic |
|
|
Term
| what is a Neoplastic Origin of hyperprolactinemia? |
|
Definition
| Prolactin-secreting pituitary adenoma, also termed a prolactinoma, these tumors can be classified as either macroadenomas or microadenomas depending on their size. |
|
|
Term
| What is an Iatrogenic Origin of hyperprolactinemia |
|
Definition
| Drug-induced prolactinemia; mostly dopamine antagonists, anti-depressants, H2 blockers and estrogens |
|
|
Term
| What is the etiology of Traumatic Origin hyperprolactinemia? |
|
Definition
| Two major etiologies are known. 1) Hypothalamic or pituitary stalk injury, especially that which injuries the dopaminergic fiber system; 2) Chest wall injuries or irritation such as herpes zoster |
|
|
Term
| What is the Metabolic Origin of hyperprolactinemia |
|
Definition
| Three major etiologies are described. 1) Hypothyroidism due to thyroid failure will elevate levels of TSH, which in turn, stimulate the release of prolactin, 2) Renal failure and 3) Hepatic failure (cirrhosis) |
|
|
Term
| What are the most common form of pituitary tumor? |
|
Definition
| Prolactinomas, they occur most often in females (10:1 ratio) age 20-50. |
|
|
Term
| Major presenting signs of hyperprolactinemia in Women? |
|
Definition
| Amenorrhea, Galactorrhea, Infertility |
|
|
Term
| Major presenting signs of hyperprolactinemia in men? |
|
Definition
| Impotance, Loss of libido, Infertility |
|
|
Term
| When treating hyperprolactinemia with medication, what class of medications are used to normalize prolactin levels? |
|
Definition
|
|
Term
| Some examples of dopamine agonists used to treat hyperprolactinemia are? |
|
Definition
Parlodel (bromocriptine)
Dostinex (cabergoline) |
|
|
Term
| Most common causes of panhypopituitarism? |
|
Definition
| pituitary tumors and surgical or radiotherapeutic ablation (Note: anterior pituitary hormone deficiencies are also seen in many individuals following traumatic brain injury) |
|
|
Term
| S/S of Cortisol deficiency |
|
Definition
| fatigue, weakness, headache, anorexia, weight loss, nausea, vomiting, abdominal pain, and altered mental activity; hyperpigmentation, orthostatic hypotension, loss of axillary and pubic hair |
|
|
Term
| S/S of Thyroid deficiency |
|
Definition
| fatigue, weakness, inability to lose weight (or weight gain), puffiness, constipation, and cold intolerance; impaired memory or altered mental activity is characteristic of severe hypothyroidism, bradycardia, periorbital puffiness, and delayed relaxation of tendon reflexes; hyponatremia and normochromic, normocytic anemia |
|
|
Term
| S/S of Gonadotropin deficiency in men |
|
Definition
| Men: decreased libido and erectile dysfunction; the volume of ejaculate may be decreased and hot flashes may occur; diminished facial and body hair, fine facial wrinkles, gynecomastia, and soft testes are characteristic of long-standing (years) hypogonadism |
|
|
Term
| S/S of Gonadotropin deficiency in women |
|
Definition
| Women: alterations in menstrual function ranging from regular but anovulatory cycles to oligomenorrhea or amenorrhea; hot flashes, decreased libido, vaginal dryness, and dyspareunia. Pubic and axillary hair is present unless there is concomitant adrenal failure |
|
|
Term
| S/S of Growth hormone deficiency |
|
Definition
| lack of vigor, decreased tolerance of exercise, and decreased social functioning; the percentage of body fat is higher in growth hormone-deficient adults than in age-matched normal subjects; fine facial wrinkles may result from a deficiency of growth hormone as well as from hypogonadism |
|
|
Term
| S/S of Vasopressin deficiency |
|
Definition
| Polyuria and polydipsia with nocturia |
|
|
Term
| Pituitary adenomas are benign neoplasms that can be divided into what two major groups? |
|
Definition
| functional and non-functional |
|
|
Term
| Pituitary adenomas are also classified by size, microadenomas are less than ? mm in diameter |
|
Definition
|
|
Term
| What do you call the production of large amounts of very low specific gravity urine? |
|
Definition
|
|
Term
| The hallmark of (blank) is excessive fluid intake in the presence of a relatively normal or slightly elevated plasma osmolality (<284 mOsm/kg) and a large volume of markedly dilute urine. |
|
Definition
|
|
Term
| Excessive production of antidiuretic hormone (ADH) leads to the retention of fluid and hyponatremia. What is the name of this condition |
|
Definition
| Syndrome of Inappropriate ADH or SIADH. |
|
|
Term
| What is the most common cause of hospital-acquired hyponatremia and the most prevalent etiology of euvolemic hyponatremia in children? |
|
Definition
|
|
Term
| What etiology is the most common cause of SIADH |
|
Definition
| Most common cause is ectopic secretion by a tumor: Bronchogenic carcinoma, Small cell carcinoma. Tumors can produce ADH, this ectopic production does not respond to feedback control |
|
|
Term
| Rapid correction or overshooting correction of hyponatremia can lead to |
|
Definition
| central pontine myelinolysis |
|
|
Term
A 70-year old man, 5 day Hx of worsening headaches w/ vomiting and confusion. Hx:HTN,CAD,TIAs,warfarin, Hypotension unresponsive to pressors, Labs: FSH, LH, testosterone, prolactin, thyrotropin, thyroxine, IGF-, and cortisol were all low
Tests: cortisol responded to cosyntropin stimulation Dx? |
|
Definition
| Pituitary apoplexy (bleeding) of a non-secreting adenoma |
|
|
Term
| What is Pituitary apoplexy? |
|
Definition
| infarction or hemorrhage of the pituitary gland in the presence of a pituitary adenoma |
|
|
Term
| What is the Tx for pituitary apoplexy |
|
Definition
| Intravenous hydrocortisone and Levothyroxine if thyroxine levels are low |
|
|
Term
| What disorder results from postpartum pituitary infarction after severe hypotension secondary to massive blood loss |
|
Definition
|
|
Term
| Name the 2 portal venous systems of the body |
|
Definition
| hepatic portal system and the hypophyseal portal system |
|
|
Term
| This neurotransmitter inhibits the release of Prolactin |
|
Definition
|
|
Term
| Only this type of tumor can cause hypersecretion of a pituitary hormone |
|
Definition
|
|
Term
| Postpartum pituitary necrosis is also known as |
|
Definition
|
|
Term
| S/S of GH decrease in men |
|
Definition
| Men: decreased libido, erectile dysfunction, decreased ejaculate, muscle weakness, fatigue |
|
|
Term
| S/S of GH decrease in women (hypogonadism) |
|
Definition
| Women: altered menstrual function, hot flashes, decreased libido, breast atrophy, vaginal dryness, and dyspareunia |
|
|
Term
| Prolactin is secreted solely by these cells |
|
Definition
|
|
Term
|
Definition
| Insulin-like growth factor 1 (IGF-1) is mainly secreted by the liver as a result of stimulation by growth hormone (GH). |
|
|
Term
| another name for somatostatin is? |
|
Definition
| Somatostatin (also known as growth hormone-inhibiting hormone (GHIH) |
|
|
Term
| Where is somatostatin produced? |
|
Definition
| stomach, intestine, delta cells of the pancreas, hypothalamus |
|
|
Term
| What does somatostatin do? |
|
Definition
| somatostatin inhibits the secretion of growth hormone from somatotrope cells. |
|
|
Term
| Over production of growth hormone in children produces (blank) and in adults produces (blank). |
|
Definition
|
|
Term
| Intolerance to glucose accompanied by hypoinsulinemia secondary to the autoimmune destruction of beta-cells in the islets of the pancreas results in the clinical presentation this disease? |
|
Definition
|
|
Term
| Name 4 Long-term complications of Diabetes |
|
Definition
| Diabetic retinopathy, Diabetic neuropathy, Diabetic macro- and microvasculopathy, Diabetic nephropathy |
|
|
Term
| Impaired tolerance to glucose and hyperinsulinemia secondary to the development of resistance to the action of insulin constitutes this disease |
|
Definition
|
|
Term
| True or False: Gestational diabetes is a risk factor for the development of T2 DM in the future. |
|
Definition
|
|
Term
| What is Human placental lactogen (HPL)? |
|
Definition
| also called human chorionic somatomammotropin, is a polypeptide placental hormone. It modifies the metabolic state of the mother during pregnancy to facilitate the energy supply of the fetus. HPL has anti-insulin properties |
|
|
Term
| Normal increase in the physiologic levels of maternal insulin resistance during gestation stimulated in part by the increase in (blank and blank) |
|
Definition
| human chorionic somatomammotropin and estrogen |
|
|
Term
| This disorder presents with: Nausea and vomiting, Severe abdominal pain, Hypotension, Hypreglycemia and glucosuria, Hypovolemia, Tachycardia, Kussmaul respiration, Ketone breath, Lethargy and CNS depression evolving into coma |
|
Definition
|
|
Term
| What is the anion gap formula |
|
Definition
| = ( [Na+]+[K+] ) − ( [Cl−]+[HCO3−] ) |
|
|
Term
| why is the anion gap useful? |
|
Definition
| The anion gap is used to aid in the differential diagnosis of metabolic acidosis. |
|
|
Term
| What cause high anion gap metabolic acidosis? |
|
Definition
| MUDPILES: M-Methanol, U-Uremia (chronic renal failure), D-Diabetic ketoacidosis, P-Paraldehyde, I-Infection, Iron, Isoniazid, L-Lactic acidosis, E-Ethylene glycol, S-Salicylates |
|
|
Term
| what is Nonketotic hyperosmolar state? |
|
Definition
| Nonketotic hyperosmolar coma is a type of diabetic coma associated with a high mortality seen in diabetes mellitus type 2. Other commonly used names are hyperosmolar hyperglycemic nonketotic coma (HHNKC)[1] or hyperosmotic non-ketotic coma (HONKC). |
|
|
Term
| Why is there a relative absence of ketoacidosis in nonketotic hyperosmolar state? |
|
Definition
| Ketosis is absent because the presence of some insulin inhibits lipolysis, unlike diabetic ketoacidosis. |
|
|
Term
| Name 4 causes of hypercalcemia |
|
Definition
| Parathyroid-related disease, Vitamin D-related disease, Renal failure, Malignancy, High bone turnover |
|
|
Term
| What is Parathyroid Dependent Hypocalcemia? |
|
Definition
Hypocalcemia (total serum calcium <8.5mg/dL) due to the absence or reduction in the production
of parathyroid hormone (PTH).Loss of PTH can be either familial or acquired. |
|
|
Term
| What is Parathyroid-Independent Hypocalcemia? |
|
Definition
Hypocalcemia (total serum calcium <8.5mg/dL) in the presence of normal of elevated parathyroid
hormone. |
|
|
Term
| What is Parathyroid-Dependent Hypercalcemia? |
|
Definition
Hypercalcemia (>10.3 mg/dL) due to hyperparathyroidism results from the excessive secretion of
parathyroid hormone from the gland. |
|
|
Term
| What is Primary hyperparathyroidism? |
|
Definition
hyperparathyroidism results from the excessive secretion of
parathyroid hormone from the gland. |
|
|
Term
| Is primary hyperparathyroidism rare? |
|
Definition
| it is one of the most common endocrinopathies. |
|
|
Term
| This causes 75-80% of primary hyperparathyroidism |
|
Definition
| Parathyroid adenoma 75-80% |
|
|
Term
| the mnemonic S/S of Primary hyperparathyroidism is? |
|
Definition
| "stones, bones, abdominal groans and psychic moans". |
|
|
Term
|
Definition
| "Stones" refers to kidney stones, nephrocalcinosis, and diabetes insipidus (polyuria and polydipsia). These can ultimately lead to renal failure. |
|
|
Term
| what does "bones" refer to in hyperparathyroidism? |
|
Definition
| osteitis fibrosa cystica (pain, pathological fractures), osteoporosis, osteomalacia, and arthritis. |
|
|
Term
| What does "abdominal groans" refer to in hyperparathyroidism? |
|
Definition
| constipation, indigestion, nausea and vomiting, peptic ulcers and acute pancreatitis. |
|
|
Term
| What does "Psychic moans" refer to in hyperparathyroidism? |
|
Definition
| lethargy, fatigue, depression, memory loss, psychosis, ataxia, delirium, and coma |
|
|
Term
| What is Parathyroid-Independent Hypercalcemia? |
|
Definition
| Parathyroid-independent hypercalcemia is elevation of plasma calcium levels above >2 ng/L in a female and >3 ng/L in a male by means other than primary overproduction of parathyroid hormone. |
|
|
Term
| Defects in the synthesis of type 1 collagen produce skeletal abnormalities classified as? |
|
Definition
|
|
Term
| Fragile bones, Blue sclera and Early deafness are the presentation of? |
|
Definition
|
|
Term
| Impairment of osteoclast activity produces osteopetrosis, resulting in a diffuse skeletal sclerosis is called? |
|
Definition
|
|
Term
a reduction in bone density due to remodeling The WHO definition is a
bone density 2.5 standard deviations below the mean for young, adults of the same gender is called? |
|
Definition
|
|
Term
| (Blank) features rapid bone remodeling due to hyperactive osteoclasts. The result is disorganized deposition of new bone and marked skeletal deformities. |
|
Definition
|
|
Term
| What gene is involved in Paget's Disease |
|
Definition
| Receptor Activator of Nuclear factor-kB (RANK), a factor critical in controlling osteoclast function Increased number and function of the osteoclast; hyperresponsive to RANK ligand (RANKL) |
|
|
Term
Lack of vitamin D results in hypocalcemia and hypophosphatemia leading to faulty matrix
mineralization. When this occurs in children the resulting skeletal abnormalities are termed (blank) in children and (blank) in adults |
|
Definition
| “rickets” whereas if it happens in an adult it is termed “osteomalacia” |
|
|
Term
| Vitamin D deficiency results in hypocalcemia and a secondary (blank) |
|
Definition
|
|
Term
| What are the main effects of parathyroid hormone? |
|
Definition
| increase the concentration of plasma calcium by increasing the release of calcium and phosphate from bone matrix, increasing calcium reabsorption by the kidney, and increasing renal production of 1,25-dihydroxyvitamin D-3 (calcitriol), which increases intestinal absorption of calcium |
|
|
Term
| This is an autosomal dominant genetic syndrome of endocrine gland neoplasms. They arise from the APUD system of neuroendocrine cells. Involvement is typically seen in the parathyroid gland, pancreas and pituitary gland but may effect the adrenal gland as well as other tissues. |
|
Definition
| Multiple Endocrine Neoplasia Type 1 |
|
|
Term
This multiglandular disease appears to involve a mutation in the RET proto-oncogene on cell
populations that have neuroepithelial origins such as the C cells of the thyroid and the adrenal
medullary cells |
|
Definition
| Multiple Endocrine Neoplasia Type 2 |
|
|
Term
This is an autosomal recessive trait involving several endocrine glands and ectodermal
derivatives. manifestations include: Mucocutaneous candidiasis, Hypoparathyroidism, Adrenal insufficiency |
|
Definition
|
|
Term
| What gene is involved in Polyglandular Autoimmune Syndrome Type 1 |
|
Definition
| Gene involved is termed Autoimmune Regulator Gene (AIRE) and located on chromosome 21 |
|
|
Term
| What is the treatment for Mucocutaneous candidiasis present in PAST1 |
|
Definition
| Oral fluconazole and ketoconazole |
|
|
Term
| What is the treatment for Hypoparathyroidism associated with PAST1 |
|
Definition
Oral calcium and vitamin D
◦ In cases with coexisting malabsorption, tetany may occur and IV calcium gluconate and magnesium may be necessary |
|
|
Term
this syndrome has a polygenic inheritance pattern and may involve exposure of a susceptible person
to an autoimmune trigger. Manifestations involve primary adrenal insufficiency in combination with
either autoimmune hypothyroidism or type 1 diabetes mellitus or both. Additional diseases
presenting can involve: Celiac disease, Pernicious anemia, Primary hypogonadism, Myasthenia gravis |
|
Definition
| Polyglandular Autoimmune Syndrome Type 2 |
|
|
