Questions and Answers
Which of the following is a cause of anterior pituitary hypofunction?
What diagnostic method is used for anterior pituitary hypofunction?
Which of the following is associated with prolactin deficiency?
Which of the following is NOT a cause of anterior pituitary hypofunction?
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Which imaging study is mentioned for the diagnosis of anterior pituitary hypofunction?
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What is the primary function of the hypothalamus?
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Which hormone is responsible for stimulating milk production?
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Which gland is referred to as the hypophysis?
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What is the function of anti-diuretic hormone (ADH)?
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What connects the hypothalamus to the pituitary gland?
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Which of the following hormones is known to inhibit the release of prolactin (PRL)?
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Which part of the pituitary gland accounts for about 75% of the total weight?
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What does the corticotropin releasing hormone (CRH) stimulate the release of?
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What is the primary function of the hypophyseal portal system?
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Which hormone is stored and released from the neurohypophysis but synthesized in the hypothalamus?
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Which anterior pituitary cell type secretes Adrenocorticotropic Hormone (ACTH)?
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What role does oxytocin play after the delivery of a baby?
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In which nuclei of the hypothalamus is Antidiuretic hormone (ADH) synthesized?
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Which factor increases the secretion of ADH?
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Which hormone is negatively regulated by dopamine?
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Which hormones are released by gonadotrophs?
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What is a common cause of Cushing's disease?
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Which tumour is derived from developmental processes and is benign but increases in size due to fluid accumulation?
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Which of the following is a clinical feature of hyperprolactinaemia in men?
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Which condition is life-threatening due to partial or complete deficiency of pituitary hormones?
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What is the primary treatment option for a craniopharyngioma to prevent its recurrence?
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What happens if a large pituitary tumour extends upwards?
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Which symptom is NOT typically associated with Cushing's disease?
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What is a common cause of acromegaly?
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Which disorder is characterized by an increase in size due to cholesterol-rich fluid accumulation?
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What is a sign of raised intracranial pressure resulting from hypothalamic disease?
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Study Notes
Anterior Pituitary Hypofunction
- Causes: postpartum haemorrhage (Sheehan's syndrome), pituitary tumours, trauma, radiotherapy, infarction, infiltration, and infections
- Diagnosis: hormone assays (basal or stimulation tests) and imaging studies (e.g., CT scans)
Prolactin Deficiency
- Characterized by low serum prolactin levels
- May be caused by anterior pituitary hypofunction
The Hypothalamus and Pituitary Gland
- The hypothalamus is the major integrating link between the nervous and endocrine systems
- The hypothalamus receives input from the cortex, thalamus, limbic system, and internal organs
- The hypothalamus controls the pituitary gland with different releasing and inhibiting hormones
- The hypothalamus produces releasing hormones, inhibiting hormones, oxytocin, and antidiuretic hormone (vasopressin)
- The hypothalamus and pituitary gland regulate growth, development, metabolism, and homeostasis
Hormones of the Hypothalamus
- Thyrotropin-releasing hormone (TRH): stimulates release of TSH
- Gonadotropin-releasing hormone (GnRH): stimulates release of FSH and LH
- Growth hormone-releasing hormone (GHRH): stimulates release of GH
- Somatostatin (SMS) or GHIH: inhibits release of GH and other hormones
- Corticotropin-releasing hormone (CRH): stimulates release of ACTH
- Dopamine or PIH: inhibits release of PRL
- Prolactin-releasing hormone (PRH): stimulates milk production
- Anti-diuretic hormone (ADH): stimulates water reabsorption in the renal tubule, muscle contraction, and decreases plasma osmolality
- Oxytocin: stimulates milk ejection and uterine contractions during labour
The Pituitary Gland
- The hypothalamus mainly controls the pituitary gland (hypophysis)
- The pituitary gland hangs down from the hypothalamus on a stalk called the infundibulum
- The gland is divided into an anterior pituitary (adenohypophysis) and a posterior pituitary (neurohypophysis)
- The anterior pituitary accounts for about 75% of the total weight of the gland
- The pituitary gland supplies blood to the anterior pituitary gland
Disorders of the Hypothalamus
Hypothalamic Tumours
- Causes: craniopharyngioma, pituitary tumours, and other tumours
- Effects: delayed puberty, small stature, anorexia nervosa
Disorders of the Pituitary Function
Anterior Pituitary Hyperfunction
- Causes: adenomas (macro and microadenomas), other tumours, infiltrations, and vascular disease
- Effects: hyperprolactinaemia (prolactin), Cushing's disease (ACTH), acromegaly (GH), and gigantism (GH)
Anterior Pituitary Hypofunction
- Causes: deficiency of a pituitary hormone (partial or complete deficiency), hypopituitarism
- Effects: prolactin deficiency, FSH and LH deficiency, GH deficiency, TSH deficiency, ACTH deficiency, and life-threatening conditions
Disorders of the Hypothalamus - Tumours
Craniopharyngioma
- Characteristics: benign, derived from developmental process, and may increase in size due to cholesterol-rich fluid accumulation
- Effects: space-occupying lesion, hypothalamic hormone deficiency
- Treatment: surgical excision of the cyst and irradiation to prevent recurrence
Pituitary Tumours
- Effects: compression of the hypothalamus, leading to hormone deficiencies
Other Tumours
- Effects: involvement of the hypothalamus, leading to hormone deficiencies
Craniopharyngioma
- Characteristics: type of tumour located near the pituitary gland, benign, and may increase in size due to fluid accumulation
- Effects: space-occupying lesion, hypothalamic hormone deficiency
- Treatment: surgical excision of the cyst and irradiation to prevent recurrence
Effects of Hypothalamic Disease
- Expanding lesions result in increasing hypothalamic dysfunction
- Large space-occupying lesions result in symptoms and signs of raised intracranial pressure
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Description
This quiz covers the causes and diagnosis of anterior pituitary hypofunction, including Sheehan's syndrome, pituitary tumors, and hormone assays. Test your knowledge of this important endocrine topic!