Podcast
Questions and Answers
What is the main purpose of the pituitary gland?
What is the main purpose of the pituitary gland?
- To regulate body temperature
- To control blood pressure
- To control the activity of many other endocrine glands (correct)
- To produce hormones for the nervous system
What percentage of the pituitary gland's total weight is made up of the anterior lobe?
What percentage of the pituitary gland's total weight is made up of the anterior lobe?
- 100%
- 50%
- 90%
- 75% (correct)
What is the function of the posterior lobe of the pituitary gland?
What is the function of the posterior lobe of the pituitary gland?
- To produce hormones
- To store and release hormones produced by the hypothalamus (correct)
- To regulate body growth
- To control the activity of other endocrine glands
Which hormone is produced by the anterior pituitary and stimulates the adrenal cortex?
Which hormone is produced by the anterior pituitary and stimulates the adrenal cortex?
What is the term for hormones produced by the anterior pituitary that stimulate other glands to release hormones?
What is the term for hormones produced by the anterior pituitary that stimulate other glands to release hormones?
What is the location of the pituitary gland?
What is the location of the pituitary gland?
What is the result of GH hypersecretion before the closure of the epiphyseal plates?
What is the result of GH hypersecretion before the closure of the epiphyseal plates?
What is the most common hormone produced in excess in hyperpituitarism?
What is the most common hormone produced in excess in hyperpituitarism?
What is the age range in which Acromegaly usually develops?
What is the age range in which Acromegaly usually develops?
What is a common symptom of Acromegaly?
What is a common symptom of Acromegaly?
What is an investigation used to diagnose Acromegaly?
What is an investigation used to diagnose Acromegaly?
What is a complication of Acromegaly?
What is a complication of Acromegaly?
What is a question that can be asked during history taking in a suspected case of Acromegaly?
What is a question that can be asked during history taking in a suspected case of Acromegaly?
What is another name for Acromegaly when it occurs in childhood?
What is another name for Acromegaly when it occurs in childhood?
What is the goal of adrenal-directed inhibition of steroidogenesis in treating Cushing disease?
What is the goal of adrenal-directed inhibition of steroidogenesis in treating Cushing disease?
What is the primary use of mifepristone in treating Cushing syndrome?
What is the primary use of mifepristone in treating Cushing syndrome?
What is the normal range for prolactin levels?
What is the normal range for prolactin levels?
What is a common symptom of hyperprolactinemia in women?
What is a common symptom of hyperprolactinemia in women?
What is a common cause of hyperprolactinemia?
What is a common cause of hyperprolactinemia?
What is the typical treatment approach for microprolactinomas?
What is the typical treatment approach for microprolactinomas?
What is the primary reason for performing a pregnancy test in diagnosing hyperprolactinemia?
What is the primary reason for performing a pregnancy test in diagnosing hyperprolactinemia?
What is the typical diagnosis threshold for hyperprolactinemia?
What is the typical diagnosis threshold for hyperprolactinemia?
What is measured in the insulin stimulation test?
What is measured in the insulin stimulation test?
Why may the insulin stimulation test cause discomfort to patients?
Why may the insulin stimulation test cause discomfort to patients?
What is the goal of growth hormone replacement therapy?
What is the goal of growth hormone replacement therapy?
What is monitored during growth hormone replacement therapy?
What is monitored during growth hormone replacement therapy?
What is SIADH?
What is SIADH?
What is the location of the nuclei that produce ADH in SIADH?
What is the location of the nuclei that produce ADH in SIADH?
What is the purpose of radiological tests in diagnosing growth hormone deficiency?
What is the purpose of radiological tests in diagnosing growth hormone deficiency?
How often is the growth hormone replacement therapy administered?
How often is the growth hormone replacement therapy administered?
What is associated with the disappearance of symptoms and improvement of general wellbeing?
What is associated with the disappearance of symptoms and improvement of general wellbeing?
What is the primary choice of treatment for Acromegaly?
What is the primary choice of treatment for Acromegaly?
What is the purpose of dopamine agonists in treating Acromegaly?
What is the purpose of dopamine agonists in treating Acromegaly?
What is a potential complication of radiation therapy for Acromegaly?
What is a potential complication of radiation therapy for Acromegaly?
What is the mode of action of Pegvisomant in treating Acromegaly?
What is the mode of action of Pegvisomant in treating Acromegaly?
What is a symptom of Acromegaly?
What is a symptom of Acromegaly?
What is Somatostatin in the context of Acromegaly?
What is Somatostatin in the context of Acromegaly?
What is a contraindication for surgery in treating Acromegaly?
What is a contraindication for surgery in treating Acromegaly?
Study Notes
Pituitary Gland Anatomy
- Located at the base of the brain, in a small depression of the sphenoid bone (sella turcica)
- Has two lobes: anterior lobe (accounts for 75% of total weight) and posterior lobe
- Anterior lobe: glandular tissue, controlled by regulating hormones from the hypothalamus
- Posterior lobe: nerve tissue, stores hormones produced by the neurosecretory cells in the hypothalamus
Pituitary Gland Hormones
- Anterior Pituitary hormones:
- GH: growth hormone
- ACTH: adrenocorticotropic hormone
- TSH: thyroid-stimulating hormone
- PRL: prolactin
- FSH: follicle-stimulating hormone
- LH: luteinizing hormone
- MSH: melanocyte stimulating hormone
- Posterior Pituitary hormones:
- ADH: anti-diuretic hormone (vasopressin)
- OT: oxytocin
Pituitary Disorders
- Hyperpituitarism: excessive hormone production, usually only one hormone is produced in excess
- Hypopituitarism: hormone deficiency
- Manifestations of the cause, e.g.: local compression of brain tissue by expanding tumor
Acromegaly and Gigantism
- Acromegaly: over secretion of GH in adulthood, leading to coarsening of facial features, enlarged hands and feet, and other symptoms
- Gigantism: GH hypersecretion before the closure of the epiphyseal plates (childhood), resulting in abnormally tall stature
- Symptoms of acromegaly: coarsening of facial features, enlarged hands and feet, prognathism, carpal tunnel syndrome, excessive sweating, and others
Diagnosis
- History and physical exam
- Investigations: GH analysis, prolactin levels, MRI or CT, and visual field tests
Treatment
- Surgery (primary choice)
- Radiotherapy
- Drug treatment: dopamine agonists, somatostatin, and pegvisomant
- Aim of treatment: reduce GH levels to normal, alleviate symptoms, and improve general wellbeing
Hyperprolactinemia
- Normal prolactin level: less than 20 nanograms per milliliter
- Symptoms: galactorrhoea, oligomenorrhoea or amenorrhoea, reduced libido, and pressure effects
- Causes: prolactinoma, pregnancy, stress, low thyroid function, and certain medications
- Diagnosis: serum prolactin level, pregnancy test, laboratory tests, and radiological tests
- Treatment: replacing growth hormone, injection of replacement hormone, and monitoring for side effects
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