Endocrine Pituitary Hormones
Terms
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- the most common secretory pituitary tumor
- Prolactinomas
-
what do these symptoms suggest?
amenorrhea
galactorrhea
infertility
Vaginal dryness
Hot flashes - prolactinoma; usually micro in women
- symptoms of prolactinoma in men
-
decrease libido
impotence
visual impairment
headache - how do you dianose a prolactinoma
- prolactin levels >200 ng/mL
- which is the most sensitive test for detecting pituitary tumors and determining their size
- MRI
- What is the treatment of prolactinomas?
-
Dopamine agonist
Trans – sphenoidal surgery
Used when the patient has visual field abnormalities or neurologic Sx - what causes gigantism and acromegaly?
- hyper secretion of GH
- what are the features of acromegaly
-
Widening of the hands and feet
Coarsening of the facial features
Frontal sinuses enlargement - what is the initial Tx of choice for acromegaly
- Trans-sphenoidal microsurgery is the initial Tx of choice
- where does 85% of T3 come from?
- its converted from T4 in the tissues, liver, muscle, and kidney
- what has a negative effect on TSH release
- free T4
- name some causes of hyperthyroidism
-
Graves disease
Toxic multinodular goiter
Toxic solitary goiter
results in excess circulating T4 or T3 - what are the signs and symptoms of Graves disease
-
Diffuse goiter
Pretibial myxoedema
Tachycardia with a bounding pulse
Exophthalmos
Lid lag (usually on downward eye movement)
Lid retraction
Peri-orbital puffiness
Increased lacrimation
Conjunctival edema and ulceration - atrial fib, heart failure and weight loss in a pt over 60, what do you suspect?
- Think hyperthyroidism
- how do you treat hyperthyroidism?
-
Anti-thyroid drugs:
Carbimazole or methimazole followed by propylthiouracil
Beta-blocking drugs in the initial stages of management
Sub-total thyroidectomy
Radioactive iodine therapy
Tx is based on pt age and history - name the hormones of the drendal gland
-
Cortisol
Aldosterone
Norepinephrine - Name the hormones produced by the ovaries
-
Estrogen
Progestrone
Testosterone - what is the half-life of peptide hormones
- only a few minutes
- how are steroid hormones eliminated from the body?
- by inactivating metabolic transformations and excretion in urine or bile
- name 2 hormones derived from Amino Acid
-
Thyroid hormones: T3,T4
Catecholamines: epinephrine and norepinephrine - what is the half-life of thyroid hormones
- a few days
- what is the half-life of catecholamines
- they are rapidly degraded, only a few minutes
- name two amino acids needed to synthesize serotonin and histamine
-
Tryptophan is the precursor to serotonin and melatonin
Glutamic acid is converted to histamine - what class of hormones are prostaglandins, prostacyclins, leukotrienes and thromboxanes
- Fatty Acid Derivatives - Eicosanoids
- what is the most abundant precursor for eicosanoid hormones
- Arachadonic acid
- what is the major role of growth hormone
- to stimulate the liver and other tissues to secrete IGF-I
- what does IGF-I do?
- stimulates proliferation of chondrocytes, resulting in bone growth
- What class of hormones are catecholamines and thyroxine
- Amines, derived from amino acids
- what class of hormones are insulin and growth hormone
- Peptide hormones
- what class of hormones are testosterone and cortisol
- fatty acid derivatives
- This hormone stimulates development of corpus luteum, release of oocyte, and production of estrogen and progesterone
- LH
- This hormone stims. the production of testosterone in males
- LH