1. Describe pituitary change during pregnancy
    • Estrogen causes an increase in size
    • Hypertrophy and hyperplasia
  2. Which park is must susceptible to trauma?
    The stalk - may rupture
  3. What is Sheehan's Syndrome?
    • Circulatory collapse secondary to severe hemorrhage at parturition
    • Reduction in blood supply causes pituitary necrosis
    • Often, gland restored with time
  4. How are breast cancers dangerous to the pituitary?
    Often metastasize to pituitary - rapid growth under prolactin influence
  5. Types of pituitary tumors
    • Chromophobe tumors (most common)
    • Acidophilic tumors
    • Basophilic tumors (least common)
  6. What is Multiple Endocrine Neoplasia?
    Genetic disease where patients develop cancers in one or more hormone-producing organs
  7. Signs/symptoms of pituitary tumors
    • Loss of visual fields (upper temporal first)
    • Headache
    • Excessive hormone secretion
    • Loss of pituitary function
  8. Identify disease states caused by excess of the hormone:

    1. Growth Hormone
    2. ACTH
    3. Prolactin
    • 1. Acromegaly, gigantism
    • 2. Cushing's disease
    • 3. Galactorrhea - amenorrhea syndrome
  9. Do pituitary tumors metastasize?
    • Yes, rarely
    • Pituitary carcinoas
  10. Where does ADH act?
    • Acts on distal tubule and collecting duct
    • Increases permeability to water
  11. How is ADH release regulated?
    • Osmoreceptors in hypothalamus
    • Volume receptors in left atrium
  12. Describe transport and storage of oxytocin and ADH
    • Transported down neurohypophyseal tract as inactive precursors
    • Cleaved to generate ADH or oxytocin
    • Stored in Herring bodies for release
  13. How do neurotransmitters control ADH secretion?
    • Norepinephrine - inhibits ADH release
    • Acetylcholine - stimulates ADH release
  14. Types of Diabetes Insipidus
    • Neurohypophyseal DI
    • Nephrogenic DI
    • Phychogenic Polydipsia
  15. Describe Neurohypophyseal DI
    • Partial or complete lack of ADH secretion
    • Hypovolemia, hyperosmolality, hypernatremia
    • Treat with ADH therapy
  16. Describe Nephrogenic DI
    • Partial or complete lack of ADH action (renal disease)
    • Caused by congenital ADH insensitivity or nephropathy
  17. Describe Psychogenic Polydipsia
    • Compulsive water drinking
    • Caused by functional disturbance in thirst mechanism
    • Causes washout effect - impairs short term ability of kidney to concentrate urine
  18. Treatment for Diabetes Insipidus
    • Neuro - give exogenous ADH or drugs which increase ADH effect
    • Nephro - give Thiazides to reduce free water clearance
Card Set