Two Questions Help Please

[coreytayloris]

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Hey,
just have two queries I need answered that i've encountered during exam prep...

1. Firstly, one past question on the exam ''4 hormones you would give to treat a boy with hypopituitarism and hypogonadism.''

the official answer was that you would give :

GH – normal growth: acts on liver to produce IGF-1; protein anabolism; protein synthesis; CHO and lipid metabolism.
LH – act on Leydig cells to secrete testosterone (male 2 sexual characteristics)
ACTH – acts on adrenal cortex (zona fasiculata) to produce glucorticoids
TSH – acts on thyroid gland to produce thryoxine and triiodothyronine. Involved in controlling the metabolic rate and influencing physical development.


(an upperclass man gave me this answer as he said said he reviewed his paper and thats how he saw it - we cant actually get past papers through official channels)

(I assume you could have given prolactin or fsh aswell though!!??? edit - maybe not prolactin actually?)

however is this right?
if you had a boy with hypopituitarism would you not just directly give him - cortisol, testosterone, thyroid hormones, and IGF 1 ???? or is it ok to give him LH,GH, ACTH and TSH?

2. Ok, another previous question that has come up has been pathogenesis/pathophysiology of skin Ulcer (diabetic and in general)

but i cannot find the answer anywhere (in any pathology book i look in. obviously skin is sloughed off, but surely there's more to it than just that) anyone know the answer???

Thanks all
any help much appreciated 🙂

 

[coreytayloris]

anyone
??

 

[sineapse]

Hey,
just have two queries I need answered that i've encountered during exam prep...

1. Firstly, one past question on the exam ''4 hormones you would give to treat a boy with hypopituitarism and hypogonadism.''

the official answer was that you would give :

GH – normal growth: acts on liver to produce IGF-1; protein anabolism; protein synthesis; CHO and lipid metabolism.
LH – act on Leydig cells to secrete testosterone (male 2 sexual characteristics)
ACTH – acts on adrenal cortex (zona fasiculata) to produce glucorticoids
TSH – acts on thyroid gland to produce thryoxine and triiodothyronine. Involved in controlling the metabolic rate and influencing physical development.


(an upperclass man gave me this answer as he said said he reviewed his paper and thats how he saw it - we cant actually get past papers through official channels)

(I assume you could have given prolactin or fsh aswell though!!??? edit - maybe not prolactin actually?)

however is this right?
if you had a boy with hypopituitarism would you not just directly give him - cortisol, testosterone, thyroid hormones, and IGF 1 ???? or is it ok to give him LH,GH, ACTH and TSH?

2. Ok, another previous question that has come up has been pathogenesis/pathophysiology of skin Ulcer (diabetic and in general)

but i cannot find the answer anywhere (in any pathology book i look in. obviously skin is sloughed off, but surely there's more to it than just that) anyone know the answer???

Thanks all
any help much appreciated 🙂

1.) Yes, depends on the degree of pituitary dysfunction I guess. Hypopituiarism would suggest a decreased amount of hormones being produced, not total dysfunction.
2.) Ulcerrr = Break in the continuity of surface epithelium!

Arterial ulcer = Tissue hypoxia and necrosis!
Venous ulcer = Increased hydrostatic pressure and usually a bit of trauma = pop! Ulcer!
Diabetic ulcer = Crappy blood vessels and poor oxygenation = ischaemic necrosis!
Syphilitic chancre = Papi Goljan taught me that this is actually an ischaemic ulcer (hence it being painless) because of the vasculitis that syphilis causes.
Don't forget your standard apthous ulcer (vitamin deficiency, stress etc)

 

[PMPMD]

Wouldn't you also need ADH/vasopressin if the patient has panhypopituitarism (including posterior pituitary)?