4th Year Pituitary Flashcards
what is a bizarre phenomena in Cushing’s?
OP + obesity
what does ACTH produce
cortisol
aldosterone
testosterone
MSH
what causes pigmentation in Addison’s?
MSH
order of panhypopituitarism
GGAT
diagnosis of prolactinoma?
pregnancy test
measure prolactin
check drugs (PPIs, antipsychotics)
what else lower prolactin?
menopause
dopamine agonists
presentation of acromegaly?
change in voice
what is affected in diabetes insipidus?
ADH V2 receptor > aquaporin translocation
normal osmolality?
275-295mOsm/kg
how to calculate osmolality?
2 x [Na+]
what does too little ADH cuase?
large volume of very dilute urine
thirst
dehydration
diagnosis of DI
water deprivation test
water deprivation result in DI
cranial will concentrate
nephrogenic will have no effect
what to think if ambiguous water deprivation test result
psychogenic polydipsia
drugs that cause excess drinking e.g. tricyclics
management of cranial DI
desmopressin
management of nephrogenic DI
correct electrolytes
thiazides
what can cause nephrogenic DI?
lithium
what is SiADH?
too much ADH being secreted from neoplasms, infections, drugs, V2 receptor hereditary, etc.
drugs that cause SiADH
desmopressin oxytocin SSRIs antipsychotics antiepileptics
presentation of SiADH
confusion
lethargy
norovolaemic
management of SiADH
correct sodium
high salt
demeclocycline
tolvaptan
what to be careful of when correcting sodium?
central pontine myelinolysis
how to avoid central pontine myelinolysis?
no more than an increase of 8mmol/l per 24 hours
presentation of central pontine myelinolysis
dysphagia paresis dysarthria diplopia LOC
what is demeclocycline?
antibiotic that uncouples V2
what is tolvaptan
V2 antagonist
removes water without sodium
FSH and LH in postmenopause
very high
what is craniopharyngioma?
cystic lesion
