5. Clinical Pituitary And Adrenal

Question 1

What are the two treatments for prolactinoma

Answer 1

Bromocriptine, cabergoline

Question 2

Analog of ACTH, what is it used for

Answer 2

DDAP, used to treat central diabetes insipidis

Question 3

Tx for nephrogenic DI

Answer 3

Thiazide diuretics, paradoxical effect

Question 4

Supraclavicular fat pad is seen in which disorder?

Answer 4

Cushings

Question 5

Order of dosings for test of cushings

Answer 5

Overnight, low, high

Suppression tells you it’s pituitary tumor - cushings disease
No suppression with high Dex tells you it’s Cushing’s syndrome (either adrenal tumor or ectopic secretion of ACTH from lungs, pancreas, thymus)

Question 6

Treatment for cushings disease (surgery)

Answer 6

Transfrontal resection
Transsphenoidal microsurgery
Bilateral adrenalectomy (what can this result in?)

ANS: Nelson syndrome

Question 7

Three organ sources for ectopic Cushing’s syndrome

Answer 7

Lungs pancreas thymus

Question 8

Addison’s disease - what is it

Answer 8

Autoimmune. Antibodies against adrenal cortex –> decreased cortisol and aldosterone

Question 9

Addison’s disease features

Answer 9

Hypotension, salt wasting, hyperpigmentation, hyponatremia, hyperkalemia, positive anti adrenal antibodies

Question 10

Tx for Addisons

Answer 10

DDAP, lV hydrocortisone, florinef (aldosterone)

Question 11

Florinef

Answer 11

Aldosterone

Question 12

21 hydroxylase deficiency causes what

Answer 12

Increased sex hormones, decreased cortisol and aldosterone

Hirsutism, amenorrhea, salt wasting, hyperpigmentation

Question 13

Difference between pituitary dwarfism and achondroplasia dwarfism (symptom)

Answer 13

Achondroplasia: normal trunks, short limbs
Pituitary: proportional everything