5.. Pituitary and Adrenal Disease Flashcards
Bitemporal hemianopia- which nerve involved
CNIII
Left side CNII palsy- eye position
Down and out
What is pit apoplexy and what can cause it and what are Sx
Bleeding of pit, due to tumour
Sx include blurred vision, sudden headache
Sx of hypothyroid and hyperthyroid
Fatigue, weight gain, low mood, consitpation, feeling cold, bradycardia
Anxiety, poor sleep, nausea, diarrhoea, wieght loss, feel hot, palpitations
What are the Sx of hypogonadism
Erectile dysfunction
Loss of libido
Amenorrheoa
Sx of low ACTH
Fatigue
Postural dizziness
Low mood
Hypogly
Hyponat
CV collapse- can’t increase BP in shock or sepsis, may have long CRT and low BP, high HR
Addisonian crisis
Sx of problems with GH
Hypertension
Agromegaly
Changes to face- big jaw, prominent forehead, slightly bigger tongue, teeth slightly widely spaced
What does prolactin inhibit and what are Sx of its excess
LH and FSH
Galactorrheoa
Breast change and erectile dysfunction
Where is the pit located in the brain
Cavernous sinus
Treatment for steroid insufficiency
Hydrocort 100mg, IV STAT
IV fluids
Hormone replacemebt
When should surgical management be considered for pit apoplexy
Severely reduced visual acuity
Severe and peristent or detiorating visual field defects
Deteriorating level of consciousness
What causes high PRL
Dopamine antagonists- metoclopromide, domperidone, antipyschotics
Stress,
Disconnection of pit stalk
What does low test, low LH and FSH suggest
NOT testes problem because would drive LH and FSH up
Pit problem instead
What does new tan suggest in endocrrinology
High ACTH- as hormone produced in parallel with ACTH causes pigmentation of skin
How does Synacthen test work
30 mins
See if adrenal glands can respond to it. If no increase, then problem with adrenals
What does it mean if morning cortisol is low
Consider replacing steroids as it should be elevated
What is used for high prolactin levels
Cabergoline- dopamine agonist
Treatment for DI if ADH can’t be made
Desmopressin
How to reduce addisonian crisis
Increase hydrocortisone/ use IV
Where does ADH act on in the glomerulus
Aquaporin 2 in the collecting duct, reabsorbs water from urine
Where does aldosterone act on
NaK pump in glomerulus
Where is the osmoreceptor located in the brain
Hypothalamus
Wher is ADH released from
Post pit
What Ix should be done for Addison’s disease
Bloods- Na and K, cortisone
Short synacthen test
