acromegaly, hypopit. & hyperaldo. Flashcards
The following flashcards are going to be from the endocrine disorders/problems blackboard recording video
What is acromegaly?
an overproduction of growth hormone
what is the usual cause of by patients develop acromegaly?
caused by a benign pituitary tumor
how does acromegaly present itself in a patient?
overgrowth in hands, feet, face
what are the major complications for patients who have acromegaly ?
thick tongue, hypertrophy of vocal cords, sleep apnea
what are some complications, listing them through systems, that patients with acromegaly can experience?
skin
eyes
pancreas
endocrine
life span ?
skin thickens = leathery
vision changes from pressure
GH causes hyperglycemia
hyperlipidemia
life expectancy is decreased by 5-10 years
what is the diagnosis for acromegaly ? (3)
testing of insulin-like growth factor 1
GH response to oral glucose tolerance test
(GH levels would fall normally, with acromegaly, levels are stable or increase)
MRI
what is the treatment of acromegaly ?
transsphenoidal removal of pituitary gland with replacement of target hormone replacement
( steroids, thyroid hormone, sex hormones )
how does a transsphenoidal work? surgery wise
up through the upper lip and goes up even further
what are post-op care we are going to need to perform on a patient who is post-op from acromegaly removal? (3)
oral care Q4 hours
observe for transient DI
neurologic evaluation
what are 3 things we are going to tell patients post-op care from acromegaly ?
no tooth brushing for 10 days
avoid valsalva ( straining )
surgery may result in infertility loss of FSH and LH
now are going to talk about hypopituitary disorders
what is the anterior pituitary hormones?
ACTH, TSH, FSH,LH, GH
what is the posterior pituitary hormones?
ADH
oxytocin
what is selective hypopituitarism ?
deficiency of one hormone
what is panhypopituitarism?
deficiency of all pituitary hormones
what is the most common reasons why patients end up developing hypopituitary disorders?
pituitary tumor
( most common ^ )
autoimmune disorder
infection
gland damage
its important to note that when patients end up developing hypopituitary disorders, the symptoms are going to be what?
related to the hormone that is affected.
( meaning if you have two hormones, a & b, and a is being affected, you are only going to see symptoms that are related to A. nothing of B symptoms will show )
If there is a tumor growing up in the pituitary, which more than often is the main cause for these disorders, what are we worrying about?
think about how the tumor is taking up space and where the pituitary is located
vision changes
loss of smells
n/v
seizures
headache
what is the treatment for hypopituitarism ?
surgery ( transphenoidal or radiation )
for post op management for patients with hypopitutairy, what do we want to monitor ?
vision changes
neuro function
mental status
hematoma affecting optic nerve
CSK leakage
what do we want to educate patients on after post op care for hypopitu ?
no
noseblowing
coughing
sneezing
straining with bowel
for 48 hours
additional information
what type of dressing do patients have after surgery for hypo pit?
mustache dressing
- we look for csf leakage
- halo sign
most of the time
if we are removing the entire pituitary, we are more than likely replacing what?
all the hormones
- gh
- corticosteroids
- thyroid hormone
- sex hormones
