Anterior Pituitary Disorders

Question 1

Why would a patient get glucose in urine if they have acromegaly?

Answer 1

Increase blood glucose levels bc release of cortisol therefore release glucose constantly. This can cause a dip in response to a glucose challenge and therefore reduced sensitivity of insulin over time

Question 2

Why do patients with acromegaly have abnormal visual fields

Answer 2

Enlargement of the pituitary gland leads to pituitary gland pushing against the optic chiasm

Question 3

What tests can you perform to test for acromegaly?

Answer 3

OGTT
Perimetry
MRI scan
Measure IGF1 levels
Measure prolactin levels and pituitary panels - TSH etc
Overnight pulse oximetry and sleep monitor to measure obstructive sleep apnoea
HBA1C

Question 4

What are treatments for acromegaly?

Answer 4

Somatostatin analogue to reduce size and therefore reduce vascularture and therefore reduce bleeding complications
d2 agnoist
Trans-sphenoidal surgery by the neurosurgery