Anterior Pituitary Disorders: Acromegaly and Hypopituitarism Flashcards
What can happen if you have a Pituitary Tumour? (Gland too large?)
Presses on adjacent structures
What can happen if you have a Pituitary Tumour? (to hormones…) (2 things)
Excess hormone secretion Deficient hormone secretion
How can deficient hormone secretion happen?
post surgery or radiotherapy pressure on normal cells from tumour
How do we tackle a Pituitary Problem? (3 things)
Take the History Examine the patient Do relevant special investigations
Most pituitary tumours are …
benign
How do we tackle a Pituitary Problem?
- Discuss management with the multidisciplinary pituitary team and the person with the problem - Decide on best personalised treatment (surgery, radiotherapy, medication, watch and wait)
What are 4 personalised treatment options for a pituitary problem?
Surgery Radiotherapy Medication Watch and wait
Pituitary History - check 6 things
Presenting Complaint Past History Family History Personal History Gynaecological History Systemic Inquiry
Examination for Pituitary
ENT - biopsy of nasal mass Histology - Pituitary Tumour
What is this showing?
What is it for?
What test is it?
phoropter - used during an eye examination to measure refractive error and determine eyeglass prescriptions. Typically, the patient sits behind the phoropter and looks through it at an eye chart
Goldman vision test
What is the most common way to remove a pituitary tumour?
Transsphenoidal surgery.
Transsphenoidalmeans that the surgery is done through the sphenoid sinus, a hollow space in the skull behind the nasal passages and below the brain. The back wall of the sinus covers the pituitary gland
What is Transsphenoidal hypophysectomy ?
Transsphenoidal hypophysectomy is an effective surgical technique for the removal of pituitary and other intrasellar tumors with minimal morbidity and hospital sta
What is Bitemporal hemianopsia (or Bitemporal hemianopia) ?
The medical description of a type of partial blindness where vision is missing in the outer half of both the right and left visual field.
What is a Pituitary adenoma?
They are benign (not cancerous) slow-growing tumors in the pituitary gland.
pPost Op Progress - What Clinical Problems?
Polyuria due to Diabetes Insipidus
What is prescribed for polyuria as a result of Diabetes Insipidus?
DDAVP (desmopressin acetate tablets)
it is an antidiuretic replacement therapy
Biochemistry after surgery for pituitary tumour - what can be an issue?
Low Thyroxine levels
What is prescribed for low thyroxine levels?
Levothyroxine
What test is perfomed to check if your adrenal glands are producing enough cortisol? (after surgery)
Short synacthen test checks if your adrenal glands are producing enough steroid hormone called cortisol.
If you have a poor cortisol response, what happens?
hydrocortisone
Estrogen Deficiency Symptoms after surgery.
What do you do?
Estrogel prescribed
mirena intrauterine system
What is the GHRH Arginine stimulation test?
GHRH stimulates growth hormone production by the pituitary gland, which is a small gland beneath the brain. You will also be given an injection of arginine, a natural amino acid (the building blocks of proteins) that also stimulates growth hormone release.
This test is used to assess your body’s ability to make growth hormone
Why is the GHRH Arginine Stimulation test done in adults Post op?
In adults, a lack of growth hormone sometimes reduces their quality of life. It may also affect their body composition (the amounts of fat and muscle in the body), with a tendency to have more fat and less muscle.
What does lack of growth hormone do in adults?
Reduce quality of life
