Anterior pituitary - hypersecretion Flashcards

1
Q

What is the most common cause of hypersecretion of pituitary hormones?

A

Pituitary tumour

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2
Q

Describe how pituitary tumours can lead to bitemporal hemianopia

A

Temporal aspects of light hit nasal aspects of retina, fibres from nasal aspect meet at optic chiasm, compression by tumour –> bitemporal hemianopia

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3
Q

What pathology is caused by an excess of ACTH?

A

Cushing’s

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4
Q

What pathology is caused by an excess of TSH?

A

Thyrotoxicosis

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5
Q

What pathology is caused by an excess of LH/FSH?

A

Precocious puberty

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6
Q

What pathology is caused by an excess of prolactin?

A

hyperprolactinaemia

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7
Q

What pathology is caused by an excess of GH?

A

Gigantism/ acromegaly

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8
Q

Recall the pathologies associates with excess GH in adults and children

A

Adults: acromegaly
Children: gigantism

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9
Q

Describe the onset of acromegaly

A

Insidious

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10
Q

Recall 5 things that grow excessively in acromegaly

A
  1. Periosteal bone
  2. Cartilage
  3. Fibrous tissue
  4. Connective tissue
  5. Internal organs (heart/spleen/liver)
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11
Q

Recall the 11 clinical features associated with acromegaly. Which of these are the main two?

A
HYPERHIDOSIS
HEADACHE
Facial changes
Prognathism
Carpal tunnel
Barrel chest
Kyphosis
Diabetes
Hypertension
Cardiomyopathy
Increased cancer risk
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12
Q

Recall the facial changes associated with acromegaly

A

Enlargement of:

  1. supraorbital ridges
  2. Nose
  3. lips
  4. Tongue
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13
Q

Recall and explain 2 methods of diagnosing acromegaly

A
  1. Measure IGF-1 (not pulsatile, elevated in acromegaly)

2. Oral glucose test (acromegaly -> failure to suppress GH)

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14
Q

What is the first-line treatment for acromegaly?

A

Surgery to remove adenohypophysial tumour

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15
Q

Recall 2 options for medical treatment of acromegaly, and give an example of each

A
Somatostatin analogues (octreotide)
DA agonists (cabergoline)
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16
Q

Recall 3 side effects of cabergoline

A

Nausea
Diarrhoea
Gall stones

17
Q

What is cabergoline’s main clinical use?

A

Pre-operative tumour reduction

18
Q

Why is octreotide known as “endocrine cyanide”?

A

Inhibits many peptides (not GH specific)

19
Q

Describe the effect of hyperprolactinaemia on GnRH

A

Suppresses GnRH pulsatility

20
Q

Recall 4 symptoms of hyperprolactinaemia in women

A

Galactorrhoea
Amenorrhoea
Loss of libido
Infertility

21
Q

Recall 4 symptoms of hyperprolactinaemia in men

A

Loss of libido
Erectile dysfunction
Infertility

22
Q

Recall the hormone-receptor interaction controlling prolactin secretion

A

Dopamine - D2 receptors on lactotrophs –> inhibition of prolactin release

23
Q

What is the first-line treatment for hyperprolactinaemia? Name 2 examples

A

D2 receptor agonist: cabergoline, bromocriptine

24
Q

Recall 5 side-effects of cabergoline

A
  1. Pathological gambling
  2. Dyskinesia
  3. Postural hypotension
  4. Depression
  5. Nausea and vomiting