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Endo Week 1 > Anterior Pituitary Issues > Flashcards

Anterior Pituitary Issues Flashcards

1
Q

what is the most common cause of hyperprolactinemia?

A

prolactinoma

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2
Q

name two issues that can lead to hyperprolactinemia other than prolactinoma

A

acromegaly and other sellar masses that compress the stalk

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3
Q

name 4 drug classes that lead to hyperprolactinemia?

A

anti hypertensives
antipsychotics
anti depressants
GI meds

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4
Q

name three findings of hyperprolactinemia in women

A

galactorrhoea
menstrual irregularity
infetility

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5
Q

name clinical manifestations of hyperprolactinemia in men

A 
galactorhoea
impotence
visual field abnormalities
headache
extraocular muscle weakness
anterior pituitary malfxn
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6
Q

who presents first with hyperprolactinemia, men or women?

A

women

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7
Q

what is Rx for hyperprolactinemia?

A

dopamine agonists

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8
Q

name the two dopamine agonists used in hyperprolactinemia

A

cabergoline

bromocriptine

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9
Q

what are the common SEs of dopamine agonists?

A

nausea and vomiting

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10
Q

how is GH released from ant pit?

A

in pulsatile fashion

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11
Q

what is GH effect on bone?

A

growth induction

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12
Q

what is GH effect on fat?

A

lipolysis

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13
Q

what is GH effect on muscle?

A

protein synthesis

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14
Q

what is the molecule in the systemic area that is similar to GH and induced by GH, but not known as GH?

A

IGF-I

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15
Q

name five changes with excess GH

A 
bone growth leading to acral changes
thickening of skin
hypertension
neuromuscular and psych issues
neoplasia
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16
Q

what heart problem can you have with increased GH?

A

cardiomyopathy

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17
Q

name two MSK diagnoses seen in excess GH?

A

carpal tunnel syndrome and arthritis

18
Q

does GH increase or decrease with increase in glucose?

A

GH drops with increasing glucose

19
Q

name two tests to diagnose acromegaly

A

measure IGF-1 and glucose test by giving glucose and not seeing GH drop

20
Q

what are three general treatment modalities for acromegaly?

A

surgical removal
conventional radiation therapy
medications

21
Q

what is the first class of medications given for acromegaly?

A

somatostatin analogs

22
Q

why are somatostatin analogs used in acromegaly?

A

they inhibit the secretion of GH from ant pit

23
Q

aside from somatostatin analogs, what other drug class (random) works for acromegaly?

A

dopamine agonists will work for some patients

24
Q

what is the last med tried in acromegaly?

A

pegvisomant

25
Q

what is MoA of pegvisomant?

A

GH receptor antagonist

26
Q

name three findings of hypopituitary in neonates

A

hypoglycemia
mid line defects
micropenis

27
Q

name three findings of hypopituitary in children

A

decreased growth
delayed puberty
deficient TSH/ATCH

28
Q

what time do you measure cortisol to see if ACTH or cortisol is low?

A

best to measure in morning..this is when it is highest

29
Q

what are signs of GH deficiency in kids?

A

truncal obesity/adiposity
immature cherubic facies with prominent forehead
delayed dentition
delayed puberty

30
Q

what are the two tests to diagnose GH deficiency in kids?

A

IGF-1
and
glucose restriction test

31
Q

what should happen to GH if you induce hypoglycemia?

A

GH should go up

32
Q

what is number 1 cause of hypopituitarism in adults?

A

pituitary tumors

33
Q

what do many of the non functioning pituitary tumors secrete?

A

alpha subunit of pituitary hormones

34
Q

what is the alpha subunit of pituitary hormones?

A

a subunit of hormones produced by pituitary tumors

35
Q

what is order of hormone loss in progressinf hypopituitary?

A

GH loss then LH/FSH loss then TSH loss then ACTH loss

36
Q

what is signs of low FSH?LH in females

A

oligo or amenorhea, vaginal dryness and hot flashes

37
Q

what are signs of low FSH/LH in men

A

low libido, erectile dysfxn

38
Q

what are signs of low TSH in hypopituitary?

A

fatigue, cold intolerance, constipation, dry skin, hari loss

39
Q

what are signs of low aCTH in hypopotuitary?

A

fatigue, anorexia, weight loss, postural hypotension

40
Q

how do panhypopituitary ppl appear?

A

overweight with fine wrinkling of skin and decreased pigmentation and absent pubic hair

41
Q

what are signs of GH loss in adults?

A 
decrease exercise performance
decrease energy
decrease muscle mass
increase fat
high LDL and low HDL

Endo Week 1 (10 decks)

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