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Pathology > C - Pituitary > Flashcards

C - Pituitary Flashcards

1
Q

can pituitary failure cause hypotension

A

no

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2
Q

name the pituitary hormones

A

GH
Prolactin
TSH
LH
FSH
ACTH

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3
Q

what does TRH increase

A

TSH
prolactin

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4
Q

what does dopamine decrease

A

prolactin

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5
Q

what 2 Sx indicate pituitary dysfunction

A

galactorrhoea
amenorrhoea

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6
Q

define macroadenoma of pituitary

A

> 1cm

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7
Q

complication of macroadenoma

A

bitemporal hemianopia

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8
Q

what is spared in bitemporal hemianopia and what does this mean for Sx

A

macular spared
fine vision normally

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9
Q

what is a raised prolactin

A

> 600

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10
Q

what does a prolactin of >600 indicate

A

pregnant or prolactinoma

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11
Q

what does a prolactin of >6000 indicate

A

ALWAYS prolactinoma

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12
Q

how is pituitary function tested

A

LHRH
TRH
stress - hypoglycaemia

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13
Q

what hormonal changes are supposed to occur when hypoglycaemia is induced

A

increased GH
increased ACTH

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14
Q

what is the risk of inducing hypoglycaemia

A

MI / epilepsy

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15
Q

what does CPFT stand for

A

combined pituitary function test

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16
Q

how is a CPFT conducted

A

fast overnight, IV access
weigh them
give IV insulin 0.15U/kg, TRH 200mcg and LHRH 100mcg
wait 25 mins
take glucose, cortisol, GH, LH, FSH every 30 mins for 1hr

17
Q

when is a hypo expected to occur in CPFT

A

30 mins

18
Q

what is a normal result in CPFT

A

glucose <2.2
cortisol >450
LH / FSH >10

19
Q

what medications are given in pituitary failure

A

stat hydrocortisone and prednisolone

20
Q

why is fludrocortisone not in the Mx of pituitary failure

A

fludrocortisone is aldosterone which is from adrenals, which isn’t affected in pituitary failure

21
Q

what other medications are given to children with pituitary failure

A

thyroxine
oestrogen
GH

22
Q

prolactin antagonists & drug type

A

cabergoline
bromocriptine
(dopamine agonist)

23
Q

why can high prolactin occur in pituitary failure

A

non functioning pituitary adenoma can press on stalk and prevent dopamine coming down, therefore unopposed prolactin production

24
Q

why is prednisolone given with hydrocortisone for pituitary failure

A

prednisolone is a longer acting hydrocortisone

25
Q

pituitary failure Sx but normal / xs GH. Dx?

A

acromegaly

26
Q

Ix to confirm acromegaly

A

glucose tolerance test

27
Q

Tx for acromegaly

A

cabergoline / octrectide
pituitary surgery
pituitary radio

28
Q

what is gold standard for Mx of acromegaly

A

pituitary surgery

Pathology (87 decks)

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