Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

endoII exam2 > Darrow pituitary diseases part I > Flashcards

Darrow pituitary diseases part I Flashcards

1
Q

increased hat and glove size

A

acromegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

skin tags and enlarged tongue

A

acromegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how can acromegaly cause abnormal menstrual cycles

A

can co secrete PRL
can activate PRL R
the GH adenoma can compress pituitary stalk and inhibit dopamine release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

PRL feedback on hypothalamus

A

inhibits GnRH release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can cause + Tinels

A

myxedema, edema, DM, infiltration, amyloid, neoplasms, trauma, RA, acromegaly and pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how does pain and stiffness in back/hips/knees relate to acromegaly

A

synovial thickening at the knees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

why is snoring a component of acromegaly

A

increased glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

HA with coughing, nausea from pain?

A

look for brain tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what causes the acanthosis nigricans and skin tags in acromegaly

A

increased IGF-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what cancers can cause increased hat size and skin tags

A

breast, thyroid, colon and renal cell cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what tests to order for suspected acromegaly with increased fasting blood sugar

A

glucose, PRL, BUN, AST, ALT, Ca, phosphorus
T4,TSH cortisol
Uosm/Posm
serum GH after 75 mg glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

when give glucose what should the GH levels be

A

decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is a + GH suppression test with glucose

A

if the GH is less than 1 ng/ml

or less than 0.4 in supersensitive assay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

effects of GH on metabolism

A

lipolysis
gluconeogenesis
increased conversion lactate and glycerol to glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

causes of acromegaly

A

microadenoma with somatotroph mutation
macroadenoma
Ectopic GH or GHRH production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what mutation causes microadenoma secreting GH

A

mutation of alpha subunit of GTP binding protein on Gsalpha

causes increased cAMP producing GH secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

syndromes assoc with acromegaly

A

MEN1
carney complex
mcCune Albright syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what causes carney complex

A

mutation in tumor suppressor gene for protein kinase A

19
Q

what are signs of MuCune Albright syndrome

A

PFD, cafe au lait sports, endocrine hyperfunction

20
Q

MEN1

A

pituitary, pancreas, PTHgland

also can have hyper Ca, peptic ulcers, hypoglycemia

21
Q

complications with GH secreting adenoma

A

mass effects

22
Q

how is a pituitary adenoma secreting GH Tx

A

surgery
radiation
drugs: dopamine agonists, somatostatin analogs
GH R antagonist (pegvisomat)

23
Q

side effect of somatostatin analogs

A

gallstones

24
Q

side effects pegvisomat

A

liver function abnormalities

25
Q

enlarged pituitary and on surgery it is hyperplasia, no evidence of adenoma

A

ectopic hormone production

e.g small cell/oat cell carcinoma that produces GHRH

26
Q

long term follow up for GH adenoma

A

follow GH and IGF1 levels

27
Q

goals of Tx for GH adenoma

A

with suppression test to have GH level under 0.4

28
Q 
F amenorrhea, galactorrhea with dysparunia, mild hirsutism and acne
takes resperidone, verapamil, lisinopril and somtimes metoclopramide for nausea
elevated BP
 BUN/Cr 10:1
high Cl
no anion gap
low HCO3
elevated PRL
A

Chronic renal failure renal cause from BUN:Cr

hyperchloremic non anion gap acidosis

29
Q

how does increased PRL lead to osteoporosis and amenorrhea

A

decreased GnRH so decreased LH and decreased estrogen

30
Q

how does increased PRL lead to dysparunia, hirsutism, and acne

A

decreased estrogen will lead to dec sex hormone binding globulin which increases free testosterone and DHEAS
leading to hirsutism and acne

31
Q

what other conditions (not pituitary or hypothalamic) can cause increased PRL

A

hypothyroidism and kidney diseases

32
Q

endocrine cuases hyper PRL

A

pituitary adenoma, hypothalamic disease, hypothyroidism, pregnancy

33
Q

what drugs can cause hyperPRL

A

CNS acting meds, antiHTN, sex hormones, certain H2 blockers, metoclopromide, PI, opiates

34
Q

lisinopril can do what to kidneys

A

type IV RTA

35
Q

another name for hyperchloremia acidosis

A

hypoaldosteronism, hyporenin

36
Q

type of RTA caused by DM

A

type IV hypoaldosterone hyporenin

37
Q

if Cl is high what should HCO3 be

A

drop in HCO3, if not then Pt will vomit

38
Q

prolactinoma level of PRL

A

> 200

39
Q

how would a men present with PRLoma

A

low libido

usually presents later on

40
Q

patient has >200 PRL levels but no Sx and negative MRI

A

macroprolactinemia

41
Q

what do you do if suspect macroprolactinmeia

A

precipitate IgGs with polyethylene glycol and then remeasure

screen for pituitary insufficiency: cortisol and T4 levels

42
Q

Tx prolactinemia

A

Dopamine agonists
surgery
radiation

43
Q

what are the side effects from dopamine agonists activating D1 R

A

nausea, fatigue, psychiatric Sx

44
Q

peripartum cardiomypopathy

A

women secreting abnormal prolactin levels

endoII exam2 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions