Endo 2 - Hypersecretion of Anterior Pituitary Hormones Flashcards
Define Hyperpituitarism
symptoms associated with excess production of adenohypophysial hormones
What is usually the cause of hyperpituitarism?
Pituitary adenomas
What visual effect is associated with pituitary adenomas?
Bitemporal hemianopia
What disease is associated with hypersecretion of corticotrophin?
Cushing’s disease
What disease is associated with hypersecretion of thyrotrophin?
Thyrotoxicosis
What disease is associated with hypersecretion of gonadotrophins?
Precocious puberty in children
What disease is associated with hypersecretion of prolactin?
Hyperprolactinaemia
What disease is associated with hypersecretion of somatotrophin?
gigantism/acromegaly
What is the usual cause of hyperprolactinaemia?
prolactinoma
Define hyperprolactinaemia
excess circulating prolactin not due to physiology such as pregnancy or breast feeding
What are the symptoms of hyperprolactinaemia in men?
- loss of libido
- impotence
- galactorrhea
What are the symptoms of hyperprolactinaemia in women?
- loss of libido
- galactorrhoea
- secondary amenorrhoea
- infertility
What are two physiological causes of hyperprolactinaemia?
pregnancy + breast feeding
What is the name given to excess growth hormone in children?
gigantism
What is the name given to excess GH in adults?
acromegaly
Outline the onset of acromegaly
- insidious onset
What are the clinical signs of acromegaly?
- increased morbidity due to cardio and resp complications
- increased organ size = increased oxygen demand
- increase in insulin resistance
Explain why diabetes is more common in acromegalics?
- increased insulin response to glucose
- increased insulin resistance
- impaired glucose tolerance
- diabetes mellitus
Name the symptoms of acromegaly
- increased bone growth
- increased cartilage
- prognathism
- enlarged supraorbital ridges
- hyperhydrosis
- carpal tunnel syndrome due to increased cartilage putting pressure on nerves
- general coarseness of features
- thickening of lips
- barrel chest and kyphosis
- hypertension
How would you diagnose acromegaly/gigantism?
suppression test
- 75mg glucose load
- should cause a decrease in in GH
- acromegalic will have a paradoxical rise in GH
What is the main treatment for acromegaly?
Transphenoidal Hypophysectomy
What are the adjuvant treatments for acromegaly?
- radiotherapy
- chemotherapy
- octreotide - to reduce size of tumour before surgery
What is the treatment of Hyperprolactinaemia?
Dopamine receptor agonists
Give 2 examples of dopamine receptor agonists?
Bromocriptine + Cabergoline
