Endo 2 - Hypersecretion of Anterior Pituitary Hormones

Question 1

Define Hyperpituitarism

Answer 1

symptoms associated with excess production of adenohypophysial hormones

Question 2

What is usually the cause of hyperpituitarism?

Answer 2

Pituitary adenomas

Question 3

What visual effect is associated with pituitary adenomas?

Answer 3

Bitemporal hemianopia

Question 4

What disease is associated with hypersecretion of corticotrophin?

Answer 4

Cushing’s disease

Question 5

What disease is associated with hypersecretion of thyrotrophin?

Answer 5

Thyrotoxicosis

Question 6

What disease is associated with hypersecretion of gonadotrophins?

Answer 6

Precocious puberty in children

Question 7

What disease is associated with hypersecretion of prolactin?

Answer 7

Hyperprolactinaemia

Question 8

What disease is associated with hypersecretion of somatotrophin?

Answer 8

gigantism/acromegaly

Question 9

What is the usual cause of hyperprolactinaemia?

Answer 9

prolactinoma

Question 10

Define hyperprolactinaemia

Answer 10

excess circulating prolactin not due to physiology such as pregnancy or breast feeding

Question 11

What are the symptoms of hyperprolactinaemia in men?

Answer 11

• loss of libido
• impotence
• galactorrhea

Question 12

What are the symptoms of hyperprolactinaemia in women?

Answer 12

• loss of libido
• galactorrhoea
• secondary amenorrhoea
• infertility

Question 13

What are two physiological causes of hyperprolactinaemia?

Answer 13

pregnancy + breast feeding

Question 14

What is the name given to excess growth hormone in children?

Answer 14

gigantism

Question 15

What is the name given to excess GH in adults?

Answer 15

acromegaly

Question 16

Outline the onset of acromegaly

Answer 16

• insidious onset

Question 17

What are the clinical signs of acromegaly?

Answer 17

• increased morbidity due to cardio and resp complications
• increased organ size = increased oxygen demand
• increase in insulin resistance

Question 18

Explain why diabetes is more common in acromegalics?

Answer 18

• increased insulin response to glucose
• increased insulin resistance
• impaired glucose tolerance
• diabetes mellitus

Question 19

Name the symptoms of acromegaly

Answer 19

1. increased bone growth
2. increased cartilage
3. prognathism
4. enlarged supraorbital ridges
5. hyperhydrosis
6. carpal tunnel syndrome due to increased cartilage putting pressure on nerves
7. general coarseness of features
8. thickening of lips
9. barrel chest and kyphosis
10. hypertension

Question 20

How would you diagnose acromegaly/gigantism?

Answer 20

suppression test

• 75mg glucose load
• should cause a decrease in in GH
• acromegalic will have a paradoxical rise in GH

Question 21

What is the main treatment for acromegaly?

Answer 21

Transphenoidal Hypophysectomy

Question 22

What are the adjuvant treatments for acromegaly?

Answer 22

• radiotherapy
• chemotherapy
• octreotide - to reduce size of tumour before surgery

Question 23

What is the treatment of Hyperprolactinaemia?

Answer 23

Dopamine receptor agonists

Question 24

Give 2 examples of dopamine receptor agonists?

Answer 24

Bromocriptine + Cabergoline