Endo diseases - pit tumour

Question 1

what type of disease originates from posterior pituitary gland

Answer 1

hypothalamic (central) diabetes insipidus

Question 2

how common is pituitary tumours

Answer 2

1 in 4 have pituitary microadenoma (doesnt do much)
mostly commonly found in young or middle-aged adults

Question 3

what are symptopms of pituiutary tumour caused by

Answer 3

• change in pituitary hormone levels = functional pituitary tumours
• direct pressure from the tumour

Question 4

first thing effected from increased pituitary tumour size

Answer 4

pressure on optic nerves
causes headaches
sight problems

Question 5

pit tumour >1cm

Answer 5

macroadenoma

Question 6

pit tumour <1cm

Answer 6

microadenoma

Question 7

Most common type of pit tumour

Answer 7

Non secreting adenomas
Benign, don’t spread

Question 8

Hypopituitarism

Answer 8

reduction in pituitary hormone secretions

Question 9

Most common hromones released by tumours of anterior pit gland

Answer 9

prolactin

Question 10

Least common hromones released by tumours of anterior pit gland

Answer 10

Thyroid stimulating hormone

Question 11

What cells are affected in prolactinomas

Answer 11

lactotropes

Question 12

Common symptoms of prolactinoma

Answer 12

Women: Monthly period stops
Production of small amounts of breast milk

Women and men : Infertility

Mostly diverse and not obvious symptoms

Question 13

What hormone is in excess when there is adeomma of pituitary somatotope cells

Answer 13

growth hromone

Question 14

What two disease can be caused by adenoma of somatotrope cells

Answer 14

Gigantism in children
Acromegaly in adults

Depends if growth plates fused or not

Question 15

Symproms of acromegaly

Answer 15

Enlarged head, hands, Jaw, tongue, lips

Excess sweating
Headaches and vision loss due to pressure on optic nerve

sweating= increased resistance to insulin
increased metabolsim
enlarged

Question 16

What disease is caused by corticotropic adenoma

Answer 16

Excess production of ACTH
So excess cortisol
Cushings

Question 17

symptoms of cushings

Answer 17

hyperglycaemia
loss of muscle mass
thin limbs, osteoporosis
fat storage in abdomen, face (adiposity, puffy face)
orange donald trump skin

Question 18

typical presentations of cushings

Answer 18

• moon face
• reddish cheeks
• truncal obesity
• abdominal striae (look like stretch marks)

Question 19

effects of gonadotropic adnomas in men and women

Answer 19

men: rise in FSH, not much change in LH levels

women: neither hormone changes

= symptoms usually associated with mass effects of tumour

Question 20

how are pit tumours usually diagnosed

Answer 20

if non secreting macroadenoma = mass effects of optic nerve

if secreting microadenoma = blood/urine tests

then scan to confirm pit involvement
either CT or MRI (preffered)

Question 21

resolution of MRI

Answer 21

can resolve tumours of 3mm and up

Question 22

if not compressing optic nerve, then what is done to manage pit tumour

Answer 22

monitor size and hormone function over time

Question 23

drug treatment for prolactinoma

Answer 23

dopamine receptor agonist
= inhibit prolactin secretion
growth of tmour can be reversed

Question 24

drug treatment for adenoma of somatotropes

Answer 24

somatostatin analogues
inhibits growth hormone

Question 25

most common pit tumour surgery

Answer 25

transphenoidal surgery

Question 26

when would transfrontal surgery be needed for pit tumour

Answer 26

if very large
uncommon

Question 27

side effects of dop agonist for prolactinoma

Answer 27

impulse control disorders ICDs
dose dependent
more studied in parkinsons disease, but recent studies have shown this taking an effect in prolactinoma patiens

increased risk of developig gambling addictions, hypersexuality, binge eating disorders
due to the reward pathway dopamine regulates