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MS 2 > ENDOCRINE DISORDERS > Flashcards

ENDOCRINE DISORDERS Flashcards

1
Q

Master Gland of the body

A

Pituitary Gland

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2
Q

Pituitary Gland is divided into the:

A

Anterior Pituitary Gland
Posterior Pituitary Gland

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3
Q

Other term for pituitary gland is

A

Hypophysis

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4
Q

Adenohypophysis

A

Anterior PG

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5
Q

Neurohypophysis

A

Posterior PG

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6
Q

Controlled by the hypothalamus

A

Pituitary Gland

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7
Q

Where is the pituitary gland located?

A

Inside the head (Sella Turcica)

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8
Q

What are the pituitary hormone in Anterior?

A

-Prolactin
-Growth Hormone (GH)
-Follicle Stimulating Hormone (FSH)
-Luteinizing Hormone (LH)
-Adrenocorticotropic hormone (ACTH)
- Thyroid-stimulating hormone (TSH)

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9
Q

What are the pituitary hormone in posterior?

A

-Antidiuretic Hormone
- Oxytocin

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10
Q

An excessive secretion or production of one or more of the hormone produced by the pituitary gland

A

Hyperpituitarism

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11
Q

What inhibits prolactin production?

A

Dopamine

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12
Q

What stimulates prolactin production?

A

Estrogen

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13
Q

Occurs in isolation or together with GH excess

A

Prolactinoma

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14
Q

Most common pituitary tumor (40%)

A

Prolactinoma

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15
Q

Clinical Manifestations of Prolactinoma

A

-Erectile dysfunction
- Loss of Libido
- Galactorrhea
-Amenorrhea
-Gynecomastia
-Unable to Reproduce

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16
Q

What are the management of Prolactinoma?

A

-Bromocriptine (dopamine agonist)
-Hypophysectomy (surgical removal of pituitary)

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17
Q

Also known as somatotropin

A

Growth Hormone

18
Q

It stimulates tissue growth

A

Growth Hormone Excess

19
Q

Antagonizes insulin

A

Growth Hormone Excess

20
Q

Growth Hormone excess in children

A

Gigantism

21
Q

Growth Hormone excess in adult

A

Acromegaly

22
Q

This results from excessive GH production before the fusion of epiphyseal plates in long bones

A

Gigantism

23
Q

Cause of Gigantism

A

Somatotropinas: GH- producing pituitary adenomas

24
Q

What are the clinical manifestations of Gigantism?

A

-Towering height
- Overgrowth of face, extremities
-Headaches
-Maxilla/Mandible protrusion

25
Q

Complications of Gigantism

A

-CV: Hypertension in children
- Ortho: Osteoarthritis
- Metabolic: Diabetes mellitus

26
Q

A rare condition characterized by overproduction of growth hormone (GH) after the appearance of the epiphyseal line in long bones

A

Acromegaly

27
Q

Cause of Acromegaly

A

Somatotropinomas: GH-producing pituitary adenomas

28
Q

Clinical Manifestations of Acromegaly

A

-Enlarged hands and feet
- Skull enlargement
-Macrognathia- jaw protrusion and enlargement
- Increased spacing of teeth
- Forehead protrusion

-Organomegaly
-Cardiomegaly
- Nephromegaly
- Vocal cord enlargement- slow, deep voice

-Joint pain, thickened skin, vision problems
-Excessive sweating, hirsutism

29
Q

Diagnostic Tests of Growth Hormone Excess

A

-Insulin-like Growth Factor-1(IGF-1)
- Oral Glucose Tolerance Test (OGTT)

30
Q

Normal level of Insulin

A

135-449 ng/ml

31
Q

Oral Glucose Tolerance Test (OGTT)

A

-Baseline GH levels are obtained before ingestion of 75-or 100-gm oral glucose
-GH levels are then measured at 30, 60, 90, and 120 minutes
-Acromegaly: GH > 0.4 mcg/L

32
Q

Medical Management of Growth Hormone Excess

A

-Ocreotide acetate
-Sandostatine agonist
- Reduces GH and IGF-1 to normal by stopping GH production

-Bromocriptine
-Dopamine agonist
- Used if unresponsive to octreotide or if tumor affects prolactin level

33
Q

Surgical Management of Growth Hormone Excess

A

-Transsphenoidal Hypophysectomy
-Removal of the pituitary gland
-Treatment of choice for small pituitary tumors

34
Q

Post-Operative Care for Patients S/P Transsphenoidal Hypophysectomy

A

-Position: Low- fowlers position (30- degrees) at all times to reduce pressure on sella turcica and decrease headaches
-Provide mouth care q4H to keep surgical area clean and free of debris
-Avoid toothbrushing for at least 10 days to protect suture line
-Instruct patient to avoid vigorous coughing, sneezing, and straining at stool to prevent cerebrospinal fluid leakage
-WOF CSF Leak: clear nasal discharge, persistent and severe generalized or supraorbital headache
-Resolves within 72 hours

35
Q

A rare disorder that involves a decrease in or more of the pituitary hormones

A

Hypopituitarism

36
Q

-Deficiency of one pituitary hormone
- Most common cause: pituitary adenoma

A

Selective hypopituitarism

37
Q

-Total failure of the pituitary gland that results to deficiency of all pituitary hormones
-Most common cause: pituitary adenoma

A

Panhypopituitarism (Simmond’s disease)

38
Q

-Hypopituitarism caused by postpartum pituitary necrosis
-Cause: postpartum hemorrhage

A

Sheehan’s syndrome

39
Q

If the cause is pituitary adenoma

A

Go Look For The Adenoma

Sequence of Loss

-Growth Hormone
-Luteinizing Hormone
-Follicle- stimulating Hormone
-Thyroid-stimulating Hormone
-Adrenocorticotropic Hormone

40
Q

Management of Hypopituitarism

A

-Hormone Replacement
- Transsphenoidal hypophysectomy for small tumors

MS 2 (27 decks)

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