Endocrine Overview 4 Flashcards
Does pathology occur more frequently in the anterior or posterior pituitary?
Anterior
What is most anterior pituitary pathology cause by?
- pituitary infarction
- genetic disorders
- trauma
- tumors
What is the definition of hyperpituitarism?
- An oversecretion of one or more of the hormones secreted by the pituitary gland
- Especially GH
Hyperpituitarism is associated with these disorders
- Gigantism
- Acromegaly
- Cushing disease
- Amenorrhea
- Hyperthyroidism
What is Cushing disease?
- One form of Cushing syndrome and results from oversecretion of ACTH by a pituitary tumor
- This in turn results in oversecretion of adrenocorticol hormones
Gigantism is primarily caused by:
- A hormone-secreting pituitary tumor
- Typically benign adenoma
When does gigantism develop?
Develops in children before the epiphyses of the bones close
Onset of gigantism?
abrupt
What happens with gigantism as a result of the pituitary tumor?
- overgrowth of long bones
- may grow up to 9 feet tall
What are characteristics see in both gigantism and acromegaly?
- Coarsened facial features
- Protrusion of jaw
- Thickened ears, nose, tongue
- Broad hands, with spade-like fingers
Acromegaly comes on (faster/slower) than gigantism
Slower
What is acromegaly caused by?
- Hormone-secreting pituitary tumor
- typically benign adenoma
Why do gigantism and acromegaly have some of the same characteristics?
Both related to hypersecretion of growth hormone
When does acromegaly develop?
Disease of adults, developing after closure of epiphyses
When does acromegaly develop?
- adulthood
- after closure of epiphyses
Acromegaly: what happens to bone and soft tissue?
- increased bone thickness
- hypertrophy of soft tissue
Bones most affected in acromegaly
- head
- face
- jaw
- hands
- feet
Why is CTS seen in ~50% of acromegaly pts?
Thickening of connective tissue
What is a common complaint for acromegaly pts? Why?
- Back pain
- Large osteophytes along ALL
- abn ossification of ALL in ~50% of pts
- mimics DISH
What is DISH?
Diffuse idiopathic skeletal hyperostosis
In acromegaly, there is an increased mortality linked to uncontrolled
GH
If diagnosed early, can be treated
What are some other medical complications seen with Acromegaly?
- Amenorrhea
- DM
- profuse sweating
- HTN
Local manifestations of acromegaly and why they occur
Occur as tumor compresses brain tissue
- HA
- Diplopia
- Blindness
- Lethargy
Why is medical management related to increased GH?
long-term exposure may predispose small % of population to malignant bone tumor
Pituitary tumors may be treated with:
- surgical removal
- drug therapy
- radiation therapy
Which is the treatment of choice for pituitary adenomas that cause acromegaly?
Surgery
What happens to pituitary following surgery?
- function usually lost
- tx with hormone replacement is then usually necessary
Which type of therapy is used for prolactin-secreting adenomas?
Drug therapy has replaced surgery in most cases
When would the PT see someone with hyperpituitarism?
- OA of hands and spine
- CTS
- Back pain
- mm weakness
- decreased activity tolerance
Helpful program for a pt with hyperpituitarism will include promotion of
- joint mobility
- muscle strength
- functional skill
In home health, consider these with hyperpituitarism pts
- ADL/energy conservation
- removing obstacles
- recommending DME
