Endocrinology Flashcards
This is a condition caused by anything that compresses or damages the pituitary gland.
Panhypopituitarism
This patient has decreased FSH and LH from decreased GnRH, Anosmia, and renal agenesis. What is the most likely diagnosis?
Kallman Syndrome
What findings would you appreciate in an adult with growth deficiency?
Central obesity
Increased LDL and Cholesterol levels
Reduced lean muscle mass
How would you go about with the treatment of Panhypopituitarism?
Replace deficient hormone with: Cortisone Thyroxine Testosterone and estrogen Recombinant human growth hormone
How would you differentiate Central Diabetes Insipidus from Nephrogenic Diabetes Insipidus?
Central DI - decrease in amount of ADH from pituitary
Nephrogenic DI - decrease in ADH effect on kidney
How will DI present?
Extreme high-volume urine with excessive thirst resulting in volume depletion and hypernatremia
How do you diagnose DI?
Vasopressin (Desmopressin) Stimulation Test
What will be the result of Central DI and Nephrogenic DI in vasopressin test?
Central DI - urine volume will decrease and urine osmolality will increase
Nephrogenic DI - no effect on urine volume and osmolality
How would you treat Central DI?
Long term Vasopressin (Desmopressin) use
How would you treat Nephrogenic DI?
Correct underlying casue (hypokalemia or hypercalcemia)
Hydrochlorthiazide, Amiloride, Prostaglandin Inhibitors such as Indomethacin
This is defined as the overproduction of growth hormone leading to soft tissue overgrowth throughout the body
Acromegaly
This is almost always the cause of Acromegaly
Pituitary Adenoma
Patient came in with complaints of increased shoe size, body odor, pain in flexion of wrist, joint pains. Upon inspection you noticed coarse facial features, deep voice, large tongue, skin tags. What is the most likely diagnosis?
Acromegaly
What will laboratory test show in a patient with Acromegaly?
Glucose intolerance and Hyperlipidemia
What is the best initial test for Acromegaly?
Insulinlike growth factor (IGF-1_
What is the most accurate test for Acromegaly?
Glucose Suppression test
What is the most accurate test for Acromegaly?
Glucose Suppression test
*Normally, glucose should suppress growth hormone levels
What are your treatment considerations for Acromegaly?
Surgery: Transphenoidal resection
Medical: Carbegoline (Dopamine will inhibit GH release), Octreotide or Lanreotide (Somatostatin inhibits GH release), Pegvisomant (GH receptor antagonist, inhibits IGF release from liver)
Radiotherapy: for those who do not respond with surgery/medications
This is the ONLY calcium blocker that raises Prolactin levels.
Verapamil
What inhibits prolactin release?
Dopamine
Give examples of drugs that increases prolactin levels
Antipsychotic medications Methyldopa Metoclopramide Opiods Tricyclic Antidepressants Verapamil
You measured the prolactin level of a patient. After finding it to be high, what should you perform?
Thyroid function tests
Pregnancy test
BUN/Crea (Kidney disease elevates prolactin)
Liver function tests (Cirrhosis elevates prolactin)
What are your treatment options for Hyperprolactinemia?
Dopamine agonists: Cabergoline is better tolerated than Bromocriptine
Transphenoidal surgery for those not responding in medication
What are the 2 occasional cause of hypothyroidism?
Dietary deficiency of iodine
Amidarone