hypersecretion of anterior pituitary hormones

Question 1

define hyperpituitarism

Answer 1

excess production of APG hormones, due to isolate pituitary hormones or ectopic (non-enddocrine tissue)

Question 2

bitemporal hemianopia DIAGRAM

Answer 2

can’t see out of either side of eye ie lose of peripheral vision to detect person has hoodie on, and series of flashes are shown- someone with this condition won’t see flashes coming from the sides

Question 3

effects of the excess hormones

Answer 3

ACTH= cushings TSH- thyrotoxicosis LH/FSH- precocious puberty (early puberty) prolactin- hyperprolactinaemia GH- gigantism/acromegaly

Question 4

causes of hyperprolactinaemia

Answer 4

physiological- breastfeeding/pregnancy pathological- prolactinoma (most common endocrine tumour)

Question 5

presentation of hyperprolactinaemia due to adenoma

Answer 5

stops GnRH pulsatility women- galactorrhoea (milk production outside of pregnancy), secondary amenorrhoea (infrequent periods), loss of libido and infertility same for men, except galactorrhoea uncommon, and erectile dysfunction

Question 6

prolactin regulation

Answer 6

only hormone that simply has inhibitory regulation- by dopamine which binds to D2 receptors

Question 7

treatment of hyperprolactinaemia

Answer 7

main treatment is is D2 agonists, which lower prolactin secretion and reduce tumour size orally given via tablet eg cabergoline/bromocriptine

Question 8

side effects of dopamine receptor agonists

Answer 8

vomiting, postural hypotension, depression and impulse control disroder eg hypersexuality

Question 9

cause of excess GH and 2 types

Answer 9

pituitary adenoma= gigantism (kids)/acromegaly (adults)

Question 10

acromegaly: onset and danger

Answer 10

insidious (gradual) onset, and if untreated can lead to death (60% caused by CVD, 25% by respiratory issues, 15% by cancer)

Question 11

what grows in acromegaly

Answer 11

periosteal bone, cartilage, fibrous and connective tissue, and internal organs like heart, kidney and liver

Question 12

clinical features of acromegaly

Answer 12

excess sweating and headaches are 2 main symptoms bigger nose, hands, feet, tongue and thicker lips protrusion of jaw due to greater mandible carpal tunnel syndrome (tinglings in hands) barrel chest

Question 13

metabolic effect of acromegaly

Answer 13

increased glucose production and decreased uptake= increased insulin production+ increased insulin resistance= diabetes

Question 14

complications of acromegaly

Answer 14

obstructive sleep apnoea- tissue chages in upper airway hypertension due to effects of GH/IGF-1 cardiomyopathy- hypertension increased risk of cancer

Question 15

cosecretion of hormone in acromegaly

Answer 15

prolactin also high in acromegaly, which causes hyperprolactinaemia= secondary hypogonadism

Question 16

diagnosing acromegaly DIAGRAM

Answer 16

GH pulsatile so limited high serum IGF-1 or oral glucose tolerance test- GH should decreased immeditely after glucose given, but in acromegaly it rises