OME Ant Pit

Question 1

post pit

Answer 1

ADH and Oxytocin

Question 2

Prolactinoma DX

Answer 2

Meds (first)
TSH(Next)
Prolactin level finally
MRI

Question 3

Prolactinoma Tx

Answer 3

Dopamine Agonist
Cabergoline>Bromocriptine
F/U Surgery/Resection (rarely)

Question 4

Dopamine Antagonist List

Answer 4

Chlorpromazine (Thorazine)

Loxapine (Loxitane):
Thiothixene (Navane):
Molindone (Moban)
Perphenazine (Trilafon)

Haloperidol (Haldol):
Fluphenazine (Prolixin):
Trifluoperazine (Stelazine):
Pimozide (Orap):

atypical antipsychcotics:
Risperidone (Risperdal)
Quetiapine (Seroquel)
Ziprasidone (Geodon)
Aripiprazole (Abilify): acts as dopamine partial agonist

Question 5

Causes of prolactin high levels

Answer 5

TRH increases levels, so hypothyroidism increases levels

Dopamine antagonists

Prolactinoma

Question 6

GH stimulates or inhibits Glucose productions?

Answer 6

Stimulates

So Acromegaly: Diabetes

Question 7

Death of GH

Answer 7

Diasystolic CHF (Left Ventricular hypertrophy so bad heart cannot relax)

Question 8

Acromegaly DX

Answer 8

ILGF levels
Glucose suppression test (if positive go to MRI)
MRI

NOT GH LEVELS

Question 9

Acromegaly TX

Answer 9

Surgery first (unlike prolactinoma)
F/U Ocreotide (somatostatin)

Question 10

Effects of Glucose on Insulin, Epi, Cortisol, GH

Answer 10

Glucose goes up, insulin goes up/ epi, cortisol, GH goes down.

Glucose suppression test is positive for acromegaly if GH does not change when Glucose goes up

Question 11

Hypopituitary

Answer 11

Acute Causes: Infxn, infarction, iatrogenic

Chronic Causes: Autoimmune, Deposition dz, Tumor
- Gets rid of FSH and GH first.
so decrease libido, periods, and fatigue

DX: insulin stim test
Vasopressin stim test
MRI

Insulin stim test: add insulin and bld glucose will go down, epi/cortisol goes up. GH should go up (positive test is GH will not go up)

TX: Replace Hormones and tx underlying dz.