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Endocrine > Pituitary > Flashcards

Pituitary Flashcards

1
Q

pituitary adenomas are the main cause of pituitary ________

A

hyperfunction

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2
Q

T/F: pituitary adenoma has more correlation with MEN2a

A

F: more with MEN1

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3
Q

functional pituitary adenomas tend to be classed by…

A

cells involved

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4
Q

which pituitary tumour is the most common

A

prolactinoma

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5
Q

prolactinoma occurs due to…

A

-ve dopamine control (dopamine inhibits prolactin)

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6
Q

aetiology of inc prolactin

A

Physiology: breast feeding
Pathology: adenoma
Pharma: dopamine antagonist

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7
Q

s/s of prolactinoma

A

early in females: galactorrhea, menstrual irregularity, amenorrhea

males- late: impotence, bitemporal hemianopia

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8
Q

what is dx of prolactinoma

A

Sr prolactin >5000

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9
Q

mx of prolactinoma

A

dopamine antagonists, surgical removal

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10
Q

pituitary adenoma may be non-functional- why may this still be an issue

A

can compress optic chiasma, CN 3,4,6 etc

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11
Q

what is the main surgical technique for pituitary adenoma removal

A

transphenoidal surgery

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12
Q

acromegaly is a tumour of…

A

growth hormone secretion resulting in inc GH

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13
Q

s/s of acromegaly

A

thick soft tissue (large tongue, forehead), sweaty, HT, headaches, gigantism

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14
Q

ix for acromegaly

A

glucose tolerance test (as GH is insulin-like growth factor), suppression test of GH +ve if >0.4mg/l

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15
Q

tx for acromegaly

A

1st line: surgery
2nd line: somatostatin, dopamine antagonists
3rd line: Radiotherapy

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16
Q

Cushing’s is an inc in…

A

cortisol

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17
Q

difference between Cushing’s disease and Cushing’s syndrome

A

Cushing’s disease= ACTH dependent- pituitary adenoma

Cushing’s syndrome: ACTH independent- adrenal adenoma, pseudocushing’s etc

18
Q

3 types of Cushing’s

A

cushion’s disease, cushion’s syndrome, paraneoplastic cushings(ACTH released from small cell lung cancer)

19
Q

s/s of Cushing’s

A

round person, thin limbs
moon face, buffalo hump
myopathy (muscle wasting)

20
Q

ix for Cushing’s

A

overnight dexamethasone suppression test (low dose)
then high dose given to identify origin
KNOW THE RESULTS

21
Q

mx for Cushing’s

A

pituitary cause= surgery, radiotherapy

adrenal: surgery

22
Q

pituitary hypofunction is due to…

A

no specific hormone- usually panhypopituitarism

23
Q

aetiology of pituitary hypofunction

A

iatrogenic* (surgery), tumours, sudden haemorrhage, ishaemic necrosis, granulomatous inflammation, hypothalamic lesions

24
Q

s/s of hypofunction

A

obesity, hair loss, dry skin, dull face, growth retardation, menstrual irregularities, infertility, gynecomastia

25
Q

mx of hypofunction

A

hormone replacement therapy (hydrocortisone, ADH, thyroxine, GH etc)

26
Q

which hormone do athletes use illegally

A

GH

27
Q

craniopharyngeoma is a cause of hypo function, what is it?

A

bengin tumour of the hypothalamus (remnant from Rethke’s pouch). may present with headache, visual disturbance

28
Q

posterior pituitary hyperfunction

A

SIADH- syndrome of inappropriate ADH

29
Q

what is SIADH

A

ectopic production of ADH leading to large amounts of ADH= concentrated urine

30
Q

why does SIADH cause a big Na dec in blood

A

large amounts being reabsorbed in kidney tubules > diluted blood so diluted Na [ ]

31
Q

2 etiological features of SIADH

A

post pit secreting too much ADH: iatrogenic, head injury
non-osmotic stimuli: hypovolaemia, hypotension
ectopic: small cell lung cancer

32
Q

what are the s/s of SIADH

A

usually only due to hyponatraemia- seizures, headache, fatigue, muscles aches, confusion

33
Q

what are some findings for U&Es of SIADH

A

hyponatrameia, high Na in urine

34
Q

mx of SIADH

A

fluid restriction, tolvaptan (ADH blocker)

35
Q

main complication of SIADH Na resuc

A

central pontine myelinolysis: Na reintroduced too fast so brain cells don’t have time to adjust- H2O leaves brain cells too fast

36
Q

posterior pituitary hypo function is….

A

Diabetes insipidus

37
Q

what is DI

A

lack of ADH or lack of ADH response = dilute urine as ADH causes reabsorption of H2O from tubules to blood, high Sr Na

38
Q

types of DI

A

cranial: hypothalamus doesn’t produce ADH
nephrogenic: collecting ducts don’t respond to ADH (resistant)

39
Q

s/s of DI

A

polyuria, polydipsia, hypernatraemia

40
Q

main sign of hypernatraemia

A

oedema

41
Q

Ix for DI

A

low urine osmolarity, high serum osmolarity

water deprivation test: norm urine: SR osmolarity >2. desmopressin then given, if ratio normalises then it is cranial DI

42
Q

mx of DI

A

cranial- desmopressin

nephrogenic: thiazide & NSAIDs

Endocrine (14 decks)

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