Pituitary Flashcards
which hormone stimulates the thyroid to produce thyroid hormones which regulate the body’s metabolism?
TSH
Thyroid stimulating hormone
which hormone increases production and release of cortisol by the adrenal glands in response to stress?
ACTH
Adrenocorticotrophic hormone
which hormone causes bone and tissue growth, raises blood glucose, and controls balance of fat & muscle tissue in the body?
GH
Growth hormone
which hormone triggers ovulation and development of corpeus luteum in females and triggers Leydig cells to produce testosterone in males?
LH
Lutinizing hormone
which hormone stimulates growth of ovarian follicles in females and acts on Sertoli cells to stimulate sperm production in males?
FSH
Follicle stimulating hormone
which hormone controls breast developments and stimulates lactation in mammary glands?
Prolactin
which hormone stimulates uterine contractions in childbirth, milk letdown reflex, bonding with sexual activity and between mom/baby?
Oxytocin
which hormone causes reabsorption of free water and increases blood pressure by constricting arterioles?
ADH
Vasopressin
In primary disease, there is impaired function at the level of the ______
target endocrine gland
In secondary disease, there is impaired function at the level of the ______
pituitary
In tertiary disease, there is impaired function at the level of the ______
hypothalamus
What are 3 ways patient present clinically with pituitary adenomas?
- syndromes related to hormone excess/deficiency
- neurological manifestations secondary to mass effect
- Incidental finding on imaging
Male pt presents with gynecomastia, impotence, ED, and infertility.
… Dx?
Prolactinoma
35 y/o female presents with oligomenorrhea, galactorrhea, decrease in libido, and infertility.
… Dx?
Prolactinoma
How would you treat a patient with prolactinoma?
What are your first and second line medications?
- Dopamine agonists
- 1st = Cabergoline
2nd = Bromocriptine
Pt presents with increase in hand and foot size, and enlarged mandible, proximal weakness, and fatigue.
… Dx?
Acromegaly
excessive growth hormone
What tests would you order if you suspected pt had acromegaly?
- IGF-1 levels (insulin-like growth factor)
- Oral glucose suppression test and GH level
- MRI
True or False: Serum GH would not be suppressed after a PO glucose intake in a patient with acromegaly
True
Female pt presents with hirsutism, menstrual irregularities, labile mood, proximal muscle weakness, and changes in facial features.
… Dx?
Cushing’s Disease
what are the most common neurologic Sx in patients with pituitary adenomas?
headaches and visual changes
If a pituitary ademona is suspected, what imaging study would you order?
MRI with and without contrast
Male patient presents with daily headaches, visual symptoms, and ED.
… Dx?
Craniopharyngioma
What is the treatment for craniopharyngioma?
- Aggressive surgical resection
- possible radiation therapy to treat residual disease
What are the main causes of hypopituitarism?
- compression due to tumors
- inflammation
- vascular damage
- disease of the hypothalamus
_____ is an infarction of the pituitary gland after severe postpartum hemorrhage
Sheehan Syndrome
Pt presents with sudden onset of severe headache, diplopia, and acute development of hypopituitarism.
… Dx?
Pituitary Apoplexy
At least one pituitary hormone deficiency develops in about 25-30% of survivors of _______ as well as 55% of survivors or _______
- moderate to severe TBI
- aneurysmal subarachnoid hemorrhage
Some degree of hypopituitarism (usually GH deficiency or hypogonadotropic hypogonadism) occurs in one-third of ____ patients
ischemic stroke patients
With empty sella syndrome, pt may have normal pituitary function. What can end up developing insidiously?
hypopituitarism
Diabetes insipidus is caused by ____ secretion of ADH
decreased
Which diabetes insipidus is caused by the posterior pituitary decreasing secretion of ADH?
Central DI
Which diabetes insipidus is caused by the kidneys not being as sensitive to ADH
Nephrogenic DI
What are the common signs of Diabetes Insipidus?
Polyuria, nocturia, polydipsia, dilute urine.
Treatment for Central DI?
- Low sodium and protein diet
- Desmopressin
- HCTZ
Treatment for Nephrogenic DI?
- Low sodium and protein diet
- HCTZ
- frequent bladder voiding
