Pituitary

Question 1

symptoms Acromegaly

Answer 1

proximal muscle weakness and joint pain, tongue enlargement, deepened voice, thick and leathery skin, acne, visual changes caused by pressure on the optic nerve, and headaches.

Affected individuals have a reduced life expectancy. They are prone to cardiovascular disease, diabetes mellitus, and colorectal cancer.

Question 2

adrenocorticotropic hormone (ACTH) level is increased

Answer 2

Cushing’s disease results.

Question 3

thyroid-stimulating hormone (TSH) level is excessive

Answer 3

hyperthyroidism develops.

Question 4

Hypopituitarism symptoms

Answer 4

Headaches
Visual changes (decreased visual acuity or decreased peripheral vision)
Loss of sense of smell
Nausea and vomiting
Seizures

Question 5

SIADH causes

Answer 5

The most common cause is cancer, especially small cell lung cancer. Although SIADH tends to be self-limiting when caused by head trauma or drugs, it is chronic when associated with tumors or metabolic diseases.

• Syndrome of inappropriate antidiuretic hormone (SIADH)

Question 6

SIADH symptoms

Answer 6

Fluid retention
Serum hypoosmolality
Dilutional hyponatremia
Concentrated urine in the presence of normal or increased intravascular volume
Low urine output
Increased body weight

Question 7

Diabetes insipidus symptoms

Answer 7

Excretion of large quantities of urine (2-20 L/day)
A very low specific gravity (<1.005)
Urine osmolality of <100 mOsm/kg (100 mmol/kg)

Question 8

Identification of central DI can be made with

Answer 8

the water deprivation test.

Before the test, body weight and urine osmolality, volume, and specific gravity are measured. Sometimes serum osmolality is also measured.
The patient is deprived of water for 8 to 12 hours and then given desmopressin acetate (1-deamino-8-D-arginine vasopressin [DDAVP]) subcutaneously or nasally.
Urine and potentially serum are then periodically measured for response to the DDAVP.

Question 9

Treatments for Patients with Diabetes Insipidus

Answer 9

Care of a patient with DI also includes maintaining adequate hydration and patient education for long-term management. A therapeutic goal is maintenance of fluid and electrolyte balances.

Question 10

Treatment for hypopituitarism

Answer 10

The treatment for hypopituitarism often consists of surgery or radiation therapy followed by lifelong hormone therapy. Appropriate hormone therapy is used to correct the deficiency (e.g., GH, corticosteroids, TSH, sex hormones).

Question 11

Treatment of SIADH

Answer 11

Treatment of SIADH is directed at the underlying cause. Medications that stimulate ADH release should be avoided or discontinued.