pituitary

Question 1

hypopituitarism Tx

Answer 1

HRT

Question 2

hypopituitarism cause

Answer 2

decreased GH, TSH, ACTH, ADH (anterior pituitary)
tumors, erosion, malnutrition, severe hypotension, RAI

Question 3

hypopituitarism: GH

Answer 3

osteoporosis –> fractures
increased serum cholesterol

Question 4

hypopituitarism: TSH

Answer 4

weight gain
intolerance to cold
alopecia
slowed cognition
lethargy
decreased thyroid hormones

Question 5

hypopituitarism: ACTH

Answer 5

decreased serum cortisol
pale
malaise
lethargy
anorexia
hypoglycemia
hyponatremia
decreased hair

Question 6

hypopituitarism: ADH

Answer 6

DI

Question 7

DI

Answer 7

increased urine output
decreased urine specific gravity (<1.005)
hypotension
dehydration
increased plasma osmolarity
increased thirst
increased plasma electrolyte levels (Na)
urine output does not decrease when intake decreases

Question 8

hyperpituitarism cause

Answer 8

increased GH, ACTH, TSH, ADH (anterior pituitary)
anterior pituitary tumors or tissue hyperplasia (overgrowth), most often caused by a benign tumor called an adenoma

Question 9

hyperpituitarism Tx

Answer 9

hypophysectomy

Question 10

hyperpituitarism: GH

Answer 10

acromegaly

Question 11

acromegaly

Answer 11

thick lips and facial features
increased head size
lower jaw protrusion
enlarged hands and feet
joint pain
hyperglycemia
sleep apnea
enlarged heart, liver, and lungs

Question 12

hyperpituitarism: ACTH

Answer 12

pituitary cushing

Question 13

cushing syndrome

Answer 13

excess ACTH overstimulates the adrenal cortex –> excess development of steroids
increased plasma cortisol
weight gain
truncal obesity
moonface
muscle wasting
decreased bone density
hypertension
hyperglycemia
striae
acne

Question 14

hyperpituitarism: TSH

Answer 14

increased thyroid hormone levels
weight loss
tachycardia
dysrhythmias
heat intolerance
increased GI motility
tremors

Question 15

hyperpituitarism: ADH

Answer 15

SIADH

Question 16

SIADH

Answer 16

water retention –> fluid overload
dilutional hyponatremia
GI disturbances (N/V, loss of appetite)
weight gain (water weight)
lethargy
headaches
bounding pulse
hypothermia
change in LOC
increased urine osmolarity
decreased plasma osmolarity

Question 17

DI Tx

Answer 17

desmopressin (vasopressin)
24 hr collection
NO fluid restriction

Question 18

SIADH Tx

Answer 18

fluid restriction
replace Na (hypertonic saline NaCl)
promote output
monitor
VAPTANS (vasopressin receptor antagonists)

Question 19

vasopressin effects

Answer 19

vasoconstriction
increases BP
decreases water excretion by the kidneys by increasing water reabsorption in the collecting ducts
ADH

Question 20

cushings NI

Answer 20

I&O
daily weights
serum glucose
serum electrolytes