Pituitary Flashcards
DDx of 2ry amenorrhea (5)
- preg
- hypothalamus
- pit
- ovary
- endomet
3 hypothalamic causes of amen
- stress low weight
- post OCP
- lesion
3 pit causes of amen
- prolactinoma
- macroadenoma with stalk effect
- sheehan’s syndrome
2 causes of of ovary
- PCOS
2. premature ovarian failure
endo metrial cause
ashermans
Sx of hypo
mass lesions
vision changes
Sx of pit
galactorrhea
Sx of ovary
hiruitism
hot flashes
PHx for amen
- BMI
- CNs exam
- hirsuitism, acne
- thyrotoxicosis
- preg
- cushings
- EDs
amen tests to order
- B-HCG, TSH, prolactin
- LH, FSH, estradiol
- pelvic US
- testo
test to order if prolactin high
- B-HCG
- TSH
- creatinine
- AST
approach to pit. adenoma
- mass lesion
- hyper function
- hypofunction
3 ways to diagnose mass effect
- CN exam
- visual field tests
- MRI
3 ways to diagnose hyperfunction
- prolactin - can’t supress
- GH - supress
- ACTH - supress
how to diagnose hypofunciton
baseline level testing
presentation of mass effect
- headache
- visual field defect
- cranial nerves in cavernous sinus
5 presentations, baseline lab, and supression test for prolactinoma
present: galactorrhea, amen, ED, infert, hypogonad
baseline: high prolactin
supressiokn test: not done
presentations, baseline lab, and supression test for acromegaly
present: bone and tissue growth, carpal tunner, heart disease, sleep apnea
baseline: high GH, IGF-1
supressiokn test: glucose supresison test
presentations, baseline lab, and supression test for cushings
present: central pbesity, moon face, metabolic
baseline: high cortisol
supressiokn test: dexamethasone
4 types of hypofunction
- GH - short stature
- LH+FSH - hypogonadism
- TSH - hypothyroid
- ACTH - hypocortisolism
what to test with hypo
test baseline and if low try to stimulate it
def. microadenoma
pit. adenome
def. pit adenoma
benign neoplasm originating from the neuroendocrine cells of adenohypophysis
when is surgery indicated
- invasive
2. resitant to medical therapy
2 roles of patho
- distinguish adenoma from other lesions
2. provide a detailed histosubtype
med from prolactinoma
DA agonist - cabergoline, bromocriptine
what are pathelogical correlates of pit adenoma
when doesn’t respond to therapy it is more likely you are dealing with a aggresive subtype
how common are they
20% of pop. - many are non-functioning
