Pituitary

Question 1

DDx of 2ry amenorrhea (5)

Answer 1

1. preg
2. hypothalamus
3. pit
4. ovary
5. endomet

Question 2

3 hypothalamic causes of amen

Answer 2

1. stress low weight
2. post OCP
3. lesion

Question 3

3 pit causes of amen

Answer 3

1. prolactinoma
2. macroadenoma with stalk effect
3. sheehan’s syndrome

Question 4

2 causes of of ovary

Answer 4

1. PCOS

2. premature ovarian failure

Question 5

endo metrial cause

Answer 5

ashermans

Question 6

Sx of hypo

Answer 6

mass lesions

vision changes

Question 7

Sx of pit

Answer 7

galactorrhea

Question 8

Sx of ovary

Answer 8

hiruitism

hot flashes

Question 9

PHx for amen

Answer 9

• BMI
• CNs exam
• hirsuitism, acne
• thyrotoxicosis
• preg
• cushings
• EDs

Question 10

amen tests to order

Answer 10

• B-HCG, TSH, prolactin
• LH, FSH, estradiol
• pelvic US
• testo

Question 11

test to order if prolactin high

Answer 11

• B-HCG
• TSH
• creatinine
• AST

Question 12

approach to pit. adenoma

Answer 12

1. mass lesion
2. hyper function
3. hypofunction

Question 13

3 ways to diagnose mass effect

Answer 13

1. CN exam
2. visual field tests
3. MRI

Question 14

3 ways to diagnose hyperfunction

Answer 14

1. prolactin - can’t supress
2. GH - supress
3. ACTH - supress

Question 15

how to diagnose hypofunciton

Answer 15

baseline level testing

Question 16

presentation of mass effect

Answer 16

1. headache
2. visual field defect
3. cranial nerves in cavernous sinus

Question 17

5 presentations, baseline lab, and supression test for prolactinoma

Answer 17

present: galactorrhea, amen, ED, infert, hypogonad
baseline: high prolactin
supressiokn test: not done

Question 18

presentations, baseline lab, and supression test for acromegaly

Answer 18

present: bone and tissue growth, carpal tunner, heart disease, sleep apnea
baseline: high GH, IGF-1
supressiokn test: glucose supresison test

Question 19

presentations, baseline lab, and supression test for cushings

Answer 19

present: central pbesity, moon face, metabolic
baseline: high cortisol
supressiokn test: dexamethasone

Question 20

4 types of hypofunction

Answer 20

1. GH - short stature
2. LH+FSH - hypogonadism
3. TSH - hypothyroid
4. ACTH - hypocortisolism

Question 21

what to test with hypo

Answer 21

test baseline and if low try to stimulate it

Question 22

def. microadenoma

Answer 22

pit. adenome

Question 23

def. pit adenoma

Answer 23

benign neoplasm originating from the neuroendocrine cells of adenohypophysis

Question 24

when is surgery indicated

Answer 24

1. invasive

2. resitant to medical therapy

Question 25

2 roles of patho

Answer 25

1. distinguish adenoma from other lesions

2. provide a detailed histosubtype

Question 26

med from prolactinoma

Answer 26

DA agonist - cabergoline, bromocriptine

Question 27

what are pathelogical correlates of pit adenoma

Answer 27

when doesn’t respond to therapy it is more likely you are dealing with a aggresive subtype

Question 28

how common are they

Answer 28

20% of pop. - many are non-functioning