Pituitary Flashcards
Name the 8 hormones secreted by the pituitary
Posterior: ADH and oxytocin
Anterior- growth hormone, FSH, LH, ACTH, TSH, prolactin
Where is the pituitary located and how can this possibly influence presentation of pituitary disease?
Pituitary fossa in base of skull; close to optic chiasm and cranial nerves III, IV and VI. May present with visual field problems (bitemporal hemanopia) or cranial nerve palsy
How do non-functioning pituitary adenomas present?
Features of local pressure
Hypopituitarism (either pan- or specific to a certain hormone e.g. secondary adrenal insufficiency)
Which classes of drug can cause raised hyperprolactinaemia?
Dopamine antagonists e.g. metoclopramide
Anti-depressants, anti-psychotics, oestrogens
What is the stand-out symptom in raised prolactin?
Galactorrhoea
How is raised prolactin treated?
Dopamine agonists e.g. bromocriptine, cabergoline
How is acromegaly diagnosed?
Age and sex-matched IGF levels
Glucose tolerance test (glucose should suppress GH)
What are the non-surgical options for management in acromegaly?
Dopamine agonists e.g. bromocriptine, cabergoline
Subcutaneous somatostatin analogues e.g. octreotide
GH antagonist pegvisomant
What causes most (non-iatrogenic) cases of Cushings disease?
Pituitary adenoma
Name five prominent Cushingoid symptoms.
Hirsutism
Central obesity
Hair loss
Increased fracture risk
Facial fullness ("moon face")What is the definitive test for Cushings?
Low-dose dexamethasone suppression test
What does posterior hypopituiarism cause?
Diabetes insipidus
