Pituitary Flashcards
what are posterior pituitary hormones?
ADH and oxytocin
how do the posterior pituitary hormones travel?
through neurones
how do anterior pituitary hormones travel?
in dat bloooood
name 5 substances made in the hypothalamus
dopamine, cortisol releasing hormone, thyroxine releasing hormone, Growth releasing hormone, gonadal releasing hormone
What does CRH produce in the pituitary?
ACTH
where does TSH come from
TRH in the pituitary
What does GnRH produce in pituitary
LH/FSH
What does GHRH produce?
GH
What negatively inhibits Prolactin?
dopamine
what is the dynamic test called done to suppress hormone
dexamethasone
Wha tis the dynamic test called that is used to stimulate hormone
synacthen test
When is the water deprivation test for?
tests for diabetes insipidus
what is the primary tumour called that is less than 1cm?
microadenoma
what is the pituitary tumour called that is >1cm
macroadenoma
what is a visual field defect due to compression of optic chiasm
bitemporal hemianopia
Why would prolactin be raised?
pregnancy, stress, lactation, sleep, dopamine antagonists
What is a pathological cause for raised prolactin?
hypothyroidism, prolactinoma
What are signs of raised prolactin?
galactorrhea, amenorrhoea, infertility, menstrual irregularity, impotence, visual disturbance, headache
What are th investigations for prolactinoma?
MRI pituitary, pituitary function tests, visual fields and prolactin concentration
What is the treatment choice for prolactinoma
carbegoline- 2x week
What is acromegaly?
excess in GH
What is their appearance?
thickened skin, hypertension, sleep apnoea, diabetes, CV death, large face
How do you diagnose acromegaly?
IGF-1, GTT
What is the treatment for acromegaly?
pituitary surgery, GTT retest, some may use somatostatin analogues (pre op)
What is cushings syndrome?
excess cortisol, mineralocorticoid, androgen
is there protein loss in cushings?
yes
what does protein loss in bushings lead to?
myopathy, osteoporosis, thin skin, striae and bruising
What is characteristic in cushings?
frontal balding in women, thin skin, myopathy, oedema and osteoporosis
What is the best way of diagnosing cushings?
2 day 2mg/ day dexamethasone suppression test - cortisol
Where does cushings most commonly arise from?
pituitary
how would you treat pituitary, adrenal and ectopic cushings?
pituitary: Hypophysectomy, adrenalectomy, ectopic= remove source
What drug would you use if the surgeries down work for cushings?
metyrapone, pasireotide- new somatostatin analogue
What are signs of anterior hypopituitarism
menstrual irregularities, infertility, gynaecomastia, loss of hair, growth retardation,
What are the drugs used for hypopituitarism therapy?
thyroxine, hydrocortisone, ADH, GH, HRT
what are the risks of testosterone replacement?
prostate enlargement, polycythaemia, hepatits
Is diabetes insipidus anterior or posterior
POSTERIOR
What is the treatment of diabetes insipidus
desmospray type thing
