Pituitary

Question 1

What does trophic mean?

Answer 1

Stimulating another gland

Question 2

What does the anterior pituitary secrete?

Answer 2

TSH (thyroid stimulatin horome)
ACTH( Adrenocorticotropic hormone)
FSH (follicle stimulating hormone)
LH (Luteinizing hormone)

GH (human growth hormone)
Prolactin

Question 3

What does the posterior pituitary gland secrete?

Answer 3

ADH

Oxytocin

Question 4

What is Rathke’s pouch?

Answer 4

the anterior pituitary is derived from it

Question 5

What is diabetes inspidus ?

Answer 5

Lack of ADH secretion leading to life threatening deydration

Question 6

How are pituitary adenomas classified?

Answer 6

By cell type/hormone produced

Question 7

What is the most commone functional piuitary adenoma?

Answer 7

Prolactinoma (30%)

Question 8

What are the symptoms of prolactinomas

Answer 8

Infertility

lack of libido

amenorrhea

Question 9

What does a ACTH secreting functional pituitary adenoma cause?

Answer 9

cushing disease

Question 10

What is a Craniopharyngioma?

Answer 10

Slow growing tumour of the remmants of Rathke’s pouch

Question 11

What are the common pathologies of the adrenal gland?

Answer 11

Hypofunction or hyper function of the cortx or medulla

Question 12

What is addison’s disease?

Answer 12

Chronic hypofunction of the arenal cortex

Question 13

What is a cause of acute hypofunction of the adrenal medulla?

Answer 13

Waterhouse-Friderichsen

Question 14

What can cause hyperfunction of the adrenal cortex?

Answer 14

Hyperplasia

Adenoma

Carcinoma

Question 15

What can cause acute primary adrenocortical insufficiencey?

Answer 15

rapid withdrawal of steroid treatment

massive adrenal haemorrhage

Question 16

How dos Addison disease present?

Answer 16

Vague symptoms- weakness, nausea, vomiting , weight loss

Raised POMC ( pigmentation)

Question 17

What cells are found in the medulla of the arenal gland

Answer 17

Neuroendocrine cells

Question 18

What does the medulla secrete?

Answer 18

catecholamine

Question 19

What is a phaeochromocytoma?

Answer 19

Neoplasm derived from chromaffin cells of the adrenal medulla

Question 20

What problem can phaeochromocytoma cause?

Answer 20

Causes secondary hypertension by secreting cateholamines

Question 21

How can phaeochromocytoma be detected?

Answer 21

catecholamines detected in urine

Question 22

What does M.E.N stand for?

Answer 22

Multiple endcorine neoplasia

Question 23

What is found in MEN2A?

Answer 23

Phaeochromocytoma

Medullary thyroid carcinoma

Parathyroid hyperplasia

Question 24

What are the three zones of the adrenal gland?

Answer 24

Zona Glomerulosa

Zona Fasciculata

Zona Reticularis

Question 25

How do pituitory problems usually present?

Answer 25

Too much hormone Too little hormone Gland too big

Question 26

What is the principle behind dynamic testing in edndocrinology?

Answer 26

Too much hormone:- try suppression test Too little hormone:- try stimulation test

Question 27

What is the difference between a macroadenoma and a microadenoma?

Answer 27

Macroadenoma \> 1cm Microadenoma \< 1cm

Question 28

What visual field problem does optic chiasim compression cause?

Answer 28

Bitemporal hemiopia

Question 29

What are the physiological causes of raised prolactin?

Answer 29

Breast feeding pregnancy stress sleep

Question 30

What are the pathological causes of raised prolactin?

Answer 30

Hypothyroidism Stalk lesions (road accident) Prolactinoma

Question 31

what is the clincial signs of raised prolactin in a female?

Answer 31

Galactorrhoea mesntrual irregularity ammenorrhoea infertility

Question 32

What are the clincial signs of raised prolactin in a male ?

Answer 32

Impotence Visual field abnormalities Headache anterior pituitory malfunction

Question 33

What investigations are apropriate in prolactinoma?

Answer 33

Prolactin concentration MRI pituitary Visual fields

Question 34

What medical treatment can be ued in prolactinoma?

Answer 34

Dopamine agonist Cabergoline 2x per week

Question 35

What are the features of Acromegaly?

Answer 35

Giant Hypertension cardiac failure colonic polyps and cancer Local pituitary effects

Question 36

What test diagnosis acromegaly?

Answer 36

Glucose tolerance test

Question 37

How does the glucose tolerance test work?

Answer 37

Growth hormone normally supresses to \>0.4micrograms pre litre Acromegaly s confirmed in GH doest change or GH remains greater than 1 microrgram per litre

Question 38

How do you treat acromegaly?

Answer 38

Somatostatin then surgery

Question 39

What are the side affects of somatostatin analogues?

Answer 39

Gastritis Gallstones

Question 40

What is cushing syndrome?

Answer 40

Excess cortisol Excess Mieralocorticoid Excess Androgen

Question 41

What is characterisitic of cushings?

Answer 41

Think skin Proximal myopathy Frontal balding in woman Conjuctival oedema Osteoporosis

Question 42

What test is approriate in cushing syndrome?

Answer 42

Too much cortisol so suppression test is appropriate high dose of sterois should result in lowering of cortisol

Question 43

What is the diference between cushing disease and cushing syndrome?

Answer 43

Cushing disease arises from the pituitary Cushing syndrome arises from everywhere else