Pituitary

Question 1

Structures that is:

• Superior
• Inferior
• Lateral

To the pituitary

Answer 1

Superior
- Diaphragma sellae

Inferior
- Sphenoidal air sinuses

Lateral
- Cavernous sinuses

Question 2

Pituitary apoplexy

• Description
• Presentation

Answer 2

Bleeding into or impaired blood supply to the pituitary

Presentation

• Sudden headache
• Nausea/ vomitting
• Visual field disturbane
• Altered level of consciousness

Question 3

Grading of pituitary tumours

Answer 3

Hardy
- Plain X-ray

Fahlbusch
- CT/ MRI of tumour size

Knosp
- Cavernous sinus invasion

Question 4

Medical treatment of tumour

Answer 4

Prolactin
- DA agonist

Somatostatin analogues
- Octreotide

Cushings
- Ketoconazole

Replacement therapy (hypopituitarism)

Question 5

Indications for surgery

Answer 5

Mass effect tumour (macroadenoma)
- Riased IC pressure

Pituitary dependant Cushings disease

GH secreting tumour

Prolactinoma
- When medical treatment failures

TSHoma

Question 6

Craniopharyngioma

Answer 6

Tumour commonly affecting children
- Pituitary gland embryonic origin (Rathke’s pouch)

Half of all suprasellar tumours in children