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Year Two - Endocrine System > Pituitary Adenoma > Flashcards

Pituitary Adenoma Flashcards

1
Q

What is a pituitary adenoma?

A

They are defined as benign tumours of the pituitary gland

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2
Q

What is the most common classification of pituitary tumours?

A

Pituitary adenoma

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3
Q

What are the two classifications mechanisms of pituatary adenomas?

A

Pituitary Adenoma Size

Pituitary Adenoma Hormonal Status

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4
Q

What are the two size classifications of pituatary adenomas?

A

Microadenomas

Macroadenomas

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5
Q

What are microadenomas?

A

They are defined as pituitary adenomas which are less than 1cm in diameter

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6
Q

What are macroadenomas?

A

They are defined as pituitary adenomas which are greater than 1cm in diameter

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7
Q

What are the two hormonal status classifications of pituitary adenomas?

A

Secretory Adenomas

Non-Secretory Adenomas

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8
Q

What is another term for secretory pituitary adenomas?

A

Functioning pituitary adenomas

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9
Q

What are secretory pituitary adenomas?

A

They are defined as pituitary adenomas which produce excess of a particular hormone

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10
Q

What is the most common subclassification of secretory pituitary adenomas?

A

Prolactinomas

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11
Q

How do secretory pituitary adenomas present?

A

Hyperpituitarism

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12
Q

What is another term for non-secretory pituitary adenomas?

A

Non-functioning pituitary adenomas

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13
Q

What are non-secretory pituitary adenomas?

A

They are defined as pituitary adenomas which don’t produce excess of a particular hormone

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14
Q

How do non-secretory pituitary adenomas present?

A

These tumours lead to compression of the normal functioning pituitary gland, therefore resulting in the presentation of generalised hypopituitarism and pressure effects

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15
Q

What are the nine clinical features of pituitary adenomas?

A

Headaches

Nausea & Vomiting

Bitemporal Hemianopia

Amenorrhea

Galactorrhoea

Decreased Libido

Cushing’s Syndrome Features

Acromegaly Features

Diabetes Insipidus Features

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16
Q

What are the three investigations used to diagnose pituitary adenomas?

A

Blood Tests

Visual Field Testing

MRI Scans

17
Q

What is the first line investigation used to diagnose pituatary adenomas?

A

Blood Tests

18
Q

What six blood test results indicate a pituitary adenoma?

A

Increased/Decreased Growth Hormone Levels

Increased/Decreased ACTH Levels

Increased/Decreased Cortisol Levels

Increased/Decreased Prolactin Levels

Increased/Decreased FH/LSH Levels

Increased/Decreased T3/T4/TSH Levels

19
Q

Which pituitary adenoma classification results in hormone hypersecretion blood results?

A

Secretory pituitary adenomas

20
Q

Which pituitary adenoma classification results in hormone hyposecretion blood results?

A

Non-secretory pituitary adenoma

21
Q

What visual field test result indiciates pituitary adenoma?

A

Bitemporal hemianopia

22
Q

What MRI scan result indicates pituitary adenoma?

A

A hyperdense mass within the sellar region

23
Q

What is the pharmacological management option of pituatary adenomas?

A

Hormonal Therapy

24
Q

When is hormonal therapy used to manage pituitary adenomas?

A

It is the first line management option used to manage secretory pituitary adenomas - prolactinomas

25
Q

Name a hormonal therapy used to manage prolactinomas

A

Bromocriptine

26
Q

What is the surgical management option of pituitary adenomas?

A

Transsphenoidal Transnasal Hypophysectomy

27
Q

When is transsphenoidal transnasal hypophysectomy used to manage pituitary adenoma?

A

It is used to manage non-secretory pituitary adenomas in which the following criteria is obtained…

  • Visual Field Defects
  • MRI Optic Chiasm Compression
  • Pituitary Apoplexy & Visual Disturbances
  • Hypersecreting Adenoma Excluding Prolactinomas
28
Q

What is transsphenoidal transnasal hypophysectomy?

A

It involves removal of the pituitary adenoma through the sphenoid sinus

29
Q

When is radiotherapy used to manage pitutary adenomas?

A

Recurrent pituitary adenomas

30
Q

In what two ways is radiotherapy used to manage pituitary adenomas?

A

To control growth rate

To reduce excess hormone secretion

31
Q

What complication is associated with pituitary adenomas?

A

Pituitary Apoplexy

32
Q

What is pituitary apoplexy?

A

It is defined as a sudden enlargement of a pituitary tumour secondary to haemorrhage/infarction

33
Q

Which pituitary adenoma classification is most commonly associated with pituitary apoplexy?

A

Non-secretory macroadenomas

34
Q

What are the four risk factors associated with pituitary apoplexy?

A

Trauma

Hypertension

Pregnancy

Anticoagulation

35
Q

What are the six clinical features associated with pituitary apoplexy?

A

Sudden Onset Headache

Nausea & Vomiting

Neck Stiffness

Bitemporal Superior Quadrantic Defect

Extraocular Nerve Palsies

Hypotension

36
Q

What are the three management options of pituitary apoplexy?

A

IV Hydrocortisone

Fluid Balance

Pituitary Surgical Resection

37
Q

What is the first line management option of pituitary apoplexy?

A

IV Hydrocortisone

This should be administered urgently, before diagnostic investigations due to the life-threatening consequences

Year Two - Endocrine System (17 decks)

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