pituitary/adrenal cases Flashcards
what are some features of acromegaly?
- sweating
- extreme tiredness
- shoe size increase
- jaw pronounciating
- frontal bossing/prominant forehead
- large nose
- thickened skin
- enlarged pores
- oily skin
- hypertension
- cardiac failure
- headaches (adenoma)
- sleep apnoea
- diabeted
what other investigations should be performed for acromegaly?
IGF-1
OGTT
MRI or CT to test for macro adenoma
what are some causes of galactorrhoea?
- prolactinoma
- dopamine antagonist
- pregnancy
- hypothyroidism
what are structures A, B and C?
A- sphenoid sinus
B- optic chiasma
C- internal carotid artery
where is most pituitary surgery done?
transsphenoidal (through sphenoidal sinus)
what is the danger of pituitary surgery?
-injuring the internal carotid arteries
what is structure A?
optic chiasma
what happens if the pituitary gland swells and presses on the optic chiasma?
-bitemporal hemianopia
what are the contents of the cavernous sinus?
- internal carotid arteries
- CN 3,4,5,6
(they are getting eyelid held open)
oculomotor (CNIII)
what is the differential diagnosis?
-Cushing’s
moon face, obesity, skin thinning so bruising, hair loss, hypertension
what are some causes of Cushings?
- pituitary adenoma (cushings disease)
- steroids
- alcohol
- depression
- exogenous steroid use
- adrenal adenoma
- ectopic ACTH
what test is done to confirm cushings?
-dexamethasone suppression test
what do you think the diagnosis is?
-hypopituitarism
what are 6 possible causes of hypopituitarism?
- pituitary tumors
- post pituitary surgery
- previous radiation near that area
- trauma to the head
- sarcoidosis
what may cause you to miss your period?
- stress
- PCOS
- hypothyroidism
- prolactinoma
- poor diet
- early menopause
- pregnancy
