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Jason's MD2 Intersession 2 > Pituitary & Adrenal Disease > Flashcards

Pituitary & Adrenal Disease Flashcards

1
Q

what is craniopharyngioma?

A

childhood, above pituitary, mass effect, hypothalamic syndrome: obesity

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2
Q

features of pituitary headache?

A

cracking headache Right between the eyes

apyplexy: bleed into the pituitary
Acute ACTH deficiency

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3
Q

70% of pituitary adenomas are?

A

non functioning tumours

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4
Q

3 most common hormone secreting pituitary adenomas

A

prolactinoma (most common)
acromegaly
cushing’s

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5
Q

what inhibits prolactin?

A

dopamine

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6
Q

what affects prolactin release?

A

dopamine modifiers like psychiatric meds etc.

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7
Q

symptoms of prolactinoma?

A

negative preg tests

galactorrhoea

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8
Q

with prolactinomas, usually secrete what two things?

A

IGF-1 and prolactin

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9
Q

how to best test for thyroid hormone?

A

TSH levels

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10
Q

how to test for thyroid pituitary problems?

A

TSH T3 T4

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11
Q

what is stalk effect?

A

pituitary mass that pushes up and cuts off the connection from hypothalamus to pituitary

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12
Q

dopamine agonists for prolactinomas? side effects?

A

bromocriptine
cabergoline (weekly)

SFx: nausea, GI upset

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13
Q

How to test suppress growth hormone?

A

oral glucose challenge,

grelin levels decrease when nutrients

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14
Q

how to measure growth hormone?

A

IGF-1

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15
Q

how to look for body’s ability to make ACTH and IGF-1?

A

insulin induced hypoglycaemia

both should raise

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16
Q

acromegaly most common causes?

A

growth hormone secreting adenoma

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17
Q

how to ask for acromegaly re: hands/feet?

A

are your rings still fitting?

need to buy new shoes?

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18
Q

acromegaly and cancer?

A

increase risk of colonic cancers, accelerating growth of existing

19
Q

macroadenoma in pituitary symptoms?

A

bitemporal hemiopnopia

20
Q

acromegaly treatment?

A

surgery
radiotherapy
octreotide - SFx: gallstones
bromocriptine

21
Q

Synacthin test?

A

give synthetic ACTH to stim the adrenals, expect rise, if don’t see a big rise then adrenals not responding

22
Q

ACTH independent cushing’s syndrome are?

A

adrenal adenoma/carcinoma

micro/macronodular hyperplasi

23
Q

ACTH dependent cushing syndrome

A

Cushing’s
ectopic ACTH
ectopic CRF

24
Q

cushing’s syndrome signs?

A 
wounds not healing
myopathy
striae
osteoporosis (spinal), kyphosis
rapid weight gain
25
Q

cushing’s syndrome dx? 2

A

free cortisol from 24 hour collection

dexamethasone suppression test

26
Q

what is inferior petrosal sinus sampling for?

A

pituitary drainage has higher level of ACTH than peripheral

confidence for treatment

27
Q

Adrenals: which enzyme important to know about

A

21 hydroxylase deficiency

28
Q

why pigmentaion in addisons disease?

A

high POMC levels, increase melanocyte production

29
Q

addison’s cause?

A

autoimmune
infection
of the adrenals

30
Q

addison’s symptoms?

A

hyperkalaemia
hyponatraemia
hypoglycaemia

31
Q

key modulator in addison’s?

A

potassium

32
Q

addisonian crisis rx?

A

fluid
hydrocortisone

Glucocorticoid (more if times of stress)
mineralcorticoids too

33
Q

Conn’s syndrome need 2 things to consider?

A

hypokalaemia

uncontrolled hypertension

34
Q

common cause of Conn Syndrome?

A

adrenal adenoma

35
Q

best test to do for Conn Syndrome?

A

saline infusion test, aldosterone should be suppressed from all the Na+, if not then it’s independent and a problem

36
Q

pheochromocytoma where?

A

in adrenal medulla

37
Q

pheochromocytoma symptoms?

A

massive episodes of panic attacks, palpitations, hypertension

38
Q

metanephrines are what?

A

degredation product of epinephrines

39
Q

how to dx pheochromocytoma?

A

24 hour collection of catecholamines

imaging: adrenals or paragangliomas in cervical/thoracics

40
Q

pre-operative in pheochromocytoma?

A

alpha blockers

not beta blockers before alpha blockers

41
Q

multiple endocrine neoplasia syndromes (MEN1 causes?)

A

3 Ps
pituitary
parathyroid
pancreas

42
Q

MEN 2 lead to?

autosomal dominant

A

medullary thyroid cancers, very deadly

pheochromocytoma

43
Q

most common pituitary mass?

A

pituitary adenoma
craniopharyngioma
Meningioma

Jason's MD2 Intersession 2 (15 decks)

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