Pituitary and Adrenal Disease

Question 1

What are some of the main classic symptoms of prolactinomas? What is the first-line treatment?

Answer 1

• Hypogonadism/infertility
• Galactorrhoea
• DA agonists (bromocriptine/cabergoline) are used

Question 2

What are the classic signs of a GH-secreting pituitary tumour? How might you treat a patient with one?

Answer 2

• Acromegaly - bony enlargement etc.
• Diabetes or impaired glucose tolerance
• DA agonists/long-acting octreotide/radiotherapy/resection

Question 3

What are the gold-standard tests for Cushing’s disease?

Answer 3

• 24-hour urinary free cortisol
• Overnight dexamethasone suppression test

Question 4

If you were to look at the electrolyte analysis of a person with Addison’s disease, what might you expect to see?

Answer 4

• Hyperkalaemia
• Hyponatraemia
• Acidosis (moderate)
• Increased uraemia
• Hypoglycaemia

Question 5

What, on an electrolyte analysis, might make you suspicious for Conn’s syndrome? How might you further investigate it?

Answer 5

• Hypokalaemia, hypernatraemia
• Acidosis
• Blood renin-aldosterone ratio