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Endocrinology > Pituitary and Hypothalamic Disorders > Flashcards

Pituitary and Hypothalamic Disorders Flashcards

1
Q

6 Regulatory hormones of the hypothalmus

A 
TRH:  Thyrotropin releasing hormone
GnRH:  Gonadotropin releasing hormone
CRH:  Corticotropin releasing hormone
GHRH:  Growth hormone releasing hormone
GHIH:  Somatostatin
PIH:  Prolactin inhibiting hormone
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2
Q

Hormones of the anterior pituitary

A 
FLAT PeG
FSH
LH
ACTH
TSH
Prolactin
GH
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3
Q

Most common cause of sellar masses?

A

Adenoma

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4
Q

Prolactinoma

A

Most common type of pituitary adenoma
Secretes prolactin
May compress optic chiasm = bitemporal hemianopsia

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5
Q

Prolactin inhibiting hormone?

A

Dopamine

If this cannot reach the pituitary because of a damaged stalk, prolactin levels will increase unchecked.

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6
Q

Medications that increase serotonin may lead to?

A

Increased prolactin levels
Antidepressants
Antipsychotics

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7
Q

Hypothyroidism may lead to?

A

Increased prolactin levels.

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8
Q

What does prolactin block?

A

Gonadotropins FSH and LH

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9
Q

Is a microadenoma more common in men or women?

A

Women

Macroadenomas (>1cm) are more common in men

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10
Q

S/S of prolactinoma in women:

A

Amenorrhea
Galactorrhea (milk w/o baby)
Infertility

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11
Q

S/S of prolactinoma in Men

A

Decreased Libido, gynecomastia, ED, infertility, bitemopral hemianopsia
Leads to decreased testosterone

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12
Q

Best test to dx prolactinoma?

A

Prolactin level

MRI to confirm

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13
Q

Tx for prolactinoma?

A

Dopamine agonists:
Cabergoline **
Bromocriptine
Surgery, chemo and radiation may be needed

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14
Q

Acromegaly

A

Excess growth hormone
Almost always caused by pituitary tumor
May also be ass’d with pancreas, paraT tumors

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15
Q

Acromegaly S/S

A 
Skeletal changes
Prominent brow, jaw protrusion
Enlarged hands and feet
Deepening of voice
Carpal tunnel syndrome
CHF
Organomegaly
Amenorrhea
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16
Q

Acromegaly Dx

A

IGF-1 level
Serum GH not suppressed following oral glucose load
MRI

17
Q

Acromegaly Tx

A

Surgery

Or oral cabergoline

18
Q

Gigantism

A

Excessive GH in children prior to closing of epiphyses

W/U and Tx same as acro…

19
Q

Pituitary Apoplexy

A

Hemorrhage into the pituitary gland
Usually secondary to adenoma
HA, N/V, AMS, low BP, low glucose

20
Q

Sheehan’s Syndrome

A

Post partum pituitary ischemic necrossi
Secondary to hypotension, emboli, HELLP syndrome.
DIfficulty breastfeeding, extended amenorrhea

21
Q

First hormone deficiency to develop with lack if functioning pituitary? 2nd, 3rd 4th?

A

1: GH
2: LH/FSH
3: TSH
4: ACTH

22
Q

S/S of LH/FSH deficiency

A

Amenorrhea, infertility, decreased pubic, axillary hair, genital atrophy, decreased libido, ED

23
Q

S/S GH deficiency

A

Clinically undectable

24
Q

S/S TSH deficiency

A

Fatigue, weight gain, weakness, decreased appetite, low BP, Low glucose

25
Q

S/S ACTH deficiency

A

Fatigue, decreased appetite, decreased pigmentation, low BP, low glucose

26
Q

Hypopituitary Dx

A 
Test anterior hormones
LH/FSH
IGF-1 or GH glucose
TSH
ACTH (cortisol)
MRI
27
Q

Hypopituitary tx

A

Adress underlying cause
Replace needed hormone
Decompression may be needed for apoplexy

28
Q

SIADH

A 
Syndrome of Inappropriate ADH (too high)
Euvolemic Hyponatremua
**Elevated ADH Levels**
Fluid is retained
Low sodium, serum osmolarity
29
Q

SIADH S/S

A

If chronic: asymptomatic
HA, N/ V
AMS
Seizures

30
Q

SIADH Causes

A

TBI
Malignancy
Meningitis
Medications

31
Q

SIADH Dx

A

CMP
Urine dip
High urine sodium, low serum sodium
Head CT

32
Q

SIADH Tx

A

Increase serum sodium levels
Restrict fluids to 1200-1800 mL/day
Hyperotonic saline (3%) for symptomatic patients
1-2 ml/kg over 3-4 hours slowly

33
Q

Diabetes Insipidus

A 
Central::
Deficient levels of ADH
Deficiency or resistance to ADH
OR
Nephrologic:: defect of renal tubules that interferes with water reabsorption
34
Q

Diabetes Insipidus S/S

A 
Elevated plasma sodium, inability to concentrate urine.
Intense thirst (2-20L/day)
Polydipsia. Polyuria, Nocturia
Craving for ice water
Hypernatremia
35
Q

Diabetes Insipidus etiology

A 
Central::
Most common:  trauma or tumor
Meningitis, radiation, idiopathic, cerebral anoxia
Nephrogenic::
Meds: lithium, demeclyocycline
Hypercalcemia, hypokalemia
Sjogrens Syndrome
36
Q

Diabetes Insipidus Dx

A

CMP
Plasma osmolarity
Plasma ADH
DDAVP Test

37
Q

Diabetes Insipidus Tx

A

Central: DDAVP
Nephrogenic:
HCTZ or amiloride
Blocks reabsorption, keeps plasma sodium low

Endocrinology (16 decks)

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