Pituitary diease Flashcards

1
Q

what are sites of action in 1ry, 2ry, and 3ry defects

A
  1. primary organ
  2. pituitary
  3. hypothalamus
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2
Q

what does T3, T4 feed back into

A

both hypo and pit NEGatively

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3
Q

what is pattern in primary defects

A

pit and target hormone in opposite direction

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4
Q

what is pattern in secondary defect

A

same direction

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5
Q

what are the 3 presentations of pit. lesions

A
  1. mass effect
  2. hyperfunciton
  3. hypofunciton
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6
Q

what are mass effect presentaitons

A
  1. headache
  2. visual field defects
  3. cranial nerve in sinus being crushed (3, 4, V1V2, 6)
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7
Q

what are hyperfunction presentations from most to least common

A

nil>high prolactin>high GH>high ACTH

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8
Q

what is order in which hormones are lost in hypofunction

A
  1. GH
  2. LH
  3. FSH
  4. TSH
  5. ACTH
  6. Prolactin
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9
Q

what is reason for bilateral hemianopsia

A

optic nerve being crushed where it crosses over

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10
Q

what are 3 main disorders of hyperfunction

A
  1. acromegaly
  2. prolactinoma
  3. cushings (ACTH)
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11
Q

what are clinical, measurment and supression test for prolactinoma

A

clinical: galactorea, hypogonadism
measures: prolactin
supression: none exists

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12
Q

what are clinical, measurment and supression test for acromegaly

A

clinical: growth and metabolic effects
measures: baseline GH and IGF-1
supression: GH

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13
Q

what are clinical, measurment and supression test for cushings

A

clinical: catabolic effect, metabolic effects, fat dist.
measures: ACTH, cortisol
supression: cortisol

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14
Q

what are clinical signs of hypo function in GH, LH/FSH, TSH, ACTH

A

GH: short stature
LH/FSH: hypogonasim
TSH: weight gain, tiredness, cold intolerance, constipation
ACTH: weight loss, hypotension, nauseas/vomiting

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15
Q

what is done to assess hypofunciton

A

measure baseline and if low-normal try to stimulate it

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16
Q

what is insulin tolerance test

A

iv insulin to induce hypoglycemia which stimulates GH and cortisol

17
Q

what is stimulant test for LH/FSH

A

GnRH

18
Q

what are Hx and 5 tests for mass effect

A

Hx of headache and diploplia, decreased vision

  1. visual acuity
  2. extraocular movements
  3. visual field testing
  4. pupilarry reaction to light
  5. Fundi
19
Q

3 treatments for acromegaly

A
  1. drugs
  2. surgery
  3. radiation
20
Q

what are 2 drugs used to treat acromegaly

A
  1. somatostatin

2. GH receptor blockers

21
Q

what is pathway by which prolactin effects T

A

prolactin - > GnRH + > LH/FSH +> T

22
Q

5 DDx of high prolactin

A
  1. physiological: pregancy, breatfeeding
  2. Pituitary: prolactinoma
  3. loss of dopaminergic inhib of prolactin
  4. hypothyroisism: high TSH > high prolactin
  5. renal and liver failure
23
Q

what is drug treatment of prolactinoma

A

dopamine agonist

24
Q

what is suppression test for cushings (high cortisol)

A

dexamethasone (synthetic cortisol)