Pituitary Disease Flashcards
What level of prolactin raises suspicion of a prolactin-secreting tumour being present?
> 5000
How are prolactinomas treated medically?
Cabergoline (a dopamine agonist)
What are known side-effects of dopamine agonists?
Nausea
Vomiting
Depression
What causes acromegaly?
Excess growth hormone secretion
Why would onset of excess GH in childhood cause gigantism, but not when starting in adults?
As in children epiphyseal fusion has not yet occurred.
What pathology occurs in acromegaly?
Thickening of the soft tissue - most will die due to heart failure.
What is the most common cause of acromegaly?
Pituitary adenoma
How is acromegaly treated?
Surgical removal of the adenoma.
If not suitable, give loreotide (a synthetic somatostatin). This will cause tumour shrinkage. Dopamine agonists can also be effective.
What should acromegaly patients be screened for?
Bowel cancers (as increased risk of polyps)
Signs of CVD
Sleep apnoea (if present give CPAP)
What is the issue in Cushing’s syndrome?
Excess cortisol production
Results in protein loss, myopathy, osteoporosis, and thinning of the skin.
What mental health act impacts can Cushing’s syndrome have?
Psychosis
Depression
What are the key features of Cushing’s syndrome?
Thin skin
Proximal myopathy
Osteoporosis
How is Cushing’s syndrome tested for?
High-dose dexamethasone suppression test
What is the difference between Cushing’s disease and Cushing’s syndrome?
Cushing’s disease involves the pituitary only, whereas Cushing’s syndrome is pathology elsewhere in the body.
Critically, both produce the same symptoms.
What is the most common cause of Cushing’s?
Pituitary disease
