pituitary disease

Question 1

what is an endocrine disease?

Answer 1

dysfunction of hormone secreting glands
either 
control failure (secondary)
gland failure (primary)

Question 2

what is multiple endocrine neoplasia?

Answer 2

tumours can develop in collection of glands from same embryological tissue

Question 3

describe MEN 1

Answer 3

parathyroid, pancreatic islets, pituitary

associated tumours- adrenal cortex, carcinoid, lipoma

Question 4

describe MEN2a

Answer 4

parathyroid, medullary thyroid, phaeochromocytoma

Question 5

describe MEN2b

Answer 5

medullary thyroid, pheochromocytoma
mucosal neuromas
marfanoid appearance

Question 6

describe the pituitary gland

Answer 6

small depression in skull base
2 components -anterior/posterior
controlled by hypothalamus
neural & peptide links
anterior vascular plexus- secreted into vascular tissue
connection can be disrupted in trauma
optic chiasm has visual field cross- pituitary growth can create pressure on optic chiasm

Question 7

what do hormones from the pituitary gland have an effect on?

Answer 7

directly on tissues

eg thyroid

Question 8

what does the pituitary control?

Answer 8

many gland activities

Question 9

what hormones does the anterior pituitary affect?

Answer 9

TSH
ACTH
GH
LH
FSH
prolactin

Question 10

what hormones does the posterior pituitary affect?

Answer 10

ADH

oxytocin

Question 11

what are the 2 types of adenoma?

Answer 11

functional/non-functional

Question 12

describe a functional adenoma

Answer 12

<40y/o prolactin/ACTH

>40y/o growth hormone

Question 13

describe a non-functional adenoma

Answer 13

> 60y/o
visual field defects
other hormone deficiencies

Question 14

what is trans-sphenoidal surgery

Answer 14

pituitary difficult to access
transnasal
-through sphenoid bone

Question 15

describe insufficient GH

Answer 15

growth failure in children
metabolic changes in adults
-increased fat
-reduced vitality

Question 16

describe excess GH

Answer 16

giantism in children

acromegaly in adults

Question 17

how is GH assessed?

Answer 17

IGF-1 measured

insulin-like growth factor

Question 18

describe acromegaly

Answer 18

insidious onset
peak incidence 30-50 y/o
benign pituitary tumour (MEN1)
changes irreversible
change in occlusion after growth stops
spaces between teeth

Question 19

what are the general presenting changes for acromegaly?

Answer 19

coarse features
enlarged supra-orbital ridges
broad nose, thickened lips and soft tissues
enlarged hands
type 2 diabetes
cardiovascular disease

Question 20

what are the intra-oral changes caused by acromegaly?

Answer 20

enlarged tongue
interdental spacing
shrunk dentures
reverse overbite