Pituitary Disorders

Question 1

• ADH deficiency results in polyuria
• Polyuria (2-10L/d)
• Tx: Desmopressin

Answer 1

Diabetes Insipidus

Question 2

• Commonly cause of hyponatremia in hospitalized pts
• Wide etiology: CNS disorders to lesions to meds to tumors
• Often asymptomatic
• Serum sodium

Answer 2

Syndrome of inappropriate ADH Secretion

Question 3

• Partial/complete deficiency of pituitary hormone (adrenocorticotropics, GH, prolactin, TSH, LH/FSH)
• Hypothalmic or pituitary dysfunction; tumors
• Symptoms depend on hormone affected
• Metabolic effects (GH), adrenal insufficiency (ACTH), hypothyroid (TSH), failure to lactate (prolactin), DI (ADH)
• MRI; serum hormones
• Tx: depends/. Removal of tumor

Answer 3

Hypopituitarism

Question 4

• Gigantism if GH excess b4 epiphyses closure; acromegaly after.
• Pitutiary tumor
• Excessive growth of hands, feet, jaw and organs. Ski tags, osteoarthritis, deep voice, HTN, CHF
• IGF-1 >5x normal; MRI
• Transnasal transsphenoidal resection

Answer 4

Acromegaly/Gigantism

Question 5

-Most common pituitary disorder
-Micoradenomas, other disease, meds
-Women: a/oligomenorrhea, galactorrhea, infertility
Men: hypogonadism, decreased libido, ED
-CT/MRI
-Dopamine (no surgery)

Answer 5

Hyperprolactinemia