Pituitary Disorders Flashcards
What hormones does the pituitary gland release?
LH, FSH, GH, TSH, ACTH
What does ACTH do?
Regulates adrenal gland
What causes pituitary dysfunction?
Tumour, hormone excess or deficiency
How test pituitary dysfunction?
Hormonal test - if abnormal MRI pituitary
What symptoms will you get with local mass?
CSF rhinorrhoea, headache, cranial nerve palsy, visual field defect
What does deficiency GH cause?
Short stature - abornmal body composition
Tx: GH
What does deficiency LG/FSH cause?
Hypogonadism, infertility, menstruation problems
What does deficiency in TSH cause?
Hypothyroidism
What does deficiency ACTH cause
Adrenal failure -decreased pigmentation
Cause hypopituitarism?
Pituitary tumour, radiotherapy, infarction, Sheehan’s syndrome
What is Sheehan’s syndrome?
Post partum pituitary necrosis
What is acromegaly?
Excessive GH after puberty w/ high IGF-1 levels
Clinical features acromegaly?
Coarse facial features, enlarged supraorbital ridge, separation of teeth, macroglossia
Other: headache, excess sweating, changes size hands/ feet
How diagnose acromegaly?
IGF1, MRI pituitary
How to tx acromegaly?
Somatostains/ pegvisomant
Dental complications in acromegaly?
Jaw malocclusion, diff speech due macroglossia, teeth mobility, teeth separation
Thickening alveolar process and enlarged posterior roots
What pattern do cortisol levels follow?
Circadian rhythm
Cause cushings syndrome?
Excess glucocorticoids
Clinical features of cushings?
Weight gain, moon faces, glucose intolerance, muscle weakness, acne, hyperpigementation, osteopenia
Diagnosis cushings?
Hormonal test - dynamic suppression test measure cortisol and ACTH
If abnormal - MRI pituitary, CT adrenals
Primary and secondary cause adrenal insufficiency?
Primary - autoimmune, adrenal haemorrhage
Secondary - exogenous glucocorticoid, hypothalamic or pituitary tumours
Clinical features of adrenal insufficiency?
Skin pigmentation, weakness, loss weight, hypotension, hypoglycaemia episode, salt craving
Investigate adrenal insufficiency?
Hormonal test - dynamic stimulation test
Radiological if hormonal test abnormal
Tx adrenal insufficiency?
Hydrocortisone replacement
Why is glucocorticoid cover required for those on steroids?
Prevent adrenal crisis - mainly double steroids before procedure
How provide steroid cover for simple procedures?
Double dose one hour before surgery - double oral dose oral medication for 24 hours
How provide steroid cover for major procedures inc GA
100mg hydrocortisone at induction
Double oral dose 24 hours
