Pituitary Disorders Flashcards

1
Q

how common are pituitary disorders ? and most common cause is?

A

rare

  • 70,000 patients in the UK
  • most common cause of pituitary malfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what’re most pituitary tumours like? and what do they result in?

A
  • non-functioning as in the don’t produce hormones
  • this results in inadequate production of 1 or more hormone due to the tumour putting pressure on the glandular tissue as it grows. so you get consequnce associated with the depleted hormone
  • aso due to the swelling it puts pressure on surrounding tissue swell c headaches and visual problems d compression of the optic nerve bi-temporal semi-anopia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

investigations of someone with a suspected pituitary tumour

A

I) delineation of the size, anatomy, topographical location of the pituitary / parapituitary mass (using MRI)

ii) assess visual field
iii) assess endocrine function (measure hormone levels in the blood or by staining sections from.a biopsy of the tumour with antibodies of the relevant hormone e.g. ACTH receptor to see if ACTH is made or not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

hypopituitarism

A
  • insufficient hormone produciton is mostly d adenoma(bening tumout from glandular tissue) of pituitary (rare c = radiation therapy, inflammation disease and head injury)
  • usually progressive loss of AP, first hormones to suffer is FSH/LH and GH
  • migh then present iwth panhypopituitarism.
  • secretionof ADh adn oxytoxin is affected if the tumour affects the hypothalamic function or if inflammation is involved with the tumour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

panhypopituitarism

A

-deficency of all hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

when are the hormones of post.pit. affected and what hormones are affected

A
  • oxytocin and ADH, only when hypothalamic function affected or inflammatory process
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

GH deficiency symptoms adults

A
  • adults ; decreased exercise tolerance, muscle strength and ^ body fat and reduced sense of well being.
  • usually due to mass d pituitary adenoma {(hypopituitarism) but sometime GHR receptor gene mutation or inflammatory response
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

GH defieiceny in kids and is there a treatment

A
  • 1/3800briths
  • little affect on fetual growth but prenatal deficiency can c hypoglycaemia and jaundice
  • post birth from 1 year till teens they have poor stature and growth
  • human recominant DNA techonology is used in the treatmetn case
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Gonadotropin deficency aka? and what is it?

A
  • hypogonadism
  • d pit. adenoma
  • c lack of libido, infertility, oligomenorrhoea (infrequent periods) or amenorrhea (no periods) of women in reproductive age
  • in men can cause v libido and impotence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ADH deficiency

A
  • d hypothalamic tumour(Since synthesised there) or d radiotherapy, autoimmune infiltration of meningitis (inflammatory process)
  • c excess urine and dehydration and polydipsia (increased thirst)
  • presents as diabetes insipidus; very dilute urine resulting in dehydration and increased sensation of thirst polydipsia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

diabetes insipidus

A
  • ADH deficicey
  • since ADh promotes water reabsorption you odnt absorb water and instead pee alot more water out, this results in more dilute urine andpolydipsia (more thirsty)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hyperpituituarism 3 important conditions

A
  • prolactin excess,
  • GH excess
  • ACTH excess
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Prolactin excess

A
  • usually c lactropes in AP to secrete prolactin d PRH and inhibit it by dopamine
  • too much prolactin in the blood due to the high levels of dopamine, so ou end up with hyperprolactinaemia (^ prolactin in the blood). symptoms as a result xs prolactin;
  • galactorrhoea (unexplained milk production rare in men)
  • gynecomastia ( hard breast tissue)
  • hypogonadsim (diminished activity of testes ovaries)
  • amonerhhea (no period)
  • erectile dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how does hyperprolactaemia cause hypogonadism

A

the high levels of dopamine in the hypothalamus (due to th enegative feedback of the high prolactin levels in the blood) inhibit GnRH secretion from the hypothalmus and therefore no FSH, LH, secretion from ant.pit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

c of hyperprolactinaemia

A
  • usually AP adenoma c XS prolactin known as prolactinoma (benign d to -oma)
  • but also stress, antipsychotics (haloperidol) and antidepressants (clomipramine ), pregnancy, exercise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

treatment d domaine c prolactin^

A

-carbergoline a dopamine receptor agonist but rarely

or trans-sphenoidal surgery or radiotherapy

17
Q

GH ex

A
  • adenoma of AP larger than 10mm in diameter

this is causes by excress GH secretion and stimlation of IGF-1 production, wc inturn causes GH and IGF-1 receptors to be activated

but this takes years to manifest and so take foeverto diagnose (6yrs)

signs = changes in phsyical appearance, broad nose, coarse facial features, acromegaly, excessive sweating, deepenign voice due ot the hypertrophy of the soft tissues in the upper airay

18
Q

GH excesss in kids

A
  • before fusion of the epiphyseal plates c gigantism, where you grow really tall forever
  • since GH antagonises insulin there’s metabolic issues and ^ IGF1 are associated with diabetes and some cancers
19
Q

treatments for acromegaly

A
  • surgery to remove ademoma /radio/drug therapy
    2) dopamine receptor inhibitor to decrease GH levels (but higher levels needed if prolactin secreting pit adenoma present
    3) somatostatin (limits GH secretion)
    4) GH receptor antaongists like Pegvisomant
20
Q

excess ACTH is a cause of what condition

A

-Cushing’s syndrome

21
Q

how does GH work compared to insulin

A

antagonises it

22
Q

pituitary apoplexy

A

-stroke