Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BPT Endocrinology > Pituitary Disorders > Flashcards

Pituitary Disorders Flashcards

1
Q

What structures can be affected by pituitary mass lesions?

A

Cranial nerves III, IV, V1, V2, VI, carotid artery, optic chiasm

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

Which hormones are released from the anterior pituitary?

A

FSH, LH, TSH, GH, ACTH, prolactin

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

What hormone stimulates FSH and LH release?

A

GnRH

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

What hormone stimulates TSH release?

A

TRH

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

What hormone stimulates GH release?

A

GRF

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

What hormone inhibits GH release?

A

Somatostatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What hormone stimulates ACTH release?

A

CRF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What hormone inhibits prolactin release?

A

Dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is produced by the posterior pituitary?

A

ADH and oxytocin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the management of non functioning pituitary adenomas?

A 
Only treat if mass effect (headache, visual changes, reduced hormone function)
Options:
1.	Surgery
2.	Radiotherapy
3.	Surgery followed by radiotherapy
4. Temozolamide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the signs and symptoms of hypopituitarism?

A 
ACTH: hypotension, weight loss, fatigue
TSH: cold intolerance, fatigue
FSH/LH: loss of menses, loss of libido
Prolactin: no lactation
GH: fatigue
ADH: central DI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What investigations should be ordered to diagnose hypopituitarism?

A 
TSH T3 T4
8am cortisol +/- short synacthen
FSH, LH and oestradiol/testosterone 
IGF-1 +/- GH stimulation test
Urine/serum Na and osmo +/- water deprivation test/hypertonic saline infusion test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What 8am cortisol level clearly indicates deficiency?

A

<100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is involved in a hypertonic saline infusion test?

A

Give hypertonic saline until Na > 150mmol/L
Measure copeptin level in blood
If copeptin doesn’t rise > 4.9 indicates partial or total central DI

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

What is copeptin?

A

C terminal segment of arginine vasopressin prohormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the treatment for hypopituitarism?

A 
Hydrocortisone and thyroxine (most important) 
OCP/HRT in women
Fertility treatment if required
Testosterone for men
Growth hormone injections
Desmopressin
17
Q

What is the usual dose of hydrocortisone?

A

10mg/m2 which usually equates to 20-30mg split into divided doses 2/3rd in AM 1/3rd in PM

18
Q

What is the result of GH excess?

A

Acromegaly in adults

Gigantism in children

19
Q

What is the most common hyperfunctioning pituitary lesion?

A

Prolactinoma

20
Q

What is the result of a lesion in the pituitary stalk?

A

Increase in prolactin with loss of other pituitary hormones

21
Q

What causes prolactin level increase?

A

Stress, oestrogen, medications (antipsychotics), tumour

Usually not more than 2-4x upper limit unless tumour

22
Q

How does hyperprolactinaemia cause hypogonadism?

A

Inhibits pulsatile gonadotropin release

23
Q

What is the treatment for prolactinoma?

A

Dopamine-2 receptor agonists e.g. cabergoline

If not effective/tolerated then surgery/radiotherapy

24
Q

What is the treatment for acromegaly?

A

Transphenoidal resection
Long acting somatostatin analogue (octreotide)
GH receptor antagonist (pegvisomant)
Dopamine agonists if co secrete prolactin
Radiotherapy if failed surgery

25
Q

What are the causes of cushing’s syndrome?

A 
Iatrogenic (exogenous glucocorticoids)
Pituitary ACTH secreting tumour
Ectopic ACTH (tumour)
Adrenal adenoma
Adrenal carcinoma
26
Q

How do you assess if there is an excess of endogenous cortisol secretion?

A

24hr urine free cortisol
overnight dexamethasone suppression test
late night salivary cortisol

27
Q

How do you differentiate cushing’s disease from ectopic ACTH excess?

A

Inferior petrosal sinus sampling

28
Q

What is the treatment for cushing’s disease?

A

Excision of pituitary adenoma
Radiotherapy
Adrenal enzyme inhibitors (often not effective)
Adrenalectomy with post operative pituitary radiotherapy

BPT Endocrinology (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions