Pituitary Disorders Lecture Powerpoint Flashcards
Prolactin is the only hormone without…
….a negative feedback loop (instead inhibited by dopamine)
Pituitary tumor characteristics (4)
- 1/3 nonfunctional (not secreting)
- Most produce one solitary hormone in excess
- Bitemporal hemianopsia (tumor forms at optic chiasm)
- Visual field exam (loss of peripheral vision)
Micro vs macroadenoma in the pituitary
<10mm in diameter is micro, >10 in macro
Pituitary hyperplasia causes that DON’T necessarily require intervention (3)
- pregnancy
- long standing hypothyroidism
- long standing primary hypogonadism
Pituitary masses clinical manifestations (3)
- Impaired vision (bitemporal hemianopsia)
- headache
- pituitary apoplexy (bleeding into and impaired blood supply to the pituitary)
Sheehan’s syndrome
Post partum pituitary apoplexy and infarction
Pituitary incidentaloma
Microadenoma presence up to 10% of people with clinically unsuspected pituitary tumors observed on MRI incidentally
Hyperprolactinemia causes (5)
- pregnancy (peak at delivery)
- nipple stimulation
- stress
- Prolactinoma
- chest wall injury
Why are men more susceptible to larger prolactinomas than females?
Men don’t have the associated symptoms regarding amenorrhea and galactorrhea while females do much earlier on
Prolactinoma is the only tumor that the preferred method of treatment is…
….medication - dopamine agonists (bromocriptine or cabergoline)
Most common cause of secondary amenorrhea
Pregnancy
Acromegaly
Condition caused by excess growth hormone from pituitary, slow gradual change in appearance of patient from symptoms to diagnosis for up to 12 years, both GH and IGF-1 increased, excess GH secretion making IGF-1 elevated
Acromegaly associated conditions (5)
- acral overgrowth
- increased bone density
- hypertension
- LVH
- DM
Best study for acromegaly diagnosis and why + one other
- IGF-1 (no diurnal variation)
- MRI of pituitary (adenoma in almost 95% of causes)
Acromegaly treatment options (2)
- Transphenoidal surgery
- Medical therapy
