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Abs Endo > Pituitary Gland > Flashcards

Pituitary Gland Flashcards

1
Q

cortisol pathway

A

CRH from hypothalamus
ACTH from pituitary
Cortisol

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2
Q

thyroxine pathway

A

TRH from hypothalamus
TSH from pituitary
Thyroxine

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3
Q

growth hormone pathway

A

GHRH from hypothalamus
GH from pituitary
IGF1 peripherally

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4
Q

oestradiol/testosterone pathway

A

GnRH from hypothalamus
LH/FSH from pituitary
oestradiol/testosterone

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5
Q

prolactin pathway

A

dopamine from hypothalamus

prolactin from pituitary

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6
Q

hormones stored in posterior pituitary

A

vasopressin/ADH

oxytocin

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7
Q

structures which may be compressed by an enlarged pituitary

A

optic chiasm
CN 3/5/6
internal carotid artery

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8
Q

surgical intervention for pituitary tumour

A

transsphenoidal

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9
Q

microadenoma

A

less than or equal to 1cm

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10
Q

macroadenoma

A

bigger than 1cm

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11
Q

most common visual field defect in pituitary tumours

A

bitemporal hemianopia

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12
Q

causes of raised prolactin

A 
breast feeding, pregnancy, stress, sleep
dopamine antagonists, antipsychotics, antidepressants
hypothyroidism 
stalk lesions 
prolactinoma
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13
Q

symptoms and signs of prolactinoma

A 
galactorrhoea 
menstrual irregularity/amenorrhoea 
infertility 
impotence 
headaches
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14
Q

treatment for prolactinoma

A

bromocriptine, quinagolide, cabergoline (dopamine agonists)

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15
Q

features of acromegaly

A 
thickened soft tissues
hypertension, cardiac failure 
headaches 
snoring/sleep apnoea 
DM 
visual defects 
colonic polyps and cancer
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16
Q

diagnosis of acromegaly

A

measure IGF1
glucose tolerance test
MRI pituitary

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17
Q

results of GTT in acromegaly

A

usually GH suppresses with glucose, in acromegaly it doesn’t, GH is unchanged or may even rise

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18
Q

treatment of acromegaly

A

pituitary surgery, radiotherapy

somatostatin analogues to shrink tumours

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19
Q

features of Cushing’s syndrome

A 
excess cortisol 
protein loss 
altered carb/lipid metabolism 
altered psyche 
excess mineralocorticoid 
excess androgen
20
Q

diagnosis of Cushings

A

low dose dexamethasone suppression test

urinary free cortisol

21
Q

results of dexamethasone suppression test in Cushings

A

cortisol remains high and is not suppressed

22
Q

aetiology of cushings

A

pituitary (majority)
adrenal adenoma
ectopic - thymus, lung, pancreas
pseuo - alcohol and depression, steroid medications

23
Q

treatment of cushings

A

pit - hypophysectomy and radiotherapy
adrenalectomy
remove ectopic

24
Q

drug treatment of Cushings

A

metyrapone - whilst waiting for radiotherapy to work
ketoconazole - hepatotoxic
pasireotide

25
Q

features of pan hypopituitarisim

A 
growth failure 
hypothyroidism 
hypogonadism 
hypoadrenal 
diabetes insipidus
26
Q

causes of hypopituitarism

A 
pituitary tumours 
mets 
brain tumours 
granulomatous disease 
vasuclar disease 
trauma 
hypothalamic disease 
iatrogenic 
autoimmune - Sheenan post-preg
infection
27
Q

symptoms/signs of anterior hypopituitarism

A 
menstrual irregularities 
infertility/impotence 
gynaecomastia 
abdo obesity 
loss of facial, axillary, pubic hair 
dry skin and hair 
growth retardation
28
Q

replacement therapy for hypopituitarism

A 
thyroxine 
hydrocortisone 
desmospray (ADH) 
GH nightly SC 
sex steroids - HRT, pill for femalres, testosterone for males
29
Q

benefits of giving GH in adults

A 
improves wellbeing/QoL
decreases abdo fat 
increase strength 
improve cardiac function 
decrease cholesterol 
increase bone density
30
Q

how can testosterone be administered

A

IM
skin gel
oral tabs

31
Q

risks of testosterone replacement

A

prostate enlargement
polycythaemia
hepatitis
infertility

32
Q

causes of diabetes insipidus

A

familial - DIDMOAD - insipidus, mellitus, optic atrophy and deafness
acquired
tumour, sarcoid, irradiation, meningitis

33
Q

diagnosis of diabetes insipidus

A

water deprivation test

34
Q

results of water deprivation test

A

urine/serum osmolality ratio should be more than two; if it is less - diagnostic

35
Q

treatment of DI

A

desmospray

desmopressin oral tabs, sub tabs, IM injection

36
Q

cells in pituitary gland

A

acidophils - somatotrophs (GH), mammotrophs (PRL)
basophils - corticotrophs (ACTH), thyrotrophs (TSH), gonadtrophs (FSH/LH)
chromophobes

37
Q

causes of hyperfunction in pituitary

A

adenoma

carcinoma

38
Q

most common functional pituitary adenoma

A

prolactinoma
then GH secreting
then ACTH secreting

39
Q

causes of hypofunction in pituitary

A 
surgery/irradiation 
haemorrhage 
ischaemic necrosis - Sheehan 
tumours 
inflammatory conditions
40
Q

where is the anterior pituitary derived from

A

Rathke’s pouch

41
Q

what is a craniopharyngoma

A 
intracranial tumour (1-5%)
derived from remnants of Rathke's pouch 
slow growth, cystic, may calcify
majority are suprasellar 
headaches and visual disturbances with growth retardation
excellent prognosis
42
Q

another name for the anterior pituitary

A

adenohypophysis

43
Q

another name for the posterior pituitary

A

neurohypophysis

44
Q

features of posterior pituitary

A

extension of neural tissue consisting of modified glial cells and axonal processes

45
Q

histology of posterior pituitary

A

non-myelinated axons of neurosecretory neurones

46
Q

two types of diabetes insipidus

A

central - ADH deficiency

nephrogenic - due to renal resistance to ADH effects

47
Q

what is SIADH

A

ectopic secretion of ADH by tumours, could be primary disorder in the pituitary, or part of paraneoplastic syndrome

Abs Endo (8 decks)

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