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D&E Pathology > Pituitary Gland Clinical > Flashcards

Pituitary Gland Clinical Flashcards

1
Q

Cushing’s disease is caused by what pituitary hypersecretion?

A

ACTH

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2
Q

agromegaly/gigantism is caused by what?

A

Excess pituitary Growth hormone secretion from pituitary

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3
Q

Hyperprolactinaemia is caused by what?

A

Excess prolactin secretion from pituitary

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4
Q

Lack of vasopressin secretion causes what?

A

Diabetes insipidus

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5
Q

Clinical features of acromegaly

A 
Soft tissue overgrowth
Spade-like hands
Wide feet
Coarse facial features
Thick lips/tongue
Carpal tunnel
Sweating
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6
Q

What are the complications of acromegaly?

A 
Headache
Chiasmal compression
DM
HTN
Cardiomyopathy
Sleep apnoea
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7
Q

How is acromegaly diagnosed?

A 
Can GH be suppressed?
Elevated IGF-1
Blood GH
OGTT
Pituitary function normal otherwise
Pituitary MRI
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8
Q

What is Cushing’s syndrome?

A

Excess corticosteroids

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9
Q

What are the high diagnostic value symptoms of Cushing’s?

A 
Skin atrophy
Spontaneous purpura
Proximal myopathy
Osteoporosis
Growth arrest in children
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10
Q

What are the intermediate diagnostic value symptoms of Cushing’s?

A

Pink striae
Fascial mooning
Oedema
Hisutism

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11
Q

What are the causes of ACTH dependent Cushing’s?

A

Pituitary tumour

Ectopic ACTH secretion

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12
Q

What are the causes of ACTH independent Cushing’s?

A

Corticosteroid therapy

Adrenal tumour

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13
Q

What are the clinical manifestations of hyperprolactinaemia in women?

A

Galactorrhoea 30-80%
Menstrual irregularity
Infertility

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14
Q

What are the clinical manifestations of hyperprolactinaemia in men?

A 
Galactorrhoea (<5%)
Impotence
Visual field abnormalities
Headache
Extraocular muscle weakness
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15
Q

What are the physiological causes of hyperprolactinaemia?

A

Pregnancy
Lactation
Stress

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16
Q

What are the pharmacological causes of hyperprolactinaemia?

A

DA depleting/antagonist drugs

17
Q

What are the pathological causes of hyperprolactinaemia?

A

Primary hypothyroidism

Pituitary lesions

18
Q

Which drugs may cause hyperprolactinaemia?

A

Dopamine antagonists (neuroleptics, antiemetics)
DA-depleting agents
Oestrogens
Some antidepressants

19
Q

What are the clinical features of hypopituitarism in adults?

A 
Tiredness
Weight gain
Depression
Reduced libido
Skin pallor
Reduced bodyhair
20
Q

What are the clinical features of hypopituitarism in children?

A

Reduced linear growth

Delayed puberty

21
Q

What is the test for cranial diabetes insipidus?

A

Water deprivation test

22
Q

What is the cause of cranial diabetes insipidus?

A

Hypofunction of vasopressin from the posterior pituitary

23
Q

What is the differential diagnosis of cranial diabetes insipidus?

A

Idiopathic
Post-trauma
Metastatic carcinoma
Craniopharyngioma

24
Q

What type of blindness is commonly caused by pituitary tumours?

A

Bitemporal hemianopia

25
Q

How are pituitary tumours managed?

A

Transsphenoidal tumours

Replacement/suppression of hormones

26
Q

How is a prolactinoma managed?

A

Dopamine agonists

27
Q

How is acromegaly due to pituitary tumour managed?

A

Somatostatin analogues

GH receptor antagonists

28
Q

What are the beneficial effects of somatostatin analogues in acromegaly

A 
Improve symptoms
Stop overgrowth
Normalise GH/IGF-1 in >50%
Induce tumour shrinkage
Reduce morbidity/mortality
29
Q

What adverse effects are associated with somatostatin anaglogues?

A

Nausea/cramps/diarrhoea
Cholesterol gallstones 20-30%
Very expensive
Monthly injections

30
Q

How is a microprolactinoma treated?

A

Dopamine agonists

cabergoline, normoprolactinaemia

31
Q

What is a microprolactinoma?

A

Prolactin secreting tumour of the pituitary <10mm
Galactorrhoea
Infertility
PRL <5000mU/L

32
Q

What is a macroprolactinoma?

A

Prolactin secreting tumour of the pituitary >10mm

Respond well to dopamine agonists

D&E Pathology (18 decks)

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