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HRR 1 > Pituitary Gland Disorders > Flashcards

Pituitary Gland Disorders Flashcards

1
Q

Hypopituitaryism- Eti

A
  • Due to hypothalamic or pituitary dysfunction
  • Single to multiple hormone deficiencies
  • Due masse, lesions, hemorrhages & infarction, trauma, infections
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2
Q

Hypopituitaryism- Sx

A
  • Symptoms are based deficiency in hormones effected
  • Confusing clinical presentation
  • Adrenal insufficiency is life threatening
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3
Q

Anterior Pituitary Hormones

A
  • Growth hormone
  • Prolactin
  • Adrenocorticotropic hormone
  • Thyroid stimulating hormone
  • Lutenizing & Follicle Stimulating hormone
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4
Q

Growth Hormone deficiency

A
  • Mild to moderate central obesity
  • Decreased energy, concentration, depression
  • Reduced been mass, increase LDL
  • Decreased CO
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5
Q

Gonadotropin deficiency

A
  • Decrease LH & FSH
  • Loss of facial, axillary, pubic & body hair
  • Men: libido, ED, infertility
  • ## Women: Amenorrhea, infertility, osteoporosis, muscle atrophy
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6
Q

TSH deficiency

A

Hypothyroidism- fatigue, weakness, weight gain, hyerplipidemia

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7
Q

ACTH deficiency

A

Weakness, fatigue, wt loss, hypotension

-

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8
Q

Hypopituitaryism- Dx

A
  • Lab studies based on suspected deficiency:
  • TSH + Free T4
  • LH, FSH, Estrogen, testosterone & prolactin
  • Cortisol & ACTH response
  • Serum IGF-I
  • MRI of hypothalamus & pituitary
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9
Q

Hypopituitaryism- Tx

A
  • Replacement of missing hormones
  • Surgical debulking if indicated
  • Hydrocortisone, levothyroxine, rhGH
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10
Q

Diabetes Insipidus- Eti

A
  • Deficiency or resistance of ADH/ vasopressin
  • Primary due to autoimmune reaction, genetics
  • Secondary due to hypothalamic or stalk damage
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11
Q

Diabetes Indipidus- Sx

A
  • Intense thirst
  • Polyuria- 2-20 L daily
  • Hypernatremia & dehydration
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12
Q

Diabetes Indipidus- Dx

A
  • No single diagnostic test
  • 24hr urine creatinine & volume >2L
  • Serum gluvose, urea, calcium, potasssium, sodium & uric acid
  • Vasopressin challenge test with desmopressin
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13
Q

Diabetes Indipidus- Tx

A
  • Desmopressin acetate
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14
Q

Acromegaly & gigantism- Eti

A
  • Acromegaly = pituitary adenoma, macro, non-malignant
  • GH stimulates release of IGF-I from liver & other tissue
  • McCune-Albright and Carney complex
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15
Q

Acromegaly & gigantism- Sx

A
  • Youth: tall stature & gigantism
  • Dough, moist, enlarged hands
  • Coarse facial features & voice
  • Cardiomegaly & HTN
  • Arthralgia, spinal stenosis
  • Skin tags, acne, acanthosis nigricans
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16
Q

Acromegaly & gigantism- Dx

A
  • Serum IGF-I- screening
  • Fasting IGF-I, PRL, glucose and CMP to determine increased levels
  • MRI indicating pituitary tumor (90% pts have)
17
Q

Acromegaly & gigantism- Tx

A
  • Pituitary transsphenoidal microsurgery- Remission in 70% patients
  • Cabergoline- dopamine agonist, tumor reduction
18
Q

Acromegaly & gigantism- Prog

A
  • M & M from cardiovascular disorders
19
Q

Hyperprolactinemia- Eti

A
  • Microadenomas

- Medications (opioids, antipsych, estrogen, SSRI, tricyclics)

20
Q

Hyperprolactinemia- Sx

A
  • Reduced fertility
  • Women: amenorrhea, galactorrhea, oligomenorrhea
  • Men: Hypogonadism, decreased libido, ED, infertility
21
Q

Hyperprolactinemia- Dx

A
  • Eval for pregnancy, hypothyroid, kidney & liver disease, & hyperparathyroid to RO other causes
  • MRI
22
Q

Hyperprolactinemia- Tx

A
  • Stop offending meds
  • Dopamine agonists!- 90% effective (cabergoline, bromocriptine)
  • No surgery
23
Q

SIADH- Eti

A
  • Excess of ADH leads to retention of water, hyponatremia
  • Carcinomas, osmostat disorders
  • Hypotonic, euvolemic hyponatremia
24
Q

SIADH- Sx

A
  • CNS symptoms- lethargy, weakness, confusion, delerium, seizures
25
Q

SIADH- Dx

A
  • Serum Na+ concentration <135

- Decreased serum osmolality with increased urine osmolality

26
Q

SIADH- Tx

A
  • Furosemide

- Restrict water intake

HRR 1 (12 decks)

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