Pituitary pathology Flashcards
Causes of pituitary hyperfunction
Adenoma
Carcinoma
Causes of pituitary hypofunction
Surgery/radiation Sudden haemorrhage into gland Ischaemic necrosis (Sheehan syndrome) Tumours extending into sella Inflammatory conditions (sarcoidosis)
What can cause central diabetes insipidus?
Trauma
Inflammatory disorders of the hypothalamus & the pituitary
What can cause death in diabetes inspidus?
Dehydration
What is SIADH?
Ectopic secretion of ADH by tumours (primary disorder of the pituitary)
What is the most common functional pituitary adenoma?
Prolactinoma
Symptoms/signs of prolactinoma
Infertility
Loss of libido
Amenorrhoea
What is the second most common functional pituitary adenoma?
GH secreting
Symptoms/signs of GH secreting pituitary adenoma
Increase in IGF
Stimulates bone growth, cartilage growth (Gigantism)
Signs of an ACTH pituitary adenoma?
Cushing’s disease
Bilateral adrenocortical hyperplasia
What type of tumour is an ACTH pituitary adenoma usually?
Microadenoma
What is a craniopharyngioma derived from?
Derived from remnants of Rathke’s pouch
Appearance of a craniopharyngioma?
Slow growing
Often cystic
May calcify
When do craniopharyngiomas tend to occur?
5-15 y/o
60-70 y/o
Presentation of craniopharyngioma
Headaches + visual disturbances
children may have growth retardation
What is the treatment for craniopharngioma and does it have a good prognosis?
Radiation
Excellent prognosis
What is a rare complication of craniopharngioma treatment?
SCC
Causes of panhypopituitarism
Pituitary tumours Secondary metastatic tumours Local brain tumours Granulomatous Vascular disease Trauma Hyppothalamic disease Autoimmuna Infection
Symptoms/signs of panhypopituitarism
Menstrual irregularities Infertility/impotence Gynaecmastia Abdominal obesity Loss of facial hair Loss of axillary/pubic hair Dry hair/skin Hypothyroid faces Growth retardation
How much thyroxine should be given as replacement in panhypopituitarism?
100-150mcg/day
How much hydrocortisone should be given as replacement in panhypopituitarism?
10-25mcg/day
How can ADH be given as replacement in panhypopituitarism?
Desmospray, tablets or injection
How is GH replacement given?
Nightly SC injection
How is diabetes insipidus diagnosed?
Water deprivation test
What familial syndrome causes diabetes inspidus?
Wolfram syndrome (DIDMOAD)
