Pituitary stuff

Question 1

What is the treatment for hyperprolactinemia?

Answer 1

bromocriptine

Question 2

If you see galactorrhea what are you thinking?

Answer 2

hyperprolactinemia

Question 3

What finding do you expect when you test visual fields in a patient with pituitary adenoma?

Answer 3

classic visual field defect bitemporal hemianopsia: vision is missing in the outer (temporal or lateral) half of both the right and left visual fields

Question 4

What physical finding do you expect when you check the DTRs of a patient with hypothyroidism?

Answer 4

hypothyroidism due to pituitary adenoma
You may see hung-up reflexes:
After a stimulus is given and the reflex action takes place, the limb slowly returns to its neutral position. This prolonged relaxation phase is characteristic of reflexes in persons with hypothyroidism.

Question 5

What type of drug is especially a cause of secondary hyperprolactinemia?

Answer 5

drugs that interfere with dopamine!

e.g. haloperidol, metoclopramide

Question 6

What type of drug is used to treat prolactinomas?

Answer 6

dopamine agonists

Question 7

What happens in growth hormone deficiency?

Answer 7

children: dwarfism
adults: metabolic effects

Question 8

What happens in ACTH deficiency?

Answer 8

adrenal insufficiency

Question 9

What happens in TSH deficiency?

Answer 9

hypothyroidism

Question 10

What happens in LH/FSH deficiency?

Answer 10

hypogonadism

Question 11

What happens in prolactin deficiency?

Answer 11

failure to lactate

Question 12

What happens in ADH deficiency?

Answer 12

diabetes insipidus

Question 13

What happens if growth hormone is overproduced?

Answer 13

children: gigantism
adults: acromegaly

Question 14

What happens if ACTH is overproduced?

Answer 14

Cushing disease

Question 15

What happens if TSH is overproduced?

Answer 15

hyperthyroidism

Question 16

What happens if LH/FSH is overproduced?

Answer 16

no symptoms

Question 17

What happens if prolactin is overproduced?

Answer 17

hypogonadism, galactorrhea

Question 18

What happens if ADH is overproduced?

Answer 18

SIADH

Question 19

What is the medication to treat acromegaly?

Answer 19

somatostatin analog e.g. octreotide

Question 20

What are the top 4 most common presenting clinical features of acromegaly?

Answer 20

1. Acral enlargement and/or coarse features
2. Sweating
3. Menstrual irregularities
4. Headache

Question 21

What are the criteria for a diagnosis of acromegaly?

Answer 21

• Elevated IGF-I

* GH > 1.0 ng/ml during an oral glucose tolerance test

Question 22

How is acromegaly treated?

Answer 22

1. surgery
2. somatostatin analogues
3. GH receptor antagonists
4. maybe dopamine agonists, in combination with others

Question 23

Patients with undiagnosed acromegaly may come to clinic complaining of impotence, arthritis, heat intolerance, or with difficulty controlling diabetes.
T/F

Answer 23

true