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Endocrine > PITUITARY STUFF > Flashcards

PITUITARY STUFF Flashcards

1
Q

what 2 hormones are stored in the pituitary?

A

vasopress and OXT

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2
Q

if there is too much hormone what sort of dynamic test should you do?

A

do a test that tries to suppress it

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3
Q

if there is too little hormone what sort of dynamic test should you do?

A

do a test that tries to stimulate the hormone

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4
Q

pituitary tumour less than or equal to 1cm

A

microadenoma

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5
Q

pituitary tumour more than 1cm

A

macroadenoma

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6
Q

causes of raised prolactin

A

breast feeding
pregnancy
stress
sleep

dopamine antagonists
antidepressents
coccaine

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7
Q

pathologic causes of raised prolactin

A

hypothyroidism
stalk lesion -RTA
prolactinoma

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8
Q

clinical signs and symptoms of increased prolactin in females?

A

early presentation
menstrual irregularity
infertility
ammenorrhoea

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9
Q

clinical signs and symptoms of increased prolactin in females?

A 
late presentation
impotence
visual field abnormal
headache
anti pit malfunction
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10
Q

investigations for prolactinoma ?

A

prolactin conc
MRI pituitary
visual fields
pituitary function tests

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11
Q

medial treatment for prolactinoma?

A

dopamine agonists:

  • bromocriptine -3x day
  • Quinagolide- 1x day
  • Cabergoline-the best 2x week
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12
Q

excess GH

A

acromegaly

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13
Q 
thickened soft tissues
large jaw
massive hands and feet
headaches
hypertension
heart failure
snoring
sleep apnoea
diabetes
A

acromegaly

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14
Q

how do you diagnose acromegaly?

A

IGF-1- age and sex matched

GTT- suppression test- no suppression= positive

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15
Q

treatment for acromegaly?

A

surgery (most successful)
external radiotehrapy
retest GTT

if GH>1ug/L then need drug therapy:

  • dopamine agonist-cabergoline
  • somatostatin analogues-octreotide
  • GH antagonist-pegvisomant
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16
Q

what type of drug is cabergoline?

A

dopamine antagonist

17
Q

what type of drug is octreotide

A

somatostain analogue

18
Q

what type of drug is pegvisomant?

A

GH antagonist

19
Q

do somatostatin analogues shrink the tumour?

A

yes

20
Q

what are the side effects of somatostatin analogues?

A

local stinging
flatulence
diarrhoea
abdominal pain

gastritis
gall stones!!

21
Q

how are GH antagonists given?

A

SC injection every day

22
Q

do G antagonists shrink tumour size?

A

no

23
Q

excess cortisol

A

cushings syndrome

24
Q

signs/symptoms of cushings?

A 
protein loss
proximal myoptahy
central obesity
moon face
buffalo hump
depression/psych problems
axcess androgen-acne, funny periods
frontal balding in women
conjunctival odema
osteoporosis
poor wound healing
easy bruising
thin skin
25
Q

definitive test for cushing?

A

low dose dexamethasone

26
Q

what other screening tests can you do for cushings?

A

overnight 1mg dexamethasone suppression test

urine free cortisol

diurinal cortisol variation

27
Q

causes of cushings?

A

pituitary problems
adenoma of adrenal
ectopid-thymus, lung, pancreas

pseudo-alcohol depression
steroid medication

28
Q

what is this cause of cushings?

low dose dexa test- abnormal
ACTH

A

pituitary

29
Q

what is this cause of cushings?

low dose dexa test- abnormal
ACTH

A

adrenal

30
Q

what is this cause of cushings?

low dose dexa test- abnormal
ACTH >300

high dose dexam suppression- nil

A

ectopic

31
Q

surgery options for cushings?

A

pituitary-hypophysectomy and external radiation

adrenal- adrenalectomy

ectopic- remove source or bilateral adrenalectomy

32
Q

drug treatment fro cushings?

A

metyrapone (if all other treatments fail)

ketoconazole

pasireotide

33
Q

signs/symptoms of anterior hypopituitarism?

A 
menstrual irregularities
infertility
gynaecomastia
abdominal obesity
loss of facial hair
loss of pubic and armpit hair
dry skin and hair
growth retardation
34
Q

replacement therapy for hypopituitarism?

A 
thyroxine
hydrocortisone
ADH
GH
sex steroids
35
Q

how is testosterone replacement therapy given?

A

IM injection every 3-4 weeks

36
Q

risks of testosterone replacement therapy?

A

prostate enlargement
hepatitis
polycythaemia

37
Q

what test do you do to diagnose diabetes insipidus?

A

water deprivation test

38
Q

treatment for diabetes insipidus?

A

desmospray

desmopressin oral tablets

desmopressin sublingual tablets

desmopressin injection

Endocrine (29 decks)

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