Pituitary Tumors Flashcards
What are the effects of hyperprolactinaemia on the HPA?
Prolactin binds to prolactin receptors on kisspeptin neurones
This inhibits gonadotrophs
FSH/LH not released
Primary hypogonadism effects
How does a prolactinoma present?
Amenorrhoea
Reduced libido
Infertility
Erectile dysfunction
Galactarrhoea
What are other causes of increased prolactin other than a prolactinoma?
Pregnancy
Breast feeding
Opiates
Stress
Post venipuncture
PCOS
Antipsychotics
How do we treat prolactinomas? What is their action mechanism?
Cabergoline- dopamine agonist
Inhibit prolactin from being released from lactotrophs by binding to D2 receptor on them (acts as an agonist)
How do you diagnose an acromegaly?
How do we treat them?
How do they present?
Measure IGF-1 serum levels
Oral glucose load should show a suppression of GH, if paradoxical rise can be seen then acromegaly may be present
Somatostatin analogue- Octreotide
Dopamine agonist-Cabergoline
Radiotherapy
Transphenoidal Pituitary Surgery
Sweatiness, headaches, coarse voice, increased hand and feet size, hypertension, T2DM
What is Cushings syndrome and how does it present? What is Cushings DISEASE?
Too much cortisol
Red cheeks, stretch marks, moon face, buffalo hump, easy bruising, high blood pressure, osteoporosis, thin skin
CUSHINGS DISEASE- has to be due to corticotroph adenoma secreting ACTH or lung cancer
How do we check for Cushings syndrome?
Check late night cortisol levels- should be low due to diurnal rhythm
Failure to suppress cortisol after oral dexamethasone (glucocorticoid)
What are the 5 types of pituitary tumours?
GH- acromegaly
Prolactin- prolactinoma
TSH-tshoma
GN- gonadotrophinoma
Corticotroph- corticotroph adenoma
What are the three classifications of pituitary tumours?
Size: >1cm = macroadenoma <1cm = microadenoma
Location: stellar or suprasellar
Secretion or no secretion: functioning or non functioning adenoma
