Pituitary tumours

Question 1

What hypothalamus hormone stimulates the anterior pituitary to produce ACTH?

Answer 1

CRH

Question 2

What hypothalamus hormone stimulates the anterior pituitary to produce TSH?

Answer 2

TRH

Question 3

What hypothalamus hormone stimulates the anterior pituitary to produce LH and FSH?

Answer 3

GnRH

Question 4

What hypothalamus hormone stimulates the anterior pituitary to produce GH?

Answer 4

GHRH

Question 5

Name 6 hormones produced by the anterior pituitary:

Answer 5

1) ACTH
2) TSH
3) LH
4) FSH
5) GH
6) prolactin

Question 6

Where is ADH (vasopressin) produced?

Answer 6

hypothalamus

Question 7

Where is ADH and oxytocin stored?

Answer 7

posterior pituitary

Question 8

Where is oxytocin produced?

Answer 8

hypothalamus

Question 9

Prolactin secretion is under inhibitory control from which hormone?

Answer 9

dopamine

Question 10

What is the most common type of pituitary tumour?

Answer 10

benign pituitary adenoma

Question 11

Give 3 general effects of benign pituitary adenomas:

Answer 11

1) excessive production of a particular hormone
2) inadequate production of all other hormones
3) space occupying effects e.g. compression

Question 12

What visual field defect is associated with pituitary tumours?

Answer 12

bitemporal hemianopia

Question 13

Why do large (>10mm) pituitary tumours often cause bitemporal hemianopia?

Answer 13

they compress the optic chiasm

Question 14

Fill in the gap: most prolactinomas are <__mm

Answer 14

<10mm

Question 15

Give 4 presentations of a prolactinoma:

Answer 15

1) galactorrhoea
2) amenorrhoea
3) hypogonadism
4) erectile dysfunction

Question 16

What condition does a growth hormone producing pituitary adenoma cause in children?

Answer 16

gigantism

Question 17

What condition does a growth hormone producing pituitary adenoma cause in adults?

Answer 17

acromegaly

Question 18

Give 6 presentations associated with acromegaly:

Answer 18

1) large hands and feet
2) enlargement of the brow, lower jaw and nose
3) teeth spacing
4) deepening of the voice
5) joint pain
6) difficulty sleeping

Question 19

A pituitary adenoma producing ACTH causes what disease?

Answer 19

Cushing’s disease

Question 20

What is the gold standard imaging method for pituitary tumours?

Answer 20

MRI pituitary

Question 21

What is the hormone stimulation test for growth hormone?

Answer 21

insulin stress test

Question 22

Summarise the management for benign pituitary adenomas:

Answer 22

1) removal of tumour via trans-sphenoidal surgery/ stereotactic radiotherapy
2) replacement of hormone deficiencies