Posterior Pituitary and Acromegaly

Question 1

Posterior Pituitary. “oxytocin deficency” CxFx

Answer 1

None. it helps uterine contraction during delivery, but delivery still occurs even if it is absent.

Question 2

Diabetes Insipidus kinds and etiologies

Answer 2

Central DI (CDI): Any destruction of the brain
Nephrogenic DI (NDI):

Question 3

Nephrogenic DI (NDI): etiologies

Answer 3

chronic pyelonephritis,
amyloidosis
myeloma, or sickle cell disease
Hypercalcemia and hypokalemia

Question 4

Diabetes Insipidus cxfx

Answer 4

extremely high-volume urine + excessive thirst
then

hypernatremia: confusion, disorientation, lethargy, +-seizures and coma

when output is>than intake: neurol symp

Question 5

Urine test when Diabetes Insipidus

Answer 5

volume ↑
↓ osmolality
↓ sodium

Question 6

serum test when Diabetes Insipidus

Answer 6

↓ vol
↑ osmolality
↑ sodium

Question 7

The difference between central and nephrogenic DI is determined by

Answer 7

the response to vasopressin.

Central improves, nephrogenic not

Question 8

Central DI tx

Answer 8

long-term vasopressin (desmopressin) use

Question 9

Nephrogenic DI is managed by

Answer 9

trying to correct the underlying cause (e.g.,
hypokalemia or hypercalcemia).

also responds to
hydrochlorothiazide, amiloride, and prostaglandin inhibitors such as NSAIDs
(e.g., indomethacin).

Question 10

Acromegaly Etiology

Answer 10

almost always caused by a pituitary adenoma.

Can be Asoc. with one of the multiple endocrine neoplasias when it is combined with parathyroid and pancreatic disorders like gastrinoma or insulinoma.

Question 11

Acromegaly weird Etiology

Answer 11

ectopic GH or GHRH production from a lymphoma or bronchial carcinoid

Question 12

Acromegaly Cx Fx
____tension
____glycemia
Increased ___, ___, and ___ size (clothing)

Answer 12

Hypertension resistant to treatment for unclear reasons in 50%
Hyperglycemia
Increased hat, ring, and shoe size

Question 13

Acromegaly Cx Fx joints:

Answer 13

Arthralgias from joints growing out of alignment

Carpal tunnel syndrome

Question 14

Acromegaly Cx Fx colon

Answer 14

Colonic polyps and skin tags

Question 15

Acromegaly Cx Fx airways

Answer 15

obstructive sleep apnea from soft tissues
enlarging
macroglossia

Question 16

Acromegaly Cx Fx sex

Answer 16

Erectile dysfunction from increased prolactin cosecreted with the pituitary
adenoma
Deep voice
Body odor from sweat gland hypertrophy

Question 17

Acromegaly Cx Fx cdv

Answer 17

Cardiomegaly and CHF

Question 18

Acromegaly some lab test

Answer 18

will show glucose intolerance and hyperlipidemia

Prolactin

Question 19

Acromegaly best initial test

Answer 19

level of insulinlike growth factor (IGF-1). elevated

he is “somatomedine”

Question 20

Acromegaly most accurate test

Answer 20

glucose suppression test.
Normally, glucose should suppress growth hormone levels

onlyyyy afterwards u can do MRI

Question 21

Acromegaly tx

Answer 21

qx Acromegaly responds to transsphenoidal resection of the pituitary
in 70% of cases. Larger adenomas are harder to cure.

Question 22

Acromegaly Medications:

Answer 22

Cabergoline: Dopamine will inhibit GH release.
Octreotide or lanreotide: Somatostatin inhibits GH release.
Pegvisomant*: A GH receptor antagonist, it inhibits IGF release from the liver.

KHE BERGOLINA Vale

Question 23

AcromegalyRadiotherapy: indication

Answer 23

only in those who do not respond to surgery

or medications.

Question 24

If GH is an antiinsulin, why does it

make insulinlike growth factor?

Answer 24

Only the effect on proteins and

amino acids is insulinlike.