Prolactin & Growth hormone Flashcards
When is prolactin increased physiologically?
Breast feeding
Pregnancy
Stress
Sleep
Pathological causes of increased prolactin
Hypothyroidism
Stalk lesions (iatrogenic, RTA)
Prolactinoma
Drugs that can cause increased prolactin
Dopamine antagonist (metaclopramide) Antipsychotics (phenothiazine) Antidepressants Cocaine Oestrogen
Investigations for prolactin
Prolactin concentration
MRI pituitary
Visual fields
Pituitary function test
Treatment of high prolactin
Dopamine AGONIST
Cabergoline 1st line
(bromocriptin, quinagolide)
Females symptoms of high prolactin
Early presentation Galactorrhoea Menstrual irregularity Ammenorrhoea Infertility
Male symptoms of high prolactin
Late presentation Impotence Visual field abnormal Headache Ant. pituitary kalfunction
What is prolactin inhibitory hormone called?
Dopamine
Actions of GH
Increase protein synthesis
Increase glycogenolysis
Increase lipolysis
What is growth hormone inhibited by?
Somatostatin
Symptoms/signs of Acromegaly
Giant Thickened soft tissues Hypertension Headaches Snoring/sleep apnoea Diaetes melitis Local pituitary effects (visual feilds, hypopituitarism) EARLY cv DEATH Colonic polyps/colonic cancer
How is acromegaly diagnosed?
GTT
Treatment of acromegaly
Pituitary surgery
How is it assessed if a patient requires drug treatment for acromegaly after pituitary surgery
1 = drug treatment
What are the drug treatment options for acromegaly?
Somatostatin analogues
Dopamine agonists
GH antagonists
