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Semester 2-MEH > Session 8-Pituitary Disorders > Flashcards

Session 8-Pituitary Disorders Flashcards

1
Q

What are the clinical presentations of pituitary tumours?

A

Visual loss

Headache

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2
Q

What can a gonadotropin deficiency lead to?

A

Delayed puberty in children
Loss of secondary sexual characteristics in adults
Loss of periods

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3
Q

What can a TSH deficiency lead to?

A

Cold
Weight gain
Tiredness
Slow pulse

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4
Q

What can an ACTH deficiency lead to?

A

Tired
Dizzy
Low BP
Low sodium

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5
Q

What is a prolactinoma?

A

Prolactin-secreting pituitary tumour

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6
Q

What size of tumour is classed as a:

1) macro-adenoma
2) micro-adenoma?

A

1) >1 cm

2) <1 cm

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7
Q

True or false: prolactinomas are treated with an operation

A

FALSE - tablets

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8
Q

What inhibits prolactin and can therefore be used to shrink a prolactinoma?

A

Dopamine agonist as dopamine inhibits prolactin

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9
Q

True or false: prolactin inhibits LH

A

TRUE - also inhibits FSH

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10
Q

What are the symptoms of hyperprolactinaemia in women?

A

Menstrual disturbance
Fertility problems
Galactorrhoea (milky discharge)

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11
Q

What are the symptoms of hyperprolactinaemia in men?

A

Men present later than women as don’t have periods
Usually larger tumours
Mass symptoms such as visual loss

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12
Q

True or false: if prolactin > 5000, high prolactin might be due to disinhibition (stalk effect) rather than active prolactin secretion

A

FALSE - ^ is if prolactin < 5000

If >5000, high prolactin due to active prolactin secretion (prolactinoma)

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13
Q

What are the long-term complications of untreated acromegaly?

A
  • premature cardiovascular death
  • increased risk of colonic tumours
  • probably increased risk of thyroid cancer
  • disfiguring irreversible body changes
  • hypertension and diabetes
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14
Q

What is the treatment of acromegaly?

A
  • surgical removal of tumour
  • reduce GH secretion using dopamine agonist and somatostatin analogues (SSA)
  • block GH receptor
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15
Q

What is Cushing’s disease?

A

ACTH-secreting pituitary tumour

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16
Q

What is the classical change in appearance in someone with Cushing’s disease?

A
  • round pink face with round abdomen
  • skinny and weak arms and legs
  • thin skin and easy bruising
  • red stretch marks (striae) on abdomen
  • high BP and diabetes
  • osteoporosis
17
Q

What is the difference between Cushing’s disease and Cushing’s syndrome?

A
  • disease due to pituitary tumour

- syndrome caused by other pathologies

18
Q

What is diabetes insipidus?

A

Large quantities of pale urine

Extreme thirst due to fluid loss

19
Q

What is cranial diabetes insipidus?

A

Vasopressin deficiency pituitary disease

20
Q

What is nephrogenic diabetes insipidus?

A

Vasopressin resistance kidney disease

21
Q

Which types of pathology cause cranial diabetes insipidus?

A

Inflammation
Infiltration
Malignancy
Infection

22
Q

What are the consequences of untreated diabetes insipidus?

A
  • severe dehydration
  • hypernatraemia
  • reduced consciousness, coma and death
23
Q

What does apoplexy mean?

A

Stroke

24
Q

What is the clinical presentation of pituitary apoplexy?

A
  • sudden onset headache
  • double vision
  • visual field loss
  • cranial nerve palsy
  • hypopituitarism
25
Q

When is a stimulation test used in a dynamic assessment of HPA and GH axes?

A

Suspected hormone deficiency

26
Q

When is a suppression test used in a dynamic assessment of HPA and GH axes?

A

Suspected hormone excess

27
Q

What is used to test whether there is an excess of ACTH in the adrenal axis?

A

Suppress ACTH axis with steroids (dexamethasone)

28
Q

What is used to test whether there is a deficiency of ACTH in the adrenal axis?

A
  • Direct stimulation of adrenals by ACTH

- Response to hypoglycaemic stress (insulin stress test)

29
Q

What is used to test whether there is a deficiency of GH in the GH axis?

A

Response to hypoglycaemic stress (insulin stress test)

30
Q

What is used to test whether there is an excess of GH in the GH axis?

A

Suppress GH axis with glucose load (glucose tolerance test)

Semester 2-MEH (21 decks)

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