Session 8- Pituitary disorders Flashcards

1
Q

What are non functioning pituitary tumours

A

They don’t produce hormones

They can result in inadequate production of one or more of the pituitary hormones

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2
Q

What symptoms can pituitary hormones cause

A

Headaches
Visual problems- compression of the optic nerve
Vomiting
Nausea

Due to pressure on surrounding structures

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3
Q

How do you investigate a pituitary tumour

A

MRI scan

  • assesment of visual field defects
  • assessment of endocrine function
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4
Q

What is the most common cause of hypopituitarism

A

Pituitary adenoma

Rarer cause

  • radiation. Theory
  • inflammatory disease
  • head injury
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5
Q

What is panohypopituitarism

A

Deficiency of all anterior pituitary hormones

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6
Q

What causes gonadotropin deficiency

A

Also known a hypogonadism

Mass effects from a pituitary adenoma

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7
Q

What causes ADH deficiency

A

Hypothalamic tumour

Pituitary tumour that extends up into hypothalamus

Cranial radiotherapy

Pituitary surgery autoimmune infiltration

Meningitis

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8
Q

Effects of ADH deficiency

A

Excess excretion of dilute urine resulting in dehydration and increased thirst

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9
Q

Symptoms of hyperprolactinaemia

A

Abnormally high prolactin in blood

Most common cause of pituitary disorder

  • galactorrhoea (unexplained milk production (rare in men))
  • gynecomastia (hard breast tissue)
  • hypogonadism (diminished activity of testes or ovaries)
  • amenorrhea (cessation of menstrual cycle)
  • erectile dysfunction.
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10
Q

How can you treat acromegaly

A

Surgery to remove adenoma

Radiation therapy

Drug. Therapy

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11
Q

What is bitemporal hemi-anopia

A

Tunnel vision can see laterally on both sides

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12
Q

Symptoms of TSH deficiency

A

Low Thyroid hormones

Cold

Weight gain

Tiredness

Slow pulse

Low t4

NON-ELEVATED TSH

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13
Q

Prolactinoma

A

Prolactin-secreting pituitary tumour

Large = macro adenoma ‘

Small= micro adenoma

Larger the tumour higher the prolactin

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14
Q

Treatment of prolactinoma

A

Dopamine agonists stimulate D2 raptor

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15
Q

What is acromegaly

A

Large extremities

Large hands and feet

GH secreting pituitary tumour

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16
Q

Long term complications of untreated acromegaly

A

Premature cardiovascular death

Increased risk of colonic tumours

Probably increased risk of thyroid cancer

Disfiguring body changes that may be irreversible

Hypertension and diabetes

17
Q

Biomedical test to confirm acromegaly

A

Oral glucose tolerance test

Failure to supress GH

Elevated IGF-1 level

Growth Hormone day curve

18
Q

Treatment of acromegaly

A

Surgical removal of tumour

Medical treatment

  1. Reduce GH secretion
  2. Block GH receptor

Radiotherapy

19
Q

What is diabetes insipidus

A

Large quantities of pale urine

Extreme thirst due to fluid loss

No vasopressin losing a lot of water

20
Q

Consequences of untreated Diabes insipidus

A

Severe dehydration

High sodium levels- hypernatraemia

Reduced consciousness, coma and death

21
Q

Treatment of diabetes insipidus

A

Cranial DI responds well to synthetic vasopressin

22
Q

Pleural apoplexy

A

Stroke

Sudden vascular event in a pituitary tumour

Leads to haemorrhage and infarction

23
Q

Clinical presentation of pituitary apoplexy

A

Sudden onset headache

Double vision

Cranial nerve palsy

Hypopituitarism