Session 8- Pituitary disorders Flashcards
What are non functioning pituitary tumours
They don’t produce hormones
They can result in inadequate production of one or more of the pituitary hormones
What symptoms can pituitary hormones cause
Headaches
Visual problems- compression of the optic nerve
Vomiting
Nausea
Due to pressure on surrounding structures
How do you investigate a pituitary tumour
MRI scan
- assesment of visual field defects
- assessment of endocrine function
What is the most common cause of hypopituitarism
Pituitary adenoma
Rarer cause
- radiation. Theory
- inflammatory disease
- head injury
What is panohypopituitarism
Deficiency of all anterior pituitary hormones
What causes gonadotropin deficiency
Also known a hypogonadism
Mass effects from a pituitary adenoma
What causes ADH deficiency
Hypothalamic tumour
Pituitary tumour that extends up into hypothalamus
Cranial radiotherapy
Pituitary surgery autoimmune infiltration
Meningitis
Effects of ADH deficiency
Excess excretion of dilute urine resulting in dehydration and increased thirst
Symptoms of hyperprolactinaemia
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.
How can you treat acromegaly
Surgery to remove adenoma
Radiation therapy
Drug. Therapy
What is bitemporal hemi-anopia
Tunnel vision can see laterally on both sides
Symptoms of TSH deficiency
Low Thyroid hormones
Cold
Weight gain
Tiredness
Slow pulse
Low t4
NON-ELEVATED TSH
Prolactinoma
Prolactin-secreting pituitary tumour
Large = macro adenoma ‘
Small= micro adenoma
Larger the tumour higher the prolactin
Treatment of prolactinoma
Dopamine agonists stimulate D2 raptor
What is acromegaly
Large extremities
Large hands and feet
GH secreting pituitary tumour
Long term complications of untreated acromegaly
Premature cardiovascular death
Increased risk of colonic tumours
Probably increased risk of thyroid cancer
Disfiguring body changes that may be irreversible
Hypertension and diabetes
Biomedical test to confirm acromegaly
Oral glucose tolerance test
Failure to supress GH
Elevated IGF-1 level
Growth Hormone day curve
Treatment of acromegaly
Surgical removal of tumour
Medical treatment
- Reduce GH secretion
- Block GH receptor
Radiotherapy
What is diabetes insipidus
Large quantities of pale urine
Extreme thirst due to fluid loss
No vasopressin losing a lot of water
Consequences of untreated Diabes insipidus
Severe dehydration
High sodium levels- hypernatraemia
Reduced consciousness, coma and death
Treatment of diabetes insipidus
Cranial DI responds well to synthetic vasopressin
Pleural apoplexy
Stroke
Sudden vascular event in a pituitary tumour
Leads to haemorrhage and infarction
Clinical presentation of pituitary apoplexy
Sudden onset headache
Double vision
Cranial nerve palsy
Hypopituitarism
