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Endocrine System > The Pituitary Gland > Flashcards

The Pituitary Gland Flashcards

1
Q

What are some hormones released from the anterior pituitary?

A

TSH - thyroid
ACTH - adrenal
FSH and LH - ovary
FSH and LH - testes
GH - bone and soft tissues

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2
Q

What can cause compression of the optic chiasm?

A

Suprasellar extension of pituitary gland

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3
Q

What does pituitary compression on optic chiasm cause?

A

Bitemporal hemianopia

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4
Q

What is the management for hypersecretion of pituitary tumours?

A

Dopamine agonists - prolactinoma
Somatostatin analogues - acromegaly
GH receptor antagonist - acromegaly

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5
Q

What is management for hyposecretion of normal pituitary?

A

Cortisol, T4, sex steroids and GH
Desmopressin

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6
Q

What is the management for pituitary tumour?

A

Surgery - mainly trans sphenoidal
Radiotherapy

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7
Q

What are some hypersecretion diseases?

A

GH - acromegaly
ACTH - Cushing’s disease
Prolactin - hyperprolactinaemia

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8
Q

What are some hyposecretion diseases?

A

Anterior - FSH/LH, GH, ACTH and TSH
and posterior - vasopressin

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9
Q

What are some clinical features of acromegaly?

A

Spade like hands
Wide feet
Coarse facial features
Thick lips and tongue
Carpal tunnel syndrome
Sweating

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10
Q

What are some complications of acromegaly?

A

Headache, chiasmal compression, DM, hypertension, cardiomyopathy, sleep apnoea, accelerated OA and colonic polyps

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11
Q

How is acromegaly diagnosed?

A

If IGF-1 is elevated and then conformation with OGTT test
MRI of pituitary
Check vision

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12
Q

Describe Cushing’s disease

A

Excess corticosteroids
Cortisol is a catabolic hormone so causes tissue breakdown (weak skin, muscles and bones), sodium retention (hypertension) and insulin antagonism (DM)

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13
Q

What are some high value symptoms of Cushing’s disease?

A

Skin atrophy
Spontaneous purpura
Proximal myopathy
Osteoporosis
Growth arrest in children

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14
Q

What are some intermediate value symptoms of Cushing’s disease?

A

Pink striae
Facial mooning and hirsutism
Oedema

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15
Q

What can cause ACTH dependant Cushing’s disease?

A

Pituitary tumour
Ectopic ACTH secretion - ex. lung carcinoid

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16
Q

What can cause ACTH independent Cushing’s disease?

A

Adrenal tumour
Corticosteroid therapy - asthma and IBD

17
Q

What are some clinical manifestations of hyperprolactinemia in women?

A

Galactorrhoea - milk production
Menstrual irregularity
Infertility

18
Q

What are some clinical manifestations of hyperprolactinaemia in men?

A

Galactorrhoea
Impotence
Visual field abnormalities
Headache
Extraocular muscle weakness
Anterior pituitary malfunction

19
Q

What are the causes of hyperprolactinaemia?

A

Pregnancy, lactation and stress
DA depleting and DA antagonist drugs
Primary hypothyroidism and pituitary lesions

20
Q

What drugs may cause hyperprolactinaemia?

A

DA antagonists
DA depleting drugs
Oestrogens
Some antidepressants

21
Q

What are the clinical features of hypothyroidism in adults?

A

Tiredness, weight gain, depression, reduced libido, impotence, menstrual problems, skin pallor and reduced body hair

22
Q

What are some clinical features of hypothyroidism in children?

A

Reduced linear growth and delayed puberty

23
Q

What test is used for diabetes insipidus?

A

Water deprivation test
DDAVP added and concentrates in diabetes insipidus
Give fluid deprivation period before

24
Q

What is some differential diagnoses for diabetes insipidus?

A

Idiopathic, post-trauma, metastatic carcinoma, craniopharyngioma, other brain tumours and rare (sarcoidosis)

25
Q

What are the beneficial effects of somatostatin analogues in acromegaly?

A

Improve soft tissue overgrowth, sweating, headaches and sleep apnoea
Normalises GH and iGF-1 levels
Induces tumour shrinkage
Reduces morbidity + mortality

26
Q

What are the somatostatin slow release injections?

A

Monthly injections of octreotide LAR and Lanreotide autogel

27
Q

What are some adverse effects of somatostatin analogues?

A

Nausea, cramps, diarrhoea, flatulence
Cholesterol gallstones
Slow release preparations require monthly IM/SC injections
High cost

28
Q

Describe pituitary radiotherapy

A

Use is declining
Acts slowly
Can cause hypothyroidism

29
Q

Describe microprolactinoma

A

<10mm
Usually women with galactorrhoea, amenorrhoea, infertility and serum PRL <5000mU/I
Most shrink

30
Q

What is the treatment of microprolactinoma

A

Dopamine agonists
Cabergoline normoprolactinaemia, ovulatory cycles and fertility usually restored

31
Q

Describe macroprolactinoma

A

> 10mm
Typical response to DA agonists - rapid fall in serum PRL, tumour shrinks, visual improvement and recovery of pituitary function

32
Q

What are some adverse effects of dopamine agonists?

A

Nausea and dizziness
Impulse control disorders - addictive behaviours
Fibrotic disorders - lung and cardio

Endocrine System (23 decks)

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