The pituitary gland (clinical case and discussion) Flashcards
What does hyper-secretion of growth hormone cause
Acromegaly (gigantism)
What does hyper secretion of ACTH
Cushing’s disease
What does hyper secretion of prolactin cause
Hyperprolactinaemia
What are the clinical features of Acromegaly
Spade like hands
wide feet
thick lips and tongue
carpal tunnel syndrome
sweating
What are complications of acromegaly
headache
chiasmal compression
diabetes mellitus
hypertension
What is a common cause of acromegaly
Hypersecretion of growth hormone caused by tumour
What does cushings syndrome cause
Excess corticosteroids
Therefore more tissue breakdown, sodium retention and insulin antagonism
What are the high value signs and symptoms in cushings syndrome
Skin atrophy
myoptathy
osteoporosis
What are intermeddiate value diagnostic symptoms in cushings syndrome
Pink striae
Facial mooning and hirsutism
Oedema
What are non specific symptoms or signs that are in cushings syndrome
Central obesity and hypertension
What is proximal myopathy
Generalised muscle weakness affecting the upper and/or lower limbs
What are the clinical manifestations of hyperprolactinameia in women
Galactorrhea - milk production
Infertility and menstrual cycle that is not regular
What are the clinical manifestations of hyperprolactinaemia in women
Galactorrhoea
Impotence - cant get a an erection
Headache
What are the physiological causes of hyperprolactinaemia
pregnancy, lactation and stress
What are the pharmacological causes of hyperprolactinaemia
Dopamine agonist antagonistic drugs
What are pathological causes of hyperprolactinaemia
Primary hyperthyroidism
Pituitary lesions
What are examples of dopamine agaonists
Neuroleptics - chlorpromazine
Anti-emetics - metoclopramide
What are clinical features of hypopituitarism in adults
Tired, weight gain, depression, reduced libido and impotence, skin pallor, reduced body hair
What are clinical features of hypopituitarism in children
Delayed puberty and reduced linear growth
What is used to treat a prolactinoma causing hyperprolactinaemia
Dopamine agonists
What can be used to treat increased secretion of GH causing acromegaly
somatostatin analogues
GH receptor antagonists
What can be used to treat hyposecretion of cortisol, T4, sEX steroids and GH
Desmopressin
What is the treatment for pituitary tumours
Surgery and rafiotherapy
What is the effect of somatostatin in acromegaly
Normalise GH and IGF-1 levels
Induce tumour shrinkage
Improve soft tissue overgrowth, headache and sleep apnoea in acromegaly patients
What are examples of somatostatin analogues
Octreotide and lanreotide
What are the side effects of somatostatin analogues
Nausea, cramps, diarrhoea and flatulence (GI upset)
Gallstones
High cost
What is the treatment for microprolactinoma and when it is used
Usually in women with galactorrhea, amenorrhea and infertility
Treatment is cabergoline normoprolactinaemia
How large is a microprolactinoma
less than 10 mm
How large is a macroprolactinaemia
more that 10 mm
