2 Endocrine - Pituitary diseases Flashcards Preview

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Flashcards in 2 Endocrine - Pituitary diseases Deck (20):
1

Deficiencies in vasopressin (Anitdiuretic hormone) cause...

diabetes insipidus - ADH normally allows you to concentrate your urine

2

Treatment for non-functioning pituitary tumors?

Surgery-
the aims are to protect eyesight (as the optic nerve is close) and restore pituitary function

3

Tumors in the ...... producing............ can cause cushings

Pituitary
ACTH

4

How can we used DA receptor agonist to treat proclactinomas (tumor secreting prolactin)?

Prolactin is inhibited by the release of DA from the hypothalamus. Enhance DA causes fall in prolactin.

5

How to get pregnant with a prolactonoma?

Need to restore menstral cycle before you can get pregnant as you won't ovulate otherwise - use cabergoline (a DA receptor agonist)

6

Agromedly is caused by....?
Treatment is...

Excess growth hormone (in childhood this causes gigantism)
Surgery

7

Cushings symptoms: (8)

Bruising
Central obesity & peripheral wasting and myopathy
Moon face/buffalo hump

Hypertension
Diabetes
Low K
Gastric ulcers

Psychological illnesss

8

Treatments of Cushings surgically is achieved how:

Remove tumor - Metyrapone in preparation for surgery

9

Why use Metyrapone in preparation for surgery to resolve cushings?

Blocks hydrocortisone synthesis - the goal is to achieve normal cortisol before surgery to aid healing/reduce chance of infection (your immune system is suppressed)

10

Pituitary failure: hormones you must mimic...

Growth hormone
Oestrogen/testosterone (LH and FSH)
Thyoxine (TSH)
Cortisone (ACTH)
Desmopressin (to prevent diabetes insupidus)

11

What is the difference between primary and secondary hypothyroidism?

Primary: underactive thyroid
Secondary: pituitary isn't stimulating your thyroid enough to produce hormones
Tertiary: hypothalamus isn't stimulating your pituitary enough

12

What to monitor in secondary hypothyroidism?

TSH is no useful. You need to monitor free T4 only.

13

Why use hydrocortisone instead of prednisolone?

hydro is shorter acting - mimics natural rhythm.
pred is longer - use for asthma

14

Cortisol is a GC or MC?

GC

15

Fucntion of MCs?

maintain your BP

16

What is used to substiture deficint MC?

fludrocortisone

17

is fludrocortisone needed in pituitary failure?

no - only needed when your adrenals don't work too

18

Equivalent dose
20mg hydrocortisone = ..........mg predinisolone = ........mg dexamethasone

20mg hydro = 5-7.5mg pred = 0.75mg dexameth

19

Hydrocortisone sick day rules -

-double dose with fever/broken limb/surgery/shock/long haul flight
- double dose with gastroeneteritis + IM
-20mg for dental exraction

20

Function of desmopressin

acts on kidney collecting ducts to allow water reabsorbtion - aim is to control polyuria. Check sodium levels.