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from flashcardlet > (2) Exam 2- Anterior Pituitary > Flashcards

(2) Exam 2- Anterior Pituitary Flashcards

0
Q

And excess excretion of PRL (prolactin) can cause

A

Infertility or milk excretion

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1
Q

What hormones are secreted by the anterior pituitary gland

I believe these were a select all that apply last year

A

TSH (thyroid stimulating hormone)-thyroid

ACTH (adrenocorticotropic hormone)-corticosteroids

FSH (follicle-stimulating hormone)– Estrogen, ova, and sperm

LH (Luteinizing hormone)- ovulation and sex

GH (growth hormone)- growth and development

PRL (prolactin)- milk production and ovaries

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2
Q

What medication is given to stop PRL secretion?

A

Parlodel

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3
Q

What is the side effects of Parlodel

A

Pastoral hypertension (seizures), cardiac arrhythmias

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4
Q

And excess excretion of ACTH cauaes

A

Cushing syndrome

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5
Q

Hyper function of growth hormone of the anterior pituitary gland causes

A

Acromegaly and gigantianism

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6
Q

What is the difference between academically and gigantianism

A

Acromegaly develops after epiphyseal closure. The bones of the arms and legs do not grow longer

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7
Q

Acromegaly is an increased excretion of which hormone

A

GH (growth hormone)

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8
Q

Acromegaly most often occurs as a result of

A

A benign pituitary tumor (adenoma)

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9
Q

Which hormones can be affected by the anterior pituitary adenoma

A

PRL (prolactin) – can cause infertility or milk expiration.
GH (Growth hormone) – causes acromegaly and gigantianism
ACTH (adrenocorticotropic hormone) – causes Cushing’s syndrome

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10
Q

Assessment findings of acromegaly

A

Large facial features, the voice, increases hat, glove or shoe size, Enlargement of the tongue, Joint pain, Sleep apnea and Obstruction, Peripheral neuropathy and proximal muscle weakness, Visual changes/headaches, Polydipsia, Polyuria, Barrel chest

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11
Q

In acromegaly how do you determine that thickening and enlargement of the bony and soft tissue on the face, feet, and head have occurred

A

compare old and new pictures

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12
Q

Clinical manifestations of acromegaly

A

Hyperglycemia, hypertension, heart failure

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13
Q

Why would a person with acromegaly experience sleep apnea

A

Upper airway narrowing and obstruction from increased amounts of pharyngeal soft tissue

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14
Q

Skin assessment for acromegaly

A

Thick, leathery, and oily

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15
Q

Why would a person with acromegaly experience visual changes and headachy

A

Pressure on the optic nerve

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16
Q

What vision changes might occur in a patient with acromegaly

A

Diplopia, blurry, or field vision

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17
Q

What diagnostic Studies can diagnose acromegaly

A

OGTT

IGF – 1

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18
Q

What diagnostic study is specific for acromegaly

A

OGTT- GH levels do not fall

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19
Q

Why are growth hormone levels not used to diagnose acromegaly

A

Growth hormone pulsates and determines inaccurate results due to the changes

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20
Q

Nonsurgical management for acromegaly

A

Drug therapy and radiation therapy

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21
Q

Drug therapy for acromegaly

A

Sandostatin (decreases GH levels, but will also decrease blood glucose) monitor glucose

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22
Q

What is the route and how often is Sandostatin given in acromegaly?

How often are GH levels measured

A

Sub Q injections three times per week.

GH is measured every two weeks

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23
Q

What do you want to monitor with the medication Sandostatin

A

Glucose and growth hormone levels every two weeks

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24
Q

Dopamine agonist (Parlodel) maybe given alone or added to Sandostatin analogs. What does Parlodel do

A

Reduces the secretion of growth hormone from the tumor

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25
Q

To reduce cranial pressure and prevent cerebrospinal fluid leakage, what medication may be given

A

Stool softener

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26
Q

Radiation therapy for acromegaly

A

Used when surgery has failed to produce a care or when patients are poor candidate for surgery.

It can also reduce the size of the tumor before surgery

27
Q

As a type of radiation therapy what can be used for small, surgically incapable pituitary tumors or in place of conventional radiation

A

Stereotactic radiosurgery (gamma knife surgery)

28
Q

What are the complications of stereotactic radiosurgery

A

Headache, nausea, vomiting, seizures

29
Q

After stereotactic radiosurgery what sites need care

A

Pin sites

30
Q

Concerned with radiation treatment for acromegaly

A

Optic chiasm

31
Q

What is the treatment of choice for acromegaly

A

Surgery (hypophysectomy)

32
Q

After a hypophysectomy what essential hormones produced by target organs are given as replacements

A

Glucocorticoids

Thyroid hormone

Sex hormone

33
Q

When the entire pituitary gland is removed, how long is hormone therapy given

A

Throughout life

34
Q

Postoperative care after a Transsphenoidal hypophysectomy

A

HOB elevated 30° at all times

Monitor the pupillary response, speech patterns, extremity strength, and signs of bleeding

Mouth care Q4 hours

Avoid brushing teeth, vigorous coughing, sneezing, Valsalva maneuver.

Assess for diabetes insipidus

Monitor for clear nasal drainage

35
Q

How long should the patient avoid brushing their teeth after hypophysectomy

A

10 days to protect the suture line

36
Q

If clear/yellow nasal drainage “yellow halo” is present after hypophysectomy what should be done

A

Notify the surgeon and send to laboratory to be tested for glucose

37
Q

What is indicated if the glucose level is greater than 30 mg/dL in the clear nasal drainage testing results?

What is the patient at risk for?

A

CSF leakage

Meningitis

38
Q

A CSF leak usually resolves within 72 hours when treated with

A

Head elevation and bed rest

39
Q

If CSF leak persists, what may be done to reduce pressure to below normal levels

A

Daily spinal taps

40
Q

To assess for diabetes insipidus, closely monitor

A

Urine output and serum and urine osmolarity

41
Q

If the hypophysectomy is performed or the pituitary gland is damaged hormone replacement therapy may be necessary for

A

ADH, cortisol, and thyroid hormone

42
Q

Signs and symptoms of meningitis

A

Stiff neck and muscle rigidity

43
Q

Patients with acromegaly are at high risk for

A

Colon polyps and color rectal cancer.

Colonoscopy every 3 to 4 years

44
Q

With acromegaly the patient is likely to succumb to what diseases/disorders

A

Cardiac and respiratory disease, diabetes mellitus, and colon cancer

45
Q

In acromegaly/hyperpituitarism, The life expectancy is decreased by

A

5 to 10 years

46
Q

Which hormones are secreted by the anterior pituitary gland

A

ACTH, TSH, FSH, LH, GH, and prolactin

47
Q

Which hormones are stored in the hypothalamus and secreted by the posterior pituitary gland

A

ADH and oxytocin

48
Q

Hypofunction of growth hormone from the anterior pituitary gland before epiphyseal closure causes

A

Dwarfism

49
Q

Decreased growth hormone after epiphyseal closure causes what clinical manifestations

A

Lean muscle mass, thinner, tendency of breakdown

50
Q

What is hypopituitarism

A

Disorder that involves a decrease in one or more of the pituitary hormones

51
Q

What is selective hypopituitarism

A

A deficiency of only one pituitary hormone

52
Q

What is panhypopituitarism

A

Total failure of the pituitary gland resulting in a deficiency of all pituitary hormones

53
Q

What is the most common cause of pituitary hypofunction

A

Pituitary tumor

54
Q

Besides a pituitary tumor, what are other causes of hypopituitarism

A

Autoimmune disorders

Infections

Pituitary infarction (Sheehan syndrome)

Destruction of pituitary gland (trauma, radiation, or surgical procedures)

55
Q

Deficiencies of the anterior pituitary gland can lead to

A

Organ failure

56
Q

Which two hormone deficiencies are life-threatening

A

TSH and ACTH

57
Q

ACTH deficiency can lead to

A

Acute adrenal insufficiency (Addison’s disease) and shock

58
Q

Assessment findings with hypopituitarism

A

Headaches, visual changes, loss of smell, nausea, vomiting, seizures, loss of secondary sex characteristics, infertility, amenorrhea

59
Q

Laboratory test for diagnosing hypopituitarism involve the direct measurement of what pituitary hormones

A

TSH and ACTH will be decreased

60
Q

Laboratory test for diagnosing hypopituitarism as an indirect determination of target organ hormones

A

T3 and T4

61
Q

What diagnostic tests are done to identify a pituitary tumor

A

CT and MRI

62
Q

What long term hormone replacement medication is used for GH deficiency

A

Somatropin

63
Q

What hormones need to be replaced with hypopituitarism

A

GH, androgens, estrogen, progesterone, thyroid, corticosteroids

64
Q

What other nonsurgical management besides medication, can be used with hypopituitarism

A

Radiation therapy

65
Q

What surgery can be performed for hypopituitarism

A

Hypophysectomy

66
Q

Treatment for hypopituitarism often consist of surgery or radiation therapy followed by

A

Lifelong hormone therapy

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