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Year 2 MBChB Endocrine > Pituitary Disease > Flashcards

Pituitary Disease Flashcards

1
Q

Test for too much + too little of a hormone?

A

Too much = suppression

Too little = stimulation

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2
Q

What is the main cause of anterior pituitary hyperfunction?

A

Tumours

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3
Q

Name causes of anterior pituitary hypofunction.

A 
Tumours
Radiation
Infection
Autoimmune disease
Ischemia
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4
Q

Name 3 causes of posterior pituitary dysfunction.

A

Tumours
Diabetes insipidus
SIADH

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5
Q

Are pituitary adenomas functional or non-functional?

A

Non-functional

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6
Q

What are the 2 types of pituitary adenoma + size?

A 
Microadenoma = < 1cm
Macroadenoma = > 1cm
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7
Q

What are pituitary adenomas associated with?

A

MEN 1

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8
Q

Name 4 ways pituitary adenomas present + if they are functional (rare) then which 2 hormones are most common?

A 
Bitemporal hemianopia
Headaches
Gland hypofunction
Diabetes insipidus
Prolactin and GH
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9
Q

Compression and infarction of the pituitary gland may lead to what condition?

A

Panhypopituitarism/ Sheehan’s syndrome

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10
Q

What is the treatment for pituitary adenomas?

A

Transsphenoidal surgery

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11
Q

What is the most common benign pituitary tumour + what condition is it linked to?

A

Prolactinoma

MEN1

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12
Q

Do prolactinomas present early or late in men/women?

A

Early in women

Late in men

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13
Q

Name 2 ways prolactinomas present in women?

A

Galactorrhea

Menstrual/fertility issues

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14
Q

Name 3 ways prolactinomas present in men?

A

Impotence
Headaches
Visual field abnormalities

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15
Q

Name 4 times prolactin is normally raised + name a dopamine antagonist which can increase prolactin.

A 
Pregnancy
Breast feeding
Stress
Sleep
Metoclopramide
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16
Q

What is the treatment for prolactinomas + mechanism + side effect?

A

Carbergoline
Dopamine agonist
N and V

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17
Q

2 treatments for prolactinoma if drugs are ineffective?

A

Surgery

Sellar radiotherapy

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18
Q

What rare tumour derives from Rathke’s pouch and presents as headaches and growth retardation?

A

Craniopharyngioma

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19
Q

What causes SIADH and what is the most common cause?

A

Excess ADH release

Ectopic tumour

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20
Q

Name a condition that releases ectopic ADH?

A

Small cell lung carcinoma

21
Q

Is Na and osmolality high or low in blood/urine in SIADH?

A

Na low in blood/high in urine

Osmolality low in blood/high in urine

22
Q

Treatment for SIADH?

A

High salt intake

Restrict fluids

23
Q

What is acromegaly caused by?

A

Excess GH due to a pituitary somatotroph adenoma

24
Q

What over expressed gene is acromegaly linked to + associated condition?

A

GRP101

MEN 1

25
Q

Name 5 signs of acromegaly.

A 
Excess bone growth
Hypertension
Headaches
Sleep apnoea
Colonic polyps
26
Q

Which 2 pituitary hormones increase blood glucose?

A

GH

ACTH

27
Q

What 2 tests for acromegaly?

A

IGF-1

OGTT

28
Q

Surgical treatment for acromegaly?

A

Transphenoidal surgery

29
Q

Name 2 drugs for acromegaly?

A

Somatostatin analogue

GH antagonist

30
Q

What is the target number for GH and random blood glucose in acromegaly?

A

GH < 0.4

Random BG < 2

31
Q

What is the difference between Cushing’s disease vs. Cushing’s syndrome?

A 
Disease = pituitary origin
Syndrome = other origin
32
Q

What is Cushing’s syndrome and what 2 things does it cause a rise in?

A

Excess cortisol

Mineralocorticoids and androgens

33
Q

Name 2 causes of ACTH dependent Cushing’s.

A

Pituitary tumour

Cushing’s disease

34
Q

Name 2 causes of ACTH independent Cushing’s?

A

Adrenal tumour

Nodular adrenal hyperplasia

35
Q

Name 4 facial/head/neck features of Cushing’s.

A

Frontal balding in women
Moon face
Buffalo hump
Eye disease

36
Q

Name 3 MSK signs of Cushing’s.

A

Proximal myopathy
Osteoporosis
AVN of femoral head

37
Q

What is dexamethasone and what should it normally do to cortisol levels + why?

A

Glucocorticoid
Reduce cortisol
Inhibits HPA axis

38
Q

What are 2 screening tests for Cushing’s + normal result?

A

Overnight 1mg dexamethasone suppression = < 5

24hr urine cortisol = no cortisol

39
Q

What is the definitive test for Cushing’s + normal result + result for a pituitary cause?

A

2 day/2 mg dexamethasone suppression test
Normal = < 50
Suppress by 50%

40
Q

Name 3 treatments for pituitary, adrenal and ectopic Cushing’s + 3 possible drugs?

A 
Pituitary = hypophysectomy + radiation
Adrenal + ectopic = adrenalectomy 
Metyrapone
Ketoconazole
Pasireotide
41
Q

Treatment for ectopic cause of Cushing’s with no obvious cause?

A

Bilateral adrenalectomy

42
Q

Posterior hypopituitarism can cause what disease + why?

A

Diabetes insipidus

Lack of ADH

43
Q

Name 3 types of diabetes insipidus.

A

Cranial
Nephrogenic
Gestational

44
Q

What is the 4 signs of familial DI?

A

DI
DM
Optic atrophy
Deafness

45
Q

Name 4 symptoms of DI?

A

Polyuria/dipsia
Nocturia
Weight loss
CNS disease

46
Q

What is the test for DI + how does it work?

A

Water deprivation test

No water for 6-8 hours then give desmopressin

47
Q

What is a cranial + nephrogenic DI result from a water deprivation test?

A 
Cranial = rises significantly after desmopressin
Nephrogenic = stays the same before/after
48
Q

Treatment for DI?

A

Desmospray or desmopressin

Year 2 MBChB Endocrine (14 decks)

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