Chem Path: Pituitary Flashcards
What are the 6 hormones made by the anterior pituitary?
ACTH, TSH, LH, FSH, prolactin, GH
How do you do pituitary fx test?
Triple test aka CPFT:
Insulin to see if ACTH and GH rise
TRH
LHRH
What happens to your brain when you are severely hypoglycaemic
Neuroglycopaenia
What do you give
20% dextrose 50ml
How is the CPFt done
0.15U/kg insulin
200mg TRH
100mg LHRH
All IV
Which is the most important hormone replacement in pituitary failure?
Hydrocortisone
In what order do you replace the hormones?
Hydrocortisone
Thyroxine
Oestrogen
GH
What would you give a patient with prolactinoma?
Dopamine agonist - bromocriptine and cabergoline
What is non-functioning adenoma
Disconnection hyperprolactinaemia. The adenoma presses on the stalk, therefore causing a drop in all hormones produced. This means that prolactin will increase due to nothing inhibiting it.
Which hormone does not need replacement in this case?
Fludrocortisone as it is not a pituitary hormone. It is to replace aldosterone, which is not affected in this case.
What else would you give this patient?
Cabergoline - dopamine agonist and will normalise the prolactin, allowing for fertility
What is acromegaly?
Excess GH
How is it diagnosed?
Glucose tolerance test
What is another test to confirm it?
IGF - 1 levels
What’s the best treatment?
Surgery, radiotherpay, cabergoline, octeotride
