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Flashcards in Endocrine - Pituitary Deck (23):
0

Prolactin deficiency presents as?

Prolactin excess?

Inhibited lactation after childbirth (no symptoms in men)

Lactation in women and hypogonadotropic hypogonadisn in men

1

LH and FSH deficiency will cause?

#Women – amenorrhea
#Man – no testosterone or sperm

Both - decreased libido, decreased body hair

2

Kallman syndrome?

#Decreased FSH and LH from decreased GnRH
#Anosmia
#Renal agenesis

3

Adults with growth hormone deficiency present with?

#Central obesity
#Reduced muscle mass
#Increased LDL and cholesterol

4

Na and K in panhypopituitarism?

Hyponatremia from hypothyroidism

Normal potassium because aldosterone is not affected

5

Primary Hypothyroid – test and confirmatory test?

TSH and thyroxine levels;

decreased TSH response to thyrotropin releasing hormone

6

Cushing's disease – test and confirmatory test?

Increased ACTH and cortisol;

#Normal adrenal cosyntropin test
#No response to CRH

7

Growth hormone deficiency – test and confirmatory test?

Low GH;

#No response to arginine infusion
#No response to GHRH

8

Prolactin deficiency – test and confirmatory test?

Low prolactin;

No response to TRH

9

Insulin Simulation test?

Insulin decreases glucose levels, causing growth hormone to rise

10

Replace hormones from panhypopituitarism in this order?

#Cortisone before thyroxine

11

Drug/disease Causes of nephrogenic diabetes insipidus?

#Lithium
#Chronic Pyelonephritis
#Amyloidosis
#sickle cell/myeloma

12

Electrolyte abnormalities can cause nephrogenic diabetes insipidus?

Hypercalcemia and hypokalemia

13

Treatment of Central versus Nephrogenic DI?

Vasopressin

Verses

#Correct underlying cause
#HCTZ, amiloride, NSAIDs

14

Acromegaly is nearly always caused by? Other possible causes?

Adenoma

Ectopic production from lymphoma or bronchial carcinoid

15

Non-bone Symptoms of acromegaly?

#Carpal tunnel syndrome
#increased Body odor
#Deep voice and macroglossia
#Colonic polyps
#Hypertension
#Cardiomegaly and CHF

16

Best initial test for acromegaly? Most accurate test?

IGF-1 (increased); glucose suppression test

17

Treatment of acromegaly?

#Transphenoidal resection
#Cabergoline - DA inhibits GH release
#Octreotide - somatostatin inhibits GH release
#Pegvisomant - GH receptor antagonist

18

Only calcium channel blocker to raise prolactin level?

Verapamil

19

Affect of DA on prolactin?

Inhibits

20

General drugs that increase prolactin?

Psych (psychotics, opioids, tricyclics)

21

Patient presents with elevated prolactin levels – next tests?

#Pregnancy test
#Thyroid function tests
#BUN/creatinine (kidney disease elevates prolactin)
#LFTs (cirrhosis elevates prolactin)

22

Treatment of prolactinoma? If fails?

DA (carbergoline, Bromocriptine)


#if fails, surgery

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