Flashcards in Endocrine - Pituitary Deck (23):
Prolactin deficiency presents as?
Inhibited lactation after childbirth (no symptoms in men)
Lactation in women and hypogonadotropic hypogonadisn in men
LH and FSH deficiency will cause?
#Women – amenorrhea
#Man – no testosterone or sperm
Both - decreased libido, decreased body hair
#Decreased FSH and LH from decreased GnRH
Adults with growth hormone deficiency present with?
#Reduced muscle mass
#Increased LDL and cholesterol
Na and K in panhypopituitarism?
Hyponatremia from hypothyroidism
Normal potassium because aldosterone is not affected
Primary Hypothyroid – test and confirmatory test?
TSH and thyroxine levels;
decreased TSH response to thyrotropin releasing hormone
Cushing's disease – test and confirmatory test?
Increased ACTH and cortisol;
#Normal adrenal cosyntropin test
#No response to CRH
Growth hormone deficiency – test and confirmatory test?
#No response to arginine infusion
#No response to GHRH
Prolactin deficiency – test and confirmatory test?
No response to TRH
Insulin Simulation test?
Insulin decreases glucose levels, causing growth hormone to rise
Replace hormones from panhypopituitarism in this order?
#Cortisone before thyroxine
Drug/disease Causes of nephrogenic diabetes insipidus?
Electrolyte abnormalities can cause nephrogenic diabetes insipidus?
Hypercalcemia and hypokalemia
Treatment of Central versus Nephrogenic DI?
#Correct underlying cause
#HCTZ, amiloride, NSAIDs
Acromegaly is nearly always caused by? Other possible causes?
Ectopic production from lymphoma or bronchial carcinoid
Non-bone Symptoms of acromegaly?
#Carpal tunnel syndrome
#increased Body odor
#Deep voice and macroglossia
#Cardiomegaly and CHF
Best initial test for acromegaly? Most accurate test?
IGF-1 (increased); glucose suppression test
Treatment of acromegaly?
#Cabergoline - DA inhibits GH release
#Octreotide - somatostatin inhibits GH release
#Pegvisomant - GH receptor antagonist
Only calcium channel blocker to raise prolactin level?
Affect of DA on prolactin?
General drugs that increase prolactin?
Psych (psychotics, opioids, tricyclics)
Patient presents with elevated prolactin levels – next tests?
#Thyroid function tests
#BUN/creatinine (kidney disease elevates prolactin)
#LFTs (cirrhosis elevates prolactin)