endocrinology

Question 1

Waar word prolactin geproduseerd

Answer 1

ant pituitary

Question 2

wat inhibeer en stimuleer prolactin

Answer 2

1. dopamine(hypothalamus) inhibeer
2. Thyrotropin releasing hormone stimuleer
3. negatief feedback loop

Question 3

oorzaken van verhoogd prolactin

Answer 3

1. physiological: pregnancy
2. prolactinoma: pituitary adenoom
3. Hypothyroidism: verhoogd TRH
4. medicatie: dopamine antagonist/estrogen
5. damage to hypothalamic pituitary stalk

Question 4

symptomen hyperprolactinemia

Answer 4

vrouw:
galactorea
anovulatory amenorhoea

man:
gynocomastia]erectile dysfunctie

prolactinoma:
press on optic nerve : headache and impaired vision.

Question 5

anterior pituitary hormonen

Answer 5

ACTH
GH
FSH
LH
TSH
Prolactin

Question 6

Post pituitary hormonen

Answer 6

oxytocin

vasopressin

Question 7

wat is acromegalie

Answer 7

verhoogd growth hormone
GH stim IGH synthesis
IGH - incr in size muscle,cartilage,bone
-impaired glucose tolerance

Question 8

Symptomen acromegalie

Answer 8

tumor mass effect:
headache
vision(bitemp hemianopsia)
CN palsie

vrou:
oligomenorh
2nd amenorhea
galactorhea
vaginal atrophy

male:
erectile dysfunctie
decr libido
decr testicular volume

soft tissue:
doughy skin
hyperhidrosis
deepening voice
macroglossia

skeletal features:
enlarged nose , forehead , jaw , widend hands , painful arthropathy

Question 9

Blood test acromegaly

Answer 9

serum IGF-1:
incr-> oral glucose tolerance test
N-> ruled out

OGGT with baseline GH
–> measure GH after 2 hrs:
GH supress: ruled out
GH not supress: pituitary MRI

Question 10

Oorzaken Hypopituitarisme

Answer 10

acquired:

• intrasellar/parasellar(most common non-secr pit adenomas)
• pituitary apoplexy(infarct/ischeamia)

congenital

Iatrogenic : radiation , resection