Excess of pituitary hormones Flashcards
(16 cards)
Typical antipsychotics may cause symptoms of ___ excess like:
- Prolactin
Galactorrhea, amenorrhea, gynecomastia.
What is the first-line treatment for gigantism?
Transsphenoidal adenomectomy
Indication of Octreotide (somatostatin analog) to treat acromegaly and gigantism.
Persistence of symptoms after transsphenoidal adenomectomy
What is the preferred initial test for evaluating patients with suspected acromegaly?
IGF-1 level
What is the next step in a patient with suspected acromegaly that is found to have elevated IGF-1 levels?
Oral glucose tolerance test (OGTT)
What is the most common cause of death in patients with acromegaly?
Heart failure
What is the likely diagnosis in a middle-aged patient that develops coarse facial features, digit enlargement, arthralgias, hypertension, secondary diabetes mellitus and carpal tunnel syndrome?
Acromegaly
What is the initial treatment for a macroprolactinoma (> 10mm) or symptomatic microprolactinoma?
Dopamine agonist (e.g., cabergoline, bromocriptine)
- In females, prolactinoma presents as:
- In males, prolactinoma presents as:
- Galactorrhea, amenorrhea, and infertility
- Headache, decreased libido, and infertility
What is the likely diagnosis in a patient with a pituitary mass and the laboratory values below? Prolactin: 250 ng/mL (normal, < 15), LH: low, TSH: normal
Prolactinoma
What is the most common type of pituitary adenoma?
Prolactinoma
Treatment
- Asymptomatic SIADH =
- Symptomatic SIADH =
- Fluid restriction ± salt tablets
- Hypertonic saline (3%)
What is the likely diagnosis in a euvolemic patient with low serum osmolality (< 275 mOsm/kg) and high urine osmolality (> 100 mOsm/kg)?
SIADH
The very low serum Na+ concentration in SIADH can lead to:
cerebral edema and seizures
_____ carcinoma may produce the posterior pituitary hormone ADH leading to SIADH
Small cell lung
Which three organs / diseases are involved in MEN 1?
- Parathyroid
- Pancreas
- Pituitary
