Pituitary 1

Question 1

what 2 things can pituitary tumours be broken into?

Answer 1

microadenoma and macroadenoma

Question 2

microadenomas are = ?cm

macroadenomas are > ?cm

Answer 2

microadenomas are = 1cm

macroadenomas are > 1cm

Question 3

a large pituitary adenoma can compress what?

Answer 3

optic chiasma

CN III,IV,VI

Question 4

name the common visual field defect in pituitary adenomas

Answer 4

bitemporal hemianopia

Question 5

an anominous hemitopnia from a stroke causes blindness in how many eyes?

Answer 5

1 exam Q

Question 6

what is under an inhibitory affect from dopamine?

Answer 6

PRL

Question 7

what causes a raised prolactin?

Answer 7

breast feeding, pregnancy, stress, sleep

Dopamine antagonists eg metoclopramide

Antipsychotics eg phenothiazines

antidepressants eg TCA, SSRIs
other eg estrogens, cocaine

pathological - hypothyroidism, stalk lesions, RTA, prolactinoma

Question 8

in prolactinomas, there is early/late presentation in females and early/late presentation in males

Answer 8

in prolactinomas, there is EARLY presentation in females and LATE presentation in males

Question 9

signs and symptoms of prolactinoma

Answer 9

galactorrhea 
menstrual irregularity
ammenorrhoea
infertility
impotence

Question 10

Prolactinoma investigations?

Answer 10

serum prolactin concentration

MRI pituitary

Question 11

name the class of drug given in prolactinoma as medical treatment

Answer 11

dopamine agonist - cabergoline (dostinex) once to twice a week

Question 12

what is there an excess in acromegaly?

Answer 12

GH

Question 13

what test is performed to diagnose acromegaly

Answer 13

glucose tolerance test - GTT

Question 14

GGT results in normal and in acromegaly?

normal -
acromegaly -

Answer 14

normal - GH suppresses

acromegaly - GH unchanged/rise/remains same

Question 15

IGF1 is important in what condition?

Answer 15

acromegaly

Question 16

acromegaly treatment?

Answer 16

pituitary surgery

external radiotherapy to pituitary fossa

Question 17

pituitary surgery cure rates are higher in ____adenoma

Answer 17

pituitary surgery cure rates are higher in MICROadenoma

Question 18

name the 3 drug classes for treatment of acromegaly

Answer 18

1. somatostatin analogues
2. dopamine agonists
3. GH antagonists

Question 19

somatostatin analogues (Sandostatin LAR/Lanreotide/(Octreotide)) side effect?

Answer 19

gallstones

Question 20

how are somatostatin analogues delivered?

Answer 20

IM or SC

Question 21

name a dopamine agonist

Answer 21

cabergoline

Question 22

name a GH antagonist

Answer 22

pegvisomant

Question 23

is pegvisomant first or last line in acromegaly treatment?

Answer 23

last line

Question 24

why is pegvisomant last line treatment for acromegaly?

Answer 24

cost - £36,000 pa

Question 25

what type of cancer are those with acromegaly at higher risk of?

Answer 25

colon and tubule-villous adenoma