Pituitary

Question 1

which hormone stimulates the thyroid to produce thyroid hormones which regulate the body’s metabolism?

Answer 1

TSH

Thyroid stimulating hormone

Question 2

which hormone increases production and release of cortisol by the adrenal glands in response to stress?

Answer 2

ACTH

Adrenocorticotrophic hormone

Question 3

which hormone causes bone and tissue growth, raises blood glucose, and controls balance of fat & muscle tissue in the body?

Answer 3

GH

Growth hormone

Question 4

which hormone triggers ovulation and development of corpeus luteum in females and triggers Leydig cells to produce testosterone in males?

Answer 4

LH

Lutinizing hormone

Question 5

which hormone stimulates growth of ovarian follicles in females and acts on Sertoli cells to stimulate sperm production in males?

Answer 5

FSH

Follicle stimulating hormone

Question 6

which hormone controls breast developments and stimulates lactation in mammary glands?

Answer 6

Prolactin

Question 7

which hormone stimulates uterine contractions in childbirth, milk letdown reflex, bonding with sexual activity and between mom/baby?

Answer 7

Oxytocin

Question 8

which hormone causes reabsorption of free water and increases blood pressure by constricting arterioles?

Answer 8

ADH

Vasopressin

Question 9

In primary disease, there is impaired function at the level of the ______

Answer 9

target endocrine gland

Question 10

In secondary disease, there is impaired function at the level of the ______

Answer 10

pituitary

Question 11

In tertiary disease, there is impaired function at the level of the ______

Answer 11

hypothalamus

Question 12

What are 3 ways patient present clinically with pituitary adenomas?

Answer 12

• syndromes related to hormone excess/deficiency
• neurological manifestations secondary to mass effect
• Incidental finding on imaging

Question 13

Male pt presents with gynecomastia, impotence, ED, and infertility.
… Dx?

Answer 13

Prolactinoma

Question 14

35 y/o female presents with oligomenorrhea, galactorrhea, decrease in libido, and infertility.
… Dx?

Answer 14

Prolactinoma

Question 15

How would you treat a patient with prolactinoma?

What are your first and second line medications?

Answer 15

• Dopamine agonists
• 1st = Cabergoline
  2nd = Bromocriptine

Question 16

Pt presents with increase in hand and foot size, and enlarged mandible, proximal weakness, and fatigue.

… Dx?

Answer 16

Acromegaly

excessive growth hormone

Question 17

What tests would you order if you suspected pt had acromegaly?

Answer 17

• IGF-1 levels (insulin-like growth factor)
• Oral glucose suppression test and GH level
• MRI

Question 18

True or False: Serum GH would not be suppressed after a PO glucose intake in a patient with acromegaly

Answer 18

True

Question 19

Female pt presents with hirsutism, menstrual irregularities, labile mood, proximal muscle weakness, and changes in facial features.

… Dx?

Answer 19

Cushing’s Disease

Question 20

what are the most common neurologic Sx in patients with pituitary adenomas?

Answer 20

headaches and visual changes

Question 21

If a pituitary ademona is suspected, what imaging study would you order?

Answer 21

MRI with and without contrast

Question 22

Male patient presents with daily headaches, visual symptoms, and ED.

… Dx?

Answer 22

Craniopharyngioma

Question 23

What is the treatment for craniopharyngioma?

Answer 23

• Aggressive surgical resection

- possible radiation therapy to treat residual disease

Question 24

What are the main causes of hypopituitarism?

Answer 24

• compression due to tumors
• inflammation
• vascular damage
• disease of the hypothalamus

Question 25

_____ is an infarction of the pituitary gland after severe postpartum hemorrhage

Answer 25

Sheehan Syndrome

Question 26

Pt presents with sudden onset of severe headache, diplopia, and acute development of hypopituitarism. ... Dx?

Answer 26

Pituitary Apoplexy

Question 27

At least one pituitary hormone deficiency develops in about 25-30% of survivors of _______ as well as 55% of survivors or _______

Answer 27

- moderate to severe TBI | - aneurysmal subarachnoid hemorrhage

Question 28

Some degree of hypopituitarism (usually GH deficiency or hypogonadotropic hypogonadism) occurs in one-third of ____ patients

Answer 28

ischemic stroke patients

Question 29

With empty sella syndrome, pt may have normal pituitary function. What can end up developing insidiously?

Answer 29

hypopituitarism

Question 30

Diabetes insipidus is caused by ____ secretion of ADH

Answer 30

decreased

Question 31

Which diabetes insipidus is caused by the posterior pituitary decreasing secretion of ADH?

Answer 31

Central DI

Question 32

Which diabetes insipidus is caused by the kidneys not being as sensitive to ADH

Answer 32

Nephrogenic DI

Question 33

What are the common signs of Diabetes Insipidus?

Answer 33

Polyuria, nocturia, polydipsia, dilute urine.

Question 34

Treatment for Central DI?

Answer 34

- Low sodium and protein diet - Desmopressin - HCTZ

Question 35

Treatment for Nephrogenic DI?

Answer 35

- Low sodium and protein diet - HCTZ - frequent bladder voiding