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Endocrinology > Pituitary > Flashcards

Flashcards in Pituitary Deck (33):
1

Where are vasopressin and OXT stored?

posterior pituitary

2

When is a pituitary tumour a microadenoma and when is it a macroadenoma?

1cm = macroadenoma

3

non functioning pituitary adenoma may cause Compression of which cranial nerves?

3,4,6

4

What are physiological causes of raised prolactin.

breast feeding, preg, sleep, stress

5

What drugs cause raised prolactin?

dopamine antagonists eg metroclopramide
antipsychotics eg phenothiazines
antidepressants eg TCA, SSRIs
cocaine
estrogens

6

Give 3 pathological causes of raised prolactin.

hypothyroidism
prolactinoma
stalk lesions

7

In whom, men or women, is the presentation of high prolactin late?

men

8

What are some female symptoms of high prolactin?

galactorrhoea
menstrual irregularity
ammenorrhoea
infertility

9

What are some male symptoms of raised prolactin?

galactorrhoea
visual field abnormal
headache
impotence
ant pit malfunction

10

What investigations should be done for prolactinoma?

Pregnancy test, basal PRL levels, MRI pituitary to look for micro/macro, stalk, optic chiasma
Visual fields - bitemporal hemianopia

11

Most common cause of raised prolactin?

drugs

12

Why does hypothyroidism cause increased prolactin?

increased TRH

13

Treatment if high prolactin?

refer to clinic
dopamine agonists are 1st line

14

In which, macro or micro may there be problems with visual acuity?

macro (near optic chiasm)

15

Name 3 dopamine agonists.

bromocriptine, quinagolide, cabergoline

16

What causes acromegaly?

GH excess

17

What happens to blood pressure in acromegaly?

hypertension

18

What are some other symptoms of acromegaly?

thickened soft tissues eg skin, large jaw, sweaty large hands
snoring
diabetes
visual fields
hypopituitarism

19

How is acromegaly diagnosed?

IGF1
GTT
also check visual fields,scan pituitary (CT/MRI)
pit function tests

20

Treatment for acromegaly?

remove lesion (transphenoidal surgery)
if surgery fails, somatostatin analogues eg octreotide/ radiotherapy
GH antagonist called pegvisomant

21

When does a acromegaly cause gigantism?

if occurs before bony epiphyses fuse (rare)

22

What is Cushing's?

excess cortisol/mineralocorticoid/androgen

23

If excess androgen, what symptoms may occur?

virilism, hirsutism, acne, oligo/amenorrhoea

24

If excess mineralocorticoid, what symptoms may occur?

hypertension, oedema

25

If excess cortisol , what symptoms may occur?

protein loss - myopathy, osteoporosis, thinning of skin, bruising
altered carbohydrate/lipid metabolism, diabetes, obesity
Altered psyche eg depression

26

What characterizes Cushing's?

- thin skin
- proximal myopathy
- frontal balding in women
- conjunctival oedema (chemosis)
- osteoporosis

27

How should pituitary Cushing's be treated?

hypophysectomy
external radiotherapy

28

How should adrenal Cushings be treated?

adrenalectomy

29

How should ectopic Cushings be treated?

remove source or bilateral adrenalectomy

30

Drug treatment of CUshings?

Metyrapone
Ketoconazole
Pasireotide (Somatostatin analogue)

31

Pan hypopituitarism in the posterior pituitary?

diabetes insipidus

32

Pan hypopituitarism in anterior pituitary?

GH - growth failure
TSH - hypothyroidism
LH/FSH - hypogonadism
ACTH - hypoadrenal

33

What infection may cause hypopituitarism.

meningitis, TB