Flashcards in Pituitary Deck (33):
Where are vasopressin and OXT stored?
When is a pituitary tumour a microadenoma and when is it a macroadenoma?
1cm = macroadenoma
non functioning pituitary adenoma may cause Compression of which cranial nerves?
What are physiological causes of raised prolactin.
breast feeding, preg, sleep, stress
What drugs cause raised prolactin?
dopamine antagonists eg metroclopramide
antipsychotics eg phenothiazines
antidepressants eg TCA, SSRIs
Give 3 pathological causes of raised prolactin.
In whom, men or women, is the presentation of high prolactin late?
What are some female symptoms of high prolactin?
What are some male symptoms of raised prolactin?
visual field abnormal
ant pit malfunction
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
Most common cause of raised prolactin?
Why does hypothyroidism cause increased prolactin?
Treatment if high prolactin?
refer to clinic
dopamine agonists are 1st line
In which, macro or micro may there be problems with visual acuity?
macro (near optic chiasm)
Name 3 dopamine agonists.
bromocriptine, quinagolide, cabergoline
What causes acromegaly?
What happens to blood pressure in acromegaly?
What are some other symptoms of acromegaly?
thickened soft tissues eg skin, large jaw, sweaty large hands
How is acromegaly diagnosed?
also check visual fields,scan pituitary (CT/MRI)
pit function tests
Treatment for acromegaly?
remove lesion (transphenoidal surgery)
if surgery fails, somatostatin analogues eg octreotide/ radiotherapy
GH antagonist called pegvisomant
When does a acromegaly cause gigantism?
if occurs before bony epiphyses fuse (rare)
What is Cushing's?
If excess androgen, what symptoms may occur?
virilism, hirsutism, acne, oligo/amenorrhoea
If excess mineralocorticoid, what symptoms may occur?
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
What characterizes Cushing's?
- thin skin
- proximal myopathy
- frontal balding in women
- conjunctival oedema (chemosis)
How should pituitary Cushing's be treated?
How should adrenal Cushings be treated?
How should ectopic Cushings be treated?
remove source or bilateral adrenalectomy
Drug treatment of CUshings?
Pasireotide (Somatostatin analogue)
Pan hypopituitarism in the posterior pituitary?
Pan hypopituitarism in anterior pituitary?
GH - growth failure
TSH - hypothyroidism
LH/FSH - hypogonadism
ACTH - hypoadrenal