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MS4 - Endocrine > Pituitary > Flashcards

Pituitary Flashcards

(70 cards)

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1
Q

Hormones secreted by anterior pituitary

A

GH

FSH and LH

PRL

TSH

ACTH

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2
Q

Hormones released by posterior pituitary

A

ADH

Oxytocin

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3
Q

Hormones synthesised in the hypothalamus

A

Oxytocin

ADH

CRH

GnRH

TRH

GHRH

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4
Q

Order in which anterior pituitary hormone secretion decreases in hypopituitarism

A

GH

FSH and LH

PRL

TSH

ACTH

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5
Q

Causes of hypopituitarism

A

Hypothalamus

Pituitary stalk

Pituitary

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6
Q

Hypothalamus causes of hypopituitarism

A

Kallman’s syndrome

Tumour

Infection (TB, meningitis)

Ischaemia

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7
Q

Pituitary stalk causes of hypopituitarism

A

Trauma

Surgery

Mass lesion (craniopharyngioma)

Carotid artery aneurysm

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8
Q

Pituitary causes of hypopituitarism

A

Tumour

Irradiation

Autoimmune

Ischaemia (eg. Sheehan’s)

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9
Q

Features of GH hypopituitarism

A

Central obesity

Atherosclerosis

Weakness

Osteoporosis

Hypoglycaemia

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10
Q

Features of gonadotropin hypopituitarism in females

A

Oligomenorrhoea

Infertility

Reduced libido

Osteoporosis

Dyspareunia

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11
Q

Features of gonadotrpin hypopituitarism in males

A

Erectile dysfunction

Reduced libido

Reduced muscle bulk

Hypogonadism

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12
Q

Features of thyroid hypopituitarism

A

Hypothyroidism

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13
Q

Features of ACTH hypopituitarism

A

Adrenal insufficiency

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14
Q

Microadenoma definition

A

Tumour < 1 cm across

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15
Q

Macroadenoma definition

A

Tumour > 1 cm across

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16
Q

Histological types of pituitary tumour

A

Chromophobe

Acidophil

Basophil

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17
Q

Features of chromophobe pituitary tumours

A

Many non secretory

Half produce prolactin

Some cause hypopituitarism

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18
Q

Features of acidophil

A

15% Secrete GH or PRL

10% Local pressure effects

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19
Q

Features of basophil pituitary tumour

A

15% secrete ACTH

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20
Q

Negative effects exerted by pituitary tumours

A

Hypopituitarism

Sx caused by pressure

Hormones secreted

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21
Q

Sx of local pressure from pituitary tumours

A

Headache

Visual field

CN palsy

Disturbance to hypothalamus

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22
Q

Mx of pituitary tumours

A

Hormone replacement

Surgery (usually trans-sphenoidal)

Radiotherapy

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23
Q

Pituitary apoplexy definition

A

Rapid pituitary enlargement from bleed into tumour

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24
Q

Pituitary apoplexy sx

A

Acute onset:

Headache

Meningism

Low GCS

Visual field defects

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25
Consequences of pituitary apoplexy
Mass effects CVS collapse Death
26
Mx of pituitary apoplexy
Hydrocortisone 100mg Fluid Surgery
27
Craniopharyngioma definition
Originates from Rathke's pouch (between pituitary and 3rd ventricle floor)
28
Sx of craniopharyngioma
Amenorrhoea Reduced libido Mass effect Sleep disturbance Diabetes insipidus
29
Mx of craniopharyngioma
Surgery +/- radiotherapy post op
30
Relationship between PRL and dopamine
Dopamine from hypothalamus inhibits PRL release
31
Causes of hyperprolactinaemia
Prolactinoma Pituitary stalk compression - reduced DA inhibition DA antagonist
32
Mx of hyperprolactinaemia
Dopamine agonist Eg, Bromocriptine or Cabergoline
33
Cause of Acromegaly
Increased GH
34
Sx of acromegaly
Amenorrhoea Headache Reduced libido Sweating Snoring Rings / Shoes no longer fitting
35
Signs of acromegaly
Growth of (spade) hands, feet and jaw Macroglossia Widely spaced teeth Acanthosis nigricans Wide nose
36
Acromegaly vs Gigantism
Acromegaly - after bone epiphyses fuse Gigantism - before bone epiphyses fuse
37
Complications of acromegaly
Impaired glucose tolerance HTN LVH Increased risk of colorectal cancer
38
Ix for acromegaly
Hyperglycaemia High Ca and PO4 OGTT
39
Diagnosis of acromegaly
OGTT Collect GH at 0, 30, 60, 90, 120 and 150 mins If lowest GH \> 1 microg/L then diagnose acromegaly
40
Mx of acromegaly
Tumour excision Somatostatin analogues Radiotherapy GH antagonist
41
Somatostatin analogue examples
Octreotide Lanreotide
42
GH antagonist example
Pegvisomant
43
Diabetes insipidus definition
Impaired water reabsorption in the kidney Passing large volumes of dilute urine
44
Sx of diabetes insipidus
Polyuria Polydipsia Dehydration Hypernatraemia
45
Types of diabetes insipidus
Cranial DI Nephrogenic DI
46
Cranial DI definition
Reduced ADH secretion from posterior pituitary
47
Nephrogenic DI definition
Impaired response of kidney to ADH
48
Causes of cranial DI
Idiopathic Congenital Tumour Trauma Haemorrhage Infection
49
Tumour causes of cranial DI
Pituitary Craniopharyngioma Mets
50
Causes of nephrogenic DI
Inherited Low K High Ca Lithium CKD
51
Diagnosis of diabetes insipidus
8 hr water deprivation test Desmopressin
52
Water deprivation test for DI
Tests ability to concentrate urine or not If urine osmolality low, diabetes insipidus likely
53
Desmopressin test for diabetes insipidus
Determines whether cranial or nephrogenic DI Urine output decreases after desmopressin = Cranial Urine output still high after desmopressin = Nephrogenic
54
Mx of cranial DI
MRI - find cause Desmopressin
55
Desmopressin
Synthetic ADH
56
Mx of nephrogenic DI
Treat cause Bendroflumathiazide NSAIDs
57
Use of NSAIDs for nephrogenic DI
NSAIDs inhibit prostaglandin synthase Prostaglandins locally inhibit action of ADH NSAIDs lower urine volume and plasma Na
58
Definition of hypogonadism
Failure of testes to produce testosterone, sperm or both
59
Features of hypogonadism
Small testes Reduced libido Erectile dysfunction Reduced muscle bulk Gynaecomastia Osteoporosis
60
Primary hypogonadism definition
Testicular failure
61
Causes of primary hypogonadism
Trauma Torsion Post-orchitis Renal / liver failure failure EtOH excess Chromosomal abnormalities
62
Mechanism by which renal failure, liver failure or alcohol excess cause primary hypogonadism
Toxic to Leydig cells
63
Chromosomal abnormalities causing primary hypogonadism
Klinefelter's syndrome | (47 XXY)
64
Features of Klinefelter's syndrome
Delayed sexual development Small testes Gynaecomastia
65
Secondary hypogonadism definition
Low gonadotropins | (FSH and LH)
66
Causes of secondary hypogonadism
Hypopituitarism Prolactinoma Kallman's syndrome Systemic illness Prader-Willi syndrome Age
67
Kallman's syndrome definition
Isolated GnRH deficiency
68
Feautures of Kallman's syndrome
Secondary hypogonadism Anosmia Colour blindness
69
Prader-Willi syndrome definition
Congenital disorder Chromosome 15
70
Sx of Prader-Willi syndrome
Excessive appetite - obesity Learning difficulties Hypotonia Lack of sexual development Short stature

MS4 - Endocrine (7 decks)

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