Pituitary

Question 1

what is Kallmanns syndrome?

Answer 1

hypothalamic condition

hypogonadotropic hypogonadism, which is a condition resulting from a lack of production of certain hormones that direct sexual development.

Question 2

what does GH deficiency lead to ?

Answer 2

central obesity, atherosclerosis, decreased strength

Question 3

what does LH/FSH deficiency lead to ?

Answer 3

decreased libido, erectile dysfunction, decreased hair, breast atrophy, amenorrhoea

Question 4

what is the treatment for hypopituitarism?

Answer 4

replace hormone

Question 5

what does TSH deficiency lead to ?

Answer 5

hypothyroidism

Question 6

what does ACTH deficiency lead to ?

Answer 6

secondary adrenal failure

Question 7

what affect does prolactin have on LH/FSH?

Answer 7

↑PRL → ↓GnRH → ↓LH/FSH

Question 8

what does excess ACTH result in ?

Answer 8

cushings syndrome

Question 9

what does excess GH result in ?

Answer 9

acromegaly

Question 10

what is pituitary apoplexy?

Answer 10

Rapid pituitary enlargement due to bleed into a tumour

Question 11

what is the treatment for pituitary apoplexy?

Answer 11

urgent hydrocortisone 100mg IV

Question 12

where does craniopharyngeoma originate from?

Answer 12

Rathke’s pouch

Question 13

what feature does craniopharyngeoma cause?

Answer 13

growth failure

Question 14

what is seen on CT/MRI for craniopharyngeoma?

Answer 14

calcification

Question 15

what are symptoms of hypoerprolactinaemia?

Answer 15

Amenorrhoea
􏰀 Infertility
􏰀 Galactorrhoea
􏰀 ↓ libido
􏰀 ED

Question 16

what level is basal prolactin for a prolactinoma?

Answer 16

> 5000

Question 17

what is the treatment of hyperprolactinaemia ?

Answer 17

Dopamine agonist

- Cabergoline or bromocroptine

Question 18

what are side effects of dopamine agonists ?

Answer 18

nausea, postural hypotension, fibrosis (lung

and heart)

Question 19

what is the commonest type of adenoma that causes acromegaly?

Answer 19

pituitary acidophil adenoma

Question 20

what condition is associated with acromegaly?

Answer 20

sleep apnoea

carpal tunnel syndrome

Question 21

state some symptoms of acormegaly?

Answer 21

Acroparaesthesia
􏰀 Amenorrhoea, ↓libido
􏰀 Headache
􏰀 Snoring
􏰀 Sweating
􏰀 Arthralgia, back ache
􏰀 Carpal tunnel (50%)

Question 22

what scalp feature does acromegaly have?

Answer 22

cutis verticis gyrata

Question 23

what endocrine problem does acromegaly cause?

Answer 23

DM

Question 24

what cancer is acromegaly patients at higher risk of ?

Answer 24

CRC

Question 25

what investigations should be done for acromegaly ?

Answer 25

increased IGF1, glucose, Ca, PO4
glucose tolerance test
visual fields and acuity
MRI head

Question 26

what is first line treatment for acromegaly ?

Answer 26

trans-sphenoidal excision

Question 27

as well are excision what other treatment is available for acromegaly ?

Answer 27

2nd line: somatostatin analogues – octreotide
􏰀 3rd line: GH antagonist – pegvisomant
􏰀 4th line: radiotherapy

Question 28

what is the commonest cause of DI?

Answer 28

idiopathic

Question 29

what test is done for DI?

Answer 29

Water deprivation test ̄c desmopressin trial

Question 30

what is the treatment for PCOS?

Answer 30

metformin
COCP
clomifene (for infertility)

Question 31

what are the main causes of ED?

Answer 31

smoking, alcohol, DM

Question 32

state some causes of gynaecomastia ?

Answer 32

Cirrhosis
􏰀 Hypogonadism
􏰀 Hyperthyroidism
􏰀 Oestrogen- or HCG-producing tumours: e.g. testicular
􏰀 Drugs: spiro, digoxin, oestrogen