Pituitary

Question 1

What do hypothalamic neurones secrete?

Answer 1

pituitary hormone releasing and inhibiting factors

Hormones

Question 2

What inhibits the secretion of prolactin?

Answer 2

dopamine

Question 3

What are the five major anterior pituitary axis’?

Answer 3

gonadotrophin axis
growth axis
thyroid axis
adrenal axis
prolactin

Question 4

What are the 2 parts of the pituitary gland?

Answer 4

anterior

posterior

Question 5

What hormones does the anterior pituitary secrete?

Answer 5

TSH, LH, FSH, GH, prolactin

Question 6

Where is the anterior pituitary derived from?

Answer 6

Rathke’s pouch

Question 7

What hormones does the posterior pituitary secrete?

Answer 7

ADH

Oxytocin

Question 8

What is pituitary adenoma associated with?

Answer 8

MEN1

Question 9

How do you know whether a pituitary adenoma is micro or macro?

Answer 9

micro - <1cm

macro - >1cm

Question 10

What are 3 types of a functional pituitary adenoma?

Answer 10

Prolactinoma
Growth hormone secreting
ACTH secreting

Question 11

Symptoms associated with prolactinoma?

Answer 11

Infertility

Amenorrhea

Question 12

Symptoms associated with a growth hormone secreting pituitary adenoma?

Answer 12

Gigantism

Acromegaly

Question 13

Symptoms associated with ACTH secreting pituitary adenoma?

Answer 13

Cushing’s

bilateral adenocorticol hypoplasia

Question 14

Causes of hypopituitarism…

Answer 14

Tumour
Congential
autoimmune
Idiopathic

Question 15

What does panhypopituitarism cause in the anterior pituitary?

Answer 15

Deficiency of ALL anterior pituitary hormones

GH, TSH, LH/FSH, ACTH

Question 16

What hormone will you be deficient of if you have Kallmann syndrome?

Answer 16

gonadotrophin (GnRH)

Question 17

Where is a craniopharyngioma most likely to arise?

Answer 17

Within sella

Question 18

Craniopharyngioma has a good prognosis

True or false

Answer 18

true

Question 19

What are the symptoms of a craniopharyngioma?

Answer 19

Headache

Visual disturbances

Question 20

What is the most common pituitary tumour?

Answer 20

non-functioning pituitary adenoma

Question 21

What structures are at risk of being compressed if a pituitary adenoma is too big?

Answer 21

Optic chiasmata

CN III, IV, VI

Question 22

Management for non-functioning pituitary adenoma…

Answer 22

Transphenoidal surgery

Hormone replacement therapy

Question 23

List some physiological causes of raised prolactin

Answer 23

Pregnancy
Breast feeding
stress
sleep
dopamine antagonists

Question 24

List some pathological causes of raised prolactin

Answer 24

prolactinoma
hypothyroidism
stalk lesions

Question 25

List some symptoms of prolactinoma...

Answer 25

Female: galactorrhea, menstrual irregularity, amenorrhea, infertility Male: impotence, visual field abnormality

Question 26

What is the visual field abnormality in prolactinoma?

Answer 26

Bitemporal hemianopia

Question 27

What is the treatment for prolactinoma?

Answer 27

Dopamine antagonist (cabergoline)

Question 28

What hormone is in excess in acromegaly?

Answer 28

GH

Question 29

Symptoms of acromegaly...

Answer 29

``` Giant thickened soft tissues (large jaw, hands etc) sleep apnoea/snoring hypertension headaches Diabetes mellitus Polyps - colon cancer?? ```

Question 30

What investigations are carried out in suspected acromegaly?

Answer 30

bloods- IGF-1 Oral glucose tolerance test GH levels

Question 31

What is the most common cause of mortality in acromegaly?

Answer 31

Cardiovascular death | CF, CAD, HT

Question 32

Treatment for acromegaly...

Answer 32

1st - trans-sphenoidal surgery radiotherapy somatostatin analogues

Question 33

What is the aim of treatment in acromegaly?

Answer 33

Raise GH | Shrink tumour

Question 34

What does panhypopotuitarism cause in posterior pituitary?

Answer 34

diabetes insipidus

Question 35

List some symptoms of hypopituitarism...

Answer 35

``` Menstrual irregularities Infertility abdominal obesity loss of facial, axillary and pubic hair gynaecosmastia ```

Question 36

Treatment for hypopituitarism...

Answer 36

``` Hormone replacement therapy: thyroxine hydrocortisone ADH GH sex steroids (pill/testeosterone) ```

Question 37

What is diabetes insipidus?

Answer 37

ADH deficiency so water isn't retained | Causes fluid imbalance

Question 38

What are the symptoms of diabetes insipidus?

Answer 38

Thirsty | Excess urination

Question 39

What investigation is carried out in suspected diabetes insipdus?

Answer 39

Water deprivation test

Question 40

Treatment for diabetes insipidus...

Answer 40

Desmospray | Desmopressin