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Flashcards in Pituitary Disease Deck (42)
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1

List the hormones secreted from the anterior pituitary

ACTH
LH/FSH
TSH
GH
Prolactin

2

List the hormones secreted from the posterior pituitary

ADH
Oxytocin

3

Production of which peripheral hormone is stimulated by ACTH?

Cortisol

4

Production of which peripheral hormone is stimulated by LH and FSH?

Testosterone
Estradiol

5

Production of which peripheral hormone is stimulated by TSH?

Thyroxine

6

Production of which peripheral hormone is stimulated by GH?

IGF-1

7

If too much hormone is produced, what kind of test is done?

Suppression test

8

If too little hormone is produced, what kind of test is done?

Stimulation test

9

Give examples of pituitary stimulation tests

Insulin stress test
Prolonged glucagon test
Water deprivation test
Synthetic ACTH injection

10

A pituitary tumour less than 1cm is called a macroadenoma. True/False?

False
Microadenoma

11

What is the most common visual defect caused by pituitary adenoma?

Bitemporal hemianopia

12

Dopamine inhibits production of prolactin. True/False?

True

13

Which drug is a dopamine antagonist that can cause excess prolactin?

Metoclopramide

14

List the main physiological causes of elevated prolactin

Breast feeding
Pregnancy
Stress
Sleep

15

Hypothyroidism causes elevated prolactin. True/False?

True

16

List some early clinical features of elevated prolactin

Galactorrhoea
Menstrual irregularity
Amennorhoea
Infertility

17

List some late clinical features of elevated prolactin

Impotence
Visual impairment
Headache

18

What is acromegaly?

Excess production of growth hormone

19

List clinical features of acromegaly

Thickened soft tissues
Hypertension
Headaches
Sleep apnoea
Hypopituitary

20

What is the main treatment for acromegaly?

Trans-sphenoidal surgery to excise tumour/pituitary

21

What dopamine agonist can be used if surgery for acromegaly fails?

Cabergoline

22

Somatostatin analogues are useful for acromegaly. True/False?

True

23

What causes Cushing's syndrome?

Excess cortisol

24

What are the clinical effects of cortisol on protein in the body?

Protein loss, causing:
(proximal) Muscle waisting
Osteoporosis
Thin skin

25

Cushing's can cause frontal balding in women. True/False?

True

26

What is the effect of exogenous high-dose steroid (dexamethasone) on cortisol?

Lowers serum cortisol by inhibiting hypothalamic-pituitary-adrenal axis

27

What is the main screening test for Cushing's syndrome?

Low-dose (1mg) dexamethasone test overnight
Cortisol should be less than 50 nmol/L next morning

28

What is the definitive test for diagnosing Cushing's syndrome?

2 day 2mg/day dexamethasone test
Cortisol should be less than 50 nmol/L after last dose

29

What are the 3 origins of Cushing's?

Pituitary
Adrenal
Ectopic ACTH

30

What is the characteristic facial change in Cushing's?

Moon-face