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Clin Med-Endocrine > Pituitary Disorders > Flashcards

Pituitary Disorders Flashcards

1
Q

what is the function of the hypothalamus

A 
homeostasis
regulates body temp
regulates pituitary
responds to hormonal autonomic and environmental effects
located in the wall third ventricle
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2
Q

what are the purpose of the endocrine glands

A

secrete hormones directly into the blood stream

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3
Q

what is the purpose of exocrine glands

A

secrete substances into ducts

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4
Q

ADH is also called

A

AVP, arginine vasopressin

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5
Q

what is the most common cause of hyper/hypo secretion of pituitary hormone

A

pituitary adenomas

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6
Q

what is an adenoma less than 10cm is called what

A

microadenomas

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7
Q

what is an adenoma greater than 10cm is called what

A

macroadenoma

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8
Q

what are some clinical features of pituitary adenomas

A

headache, visual loss, bitemporal hemianopsia
ptosis, decreased facial sensation
excess hormones

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9
Q

what causes pituitary apoplexy

A

from a hemorrhage into a pre-existing adenoma

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10
Q

what are the clinical feature of pituitary apoplexy

A

headache, biltateral visual changes, opthaloplegia, LOC, hypoglycemia, CNS hemmorage

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11
Q

what is the treatment for pituitary apoplexy

A

glucocorticoids if no visual loss

if visual loss then sx decompression

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12
Q

what does dopamine inhibit

A

prolactin

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13
Q

what is the function of prolactin

A

stimulates production of breast milk, metabolism and immune function

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14
Q

what is hyperprolactinemia

A

elevated prolactin levels

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15
Q

what is the most common cause of amenorrhea in premenstrual women

A

hyperprolactinemia

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16
Q

what is the most common pituitary hormone hypersecretion in men and women

A

hyperprolactinemia

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17
Q

prolactin inhibits what

A

decreased reproductive function and drive

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18
Q

what does prolactin inhibit

A

GnRH which decreases the sex hormones

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19
Q

what are the clinical features of hyperprolactinemia in women

A 
menstrual changes
stopped period of infrequent period
galactorrhea (spontaneous milk flow)
infertility
nipple discharge
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20
Q

what are the clinical features of hyperprolactinemia in men

A 
hypogonadism
decreased libido
ED
Infertility
gyneocmastia
galactorrhea
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21
Q

how is hyperprolactinemia diagnosed

A

fasting and morning prolactin levels

22
Q

what is the treatment for hyperprolactinemia

A

discontinue med if cause

or MRI of pituitary

23
Q

how do you treat a prolactinoma

A

dopamine agonist

trans-sphenoid resection

24
Q

what is galactorrhea

A

inappropriate lactation
not breast feeding
not post partum

25
Q

how is galatorrhea diagnosed

A

persistent discharge
unilateral
limited to one duct
serous, sanguinous, serosanguinous

26
Q

what drugs can cause galatorrhea

A

methlydopa
phenothiazines,
tricyclics

27
Q

what is the treatment for galatorrhea

A

correct underlying cause
medication side effect
surgical removal of intraductal papilloma

28
Q

what is gigantism

A

extreme linear growth mandifesting in height occurs prior to closure of epiphysial plates leading to long bone growth. Inhibition of GnRH delays puberty further delaying epiphysial closure and leading to increased height

29
Q

what is acromegaly

A

bony and soft tissue over begins post pubertal thus linear growth does not occur

30
Q

characteristic of gigantism

A

arises from pituitary adenoma producing GH

there is an increase in GH, IGF-1 (screening test)

31
Q

how do you treat gigantism

A

tanssphenoidal sx
bromocriptine, octretide
radiation therapy

32
Q

what is the physiology of acromegaly

A

growth hormone may be produce by microadenoma
local invasion can occur, disruption of other anterior pituitary hormones
systemic effects mediated by final common denominator IFG-1 largely made in the liver

33
Q

what are the clinical presentations of acromegaly

A

systemic fatigue, weight gain, lethargy
enlarged nose, jaw, lips, hands, feet, brow, acne
cardiac hypertrophy, nerve entrapment (carpel tunnel), arthritis,
hyperlipidemia
HTN, CAD, atherosclerosis
hypogonadism, decreased libido
changes in visual field

34
Q

how is acromegaly diagnosed

A

clinical suspicion, enlarging hat , shoe/glove size

GH level not reliable

35
Q

what is the gold standard for acromegaly

A

OGTT: 80 glucose load over 5 min then GH levels are obtained at 0, 30, 60, 90, 120, post, lack of supression of GH to <1ng/ml diagnostic

36
Q

what is the treatment of acromegaly

A

surgery or radiotherapy
control tumor mass without remaining pituitary being disrupted
restore life expectancy via cardiovascular management, DM control

37
Q

what is the most common form of hypopituitarism

A

neoplastic

38
Q

how is hypopituitarism diagnosed

A

8am cortisol level, TSH, FT4, IGF-1, testosterone in men

39
Q

what is the treatment for hypopituitarism

A

hormone replacement

40
Q

what regulates ADH

A

CRH and barorecptors

41
Q

what is the pathophysiology behind central diabetes insipidus

A

often no identifiable pituitary/hypothalmus lesions

due to trauma, familial, genetic

42
Q

what is the pathophysiology behind nephrogenic diabetes insipidus

A

ADH resistance in kidneys

43
Q

what is the clinical presentation of DI

A 
polydipsia, especially ice water, polyuria, Enuresis (bed wetting)
nocturia
day time fatigue
hypernatermia
dehydrated
44
Q

how do you monitor a person with DI

A

24hr urine collection
check volume, osmolarity
Serum
glucose, urea nitrogen, calcium, uric acid, potassium, sodium, osmolarity increased due to excess water excretion

45
Q

how do you differentiate central from nephrogenic DI

A

vasopressin challenge test

46
Q

what would it mean if there was decreased urine output after administering vasopressin

A

central diabetes

47
Q

what would it mean if there was no decrease in urine output

A

nephrogenic diabetes

48
Q

what is the treatment for central DI

A

demopression

49
Q

what is the treatment for nephrogenic DI

A

hydrochrolothiazide causes excretion of more water than sodium

50
Q

What is SIADH

A

excess ADH interferes with water excretion, even when there is normal water intake, resulting in a imbalance of input vs output
there is an increase in ADH results in increased water reabsorption by the kidneys, decreased aldosterone secretion

Clin Med-Endocrine (8 decks)

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