Pituitary Disorders Flashcards Preview

Clin Med-Endocrine > Pituitary Disorders > Flashcards

Flashcards in Pituitary Disorders Deck (50):
1

what is the function of the hypothalamus

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

2

what are the purpose of the endocrine glands

secrete hormones directly into the blood stream

3

what is the purpose of exocrine glands

secrete substances into ducts

4

ADH is also called

AVP, arginine vasopressin

5

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

pituitary adenomas

6

what is an adenoma less than 10cm is called what

microadenomas

7

what is an adenoma greater than 10cm is called what

macroadenoma

8

what are some clinical features of pituitary adenomas

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

9

what causes pituitary apoplexy

from a hemorrhage into a pre-existing adenoma

10

what are the clinical feature of pituitary apoplexy

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

11

what is the treatment for pituitary apoplexy

glucocorticoids if no visual loss
if visual loss then sx decompression

12

what does dopamine inhibit

prolactin

13

what is the function of prolactin

stimulates production of breast milk, metabolism and immune function

14

what is hyperprolactinemia

elevated prolactin levels

15

what is the most common cause of amenorrhea in premenstrual women

hyperprolactinemia

16

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

hyperprolactinemia

17

prolactin inhibits what

decreased reproductive function and drive

18

what does prolactin inhibit

GnRH which decreases the sex hormones

19

what are the clinical features of hyperprolactinemia in women

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

20

what are the clinical features of hyperprolactinemia in men

hypogonadism
decreased libido
ED
Infertility
gyneocmastia
galactorrhea

21

how is hyperprolactinemia diagnosed

fasting and morning prolactin levels

22

what is the treatment for hyperprolactinemia

discontinue med if cause
or MRI of pituitary

23

how do you treat a prolactinoma

dopamine agonist
trans-sphenoid resection

24

what is galactorrhea

inappropriate lactation
not breast feeding
not post partum

25

how is galatorrhea diagnosed

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

26

what drugs can cause galatorrhea

methlydopa
phenothiazines,
tricyclics

27

what is the treatment for galatorrhea

correct underlying cause
medication side effect
surgical removal of intraductal papilloma

28

what is gigantism

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

what is acromegaly

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

30

characteristic of gigantism

arises from pituitary adenoma producing GH
there is an increase in GH, IGF-1 (screening test)

31

how do you treat gigantism

tanssphenoidal sx
bromocriptine, octretide
radiation therapy

32

what is the physiology of acromegaly

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

what are the clinical presentations of acromegaly

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

how is acromegaly diagnosed

clinical suspicion, enlarging hat , shoe/glove size
GH level not reliable

35

what is the gold standard for acromegaly

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

what is the treatment of acromegaly

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

37

what is the most common form of hypopituitarism

neoplastic

38

how is hypopituitarism diagnosed

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

39

what is the treatment for hypopituitarism

hormone replacement

40

what regulates ADH

CRH and barorecptors

41

what is the pathophysiology behind central diabetes insipidus

often no identifiable pituitary/hypothalmus lesions
due to trauma, familial, genetic

42

what is the pathophysiology behind nephrogenic diabetes insipidus

ADH resistance in kidneys

43

what is the clinical presentation of DI

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

44

how do you monitor a person with DI

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

45

how do you differentiate central from nephrogenic DI

vasopressin challenge test

46

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

central diabetes

47

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

nephrogenic diabetes

48

what is the treatment for central DI

demopression

49

what is the treatment for nephrogenic DI

hydrochrolothiazide causes excretion of more water than sodium

50

What is SIADH

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