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Flashcards in Pituitary Disorders Deck (23)
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1
Q

What are the two types of pituitary tumours and why can they be harmful

A

Non-functioning tumours - can cause inadequate production of one or more of the hormones due to pressure from tumour on glandular tissue, tumour can press on surroundings causing other problems

Functioning tumours - cause overproduction of one or more pituitary hormone

2
Q

What is hypopituitarism and what are its causes

A

Insufficient pituitary hormone production

Causes - pituitary adenoma, radiation therapy, inflammatory disease, head injury

Usually secondary to mass effect from adenoma

3
Q

What is a complete deficiency of all anterior pituitary hormones called

A

Panhypopituitarism

4
Q

What are the effects of growth hormone deficiency

A

Adults - decreased exercise tolerance, increased body fat, decreased muscle strength, reduced sense of well-being

Fetus - little effect on fetal growth, severe prenatal deficiency can result in hypoglcaemia and jaundice

Children - poor growth and short stature

5
Q

Effects of hypogonadism

A

Women - lack of libido, infertility, oligomenorrhea or amenorrhea

Men - decreased libido, impotence

6
Q

Effects of ADH deficiency

A

Dehydration odue to excess excretion of dilute urine

Polydipsia

7
Q

What effects does a non-functioning pituitary tumour pressing on the surrounding structures have

A

Headaches

Visual problems - compression of optic nerve

Vomiting

Nausea

8
Q

How are pituitary tumours investigated

A

Delineation of anatomy, size and topographical location of pituitary or parapituitary mass usually by MRI

Assessment of visual field defects

Assessment of endocrine function - determine whether hormone excess or deficiency

9
Q

How does hypopituitarism usually progress

A

Typically have progressive loss of anterior pituitary function with GH and LH/FSH usually first hormones affected

10
Q

What are the causes of GH deficiency

A

In adults usually due to the mass effects from pituitary adenoma

In children GH deficiency is typically idiopathic but specific gene mutations and autoimmune inflammation has caused some cases

11
Q

What causes gonadotropin deficiency

A

Mass effects from pituitary adenoma

12
Q

Name some types of hypopituitarism

A

GH deficiency

Gonadotropin deficiency

ADH deficiency

TSH and ACTH deficiency

13
Q

What can cause TSH and ACTH deficiency

A

Pituitary adenoma

14
Q

What type of disease does ADH deficiency represent

A

Cranial form of diabetes insipidus

15
Q

What causes ADH deficiency

A

Hypothalamic tumour

Pituitary tumour extended up intohypothalamus

Cranial radiotherapy

Pituitary surgery

Autoimmune infiltration

Infection - meningitis

16
Q

What are the three main conditions caused by excess pituitary hormone production and what are they caused by

A

Prolaction excess

Growth hormone excess

ACTH excess

Caused by hypersecreting pituitary adenoma

17
Q

What symptoms does hyperprolactinaemia cause

A

Galactorrhoea

Gynecomastia

Hypogonadism

Amenorrhea

Erectile dysfunction

18
Q

What can hyperprolactinaemia cause due to negative feedback

A

Prolactin inhibits GnRH secretion and therefore FSH and LH secretion causing hypogonadism

19
Q

What is a common cause of hyperprolactinaemia

A

Prolactinoma - pituitary adenoma secreting prolactin

20
Q

What are the other causes of hyperprolactinaemia

A

Pregnancy

Suckling

Stress

Exercise

Drugs like antipsychotics and antidepressents

21
Q

What treatments are there for hyperprolactinaemia

A

Dopamine receptor agonists - cabergoline

Rare cases - Trans-sphenoidal surgery or Radiotherapy

22
Q

What are the effects of growth hormone excess caused by a GH secreting pituitary adenoma

A

Local mass effects due to large pituitary adenoma - headache, visual field defects, other cranial nerve palsies

Changes in physical appearance - broad nose, coarse facial features, thick lips, prominent supraorbital ridge

Enlargment of hands and feet

Skin often greasy with excessive sweating

Deepening of the voice

Gigantism in children if left untreated

Metabolic complications including diabetes mellitus

23
Q

What are the treatment options for patients with growth hormone excess

A

Surgery to remove adenoma

Radiation therapy

Drug therapy - dopamine receptor agonists