Pituitary Disorders Flashcards Preview

Gen Med (Endocrine) > Pituitary Disorders > Flashcards

Flashcards in Pituitary Disorders Deck (50)
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1

What hormones are released from the anterior pituitary gland?

TSH, ACTH, GH, prolactin, LH/FSH

2

What hormones are released from the posterior pituitary gland?

Oxytocin and ADH

3

Which hormones released from the anterior pituitary gland are trophic hormones, and are released from cells known as basophils?

TSH, ACTH and LH/FSH

4

Which hormones released from the anterior pituitary gland are non-trophic hormones, and are released from cells known as acidophils?

GH and prolactin

5

What is the most common pituitary tumour?

Pituitary adenoma

6

What is the definition of a microadenoma and macroadenoma?

Microadenoma = < 1cm, macroadenoma = > 1cm

7

A non-functioning pituitary adenoma does not produce a hormone in excess but instead may cause what?

Generalised hypopituitarism

8

Pituitary adenomas may be sporadic or they may be associated with which genetic condition?

MEN1

9

What is the most common type of pituitary adenoma?

Prolactinoma

10

What is the second most common type of pituitary adenoma?

Non-functioning

11

What are the most common symptoms of a pituitary adenoma caused by a local pressure effect?

Headache, bitemporal hemianopia, palsy of cranial nerves III/IV/VI

12

Which 3 investigations are required for everyone with a suspected pituitary adenoma?

Hormone profile, formal visual field testing, pituitary MRI

13

When replacing hormones (in cases of panhypopituitarism for example), which hormone should be given first?

Hydrocortisone

14

Most pituitary surgery is carried out with what approach?

Trans-sphenoidal

15

What treatment can be used for residual or recurrent pituitary adenomas after surgery?

Radiotherapy

16

Why may fertility be reduced after surgery to remove a pituitary adenoma?

Decreased gonadotrophins

17

What is pituitary apoplexy?

Rapid pituitary enlargement from a bleed into a tumour

18

How is the release of prolactin controlled?

It is under tonic inhibition by hypothalamic dopamine

19

What are some physiological causes of hyperprolactinaemia?

Pregnancy, breastfeeding, stress

20

What is the most common cause of hyperprolactinaemia?

Drugs

21

What are some examples of drugs which may cause hyperprolactinaemia?

Metoclopramide, anti-psychotics, oestrogens, ecstasy/MDMA

22

What other endocrine abnormality may cause hyperprolactinaemia as a result?

Hypothyroidism

23

Hyperprolactinaemia tends to present earlier in which gender?

Females

24

If the lowest GH level during an OGTT is above what value, acromegaly can be diagnosed?

1mcg/L

25

Both bromocriptine and cabergoline are associated with what severe side effect? How should this be monitored?

Pulmonary/cardiac/retroperitoneal fibrosis - monitor with ECHO

26

What is the second line treatment for a prolactinoma?

Trans-sphenoidal surgery

27

When should the GH antagonist pegvisomant be used in the treatment of acromegaly?

In those who are intolerant of a somatostatin analogue

28

What hormone, released from the hypothalamus, increases secretion of growth hormone from the anterior pituitary gland?

Growth hormone releasing hormone

29

What hormone, released from the hypothalamus, decreases secretion of growth hormone from the anterior pituitary gland?

Somatostatin

30

What effect does a high-dose dexamethasone suppression test have on plasma cortisol levels in those with Cushing's disease?

May more than halve the level