Flashcards in Pituitary Disorders Deck (50)
What hormones are released from the anterior pituitary gland?
TSH, ACTH, GH, prolactin, LH/FSH
What hormones are released from the posterior pituitary gland?
Oxytocin and ADH
Which hormones released from the anterior pituitary gland are trophic hormones, and are released from cells known as basophils?
TSH, ACTH and LH/FSH
Which hormones released from the anterior pituitary gland are non-trophic hormones, and are released from cells known as acidophils?
GH and prolactin
What is the most common pituitary tumour?
What is the definition of a microadenoma and macroadenoma?
Microadenoma = < 1cm, macroadenoma = > 1cm
A non-functioning pituitary adenoma does not produce a hormone in excess but instead may cause what?
Pituitary adenomas may be sporadic or they may be associated with which genetic condition?
What is the most common type of pituitary adenoma?
What is the second most common type of pituitary adenoma?
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
Which 3 investigations are required for everyone with a suspected pituitary adenoma?
Hormone profile, formal visual field testing, pituitary MRI
When replacing hormones (in cases of panhypopituitarism for example), which hormone should be given first?
Most pituitary surgery is carried out with what approach?
What treatment can be used for residual or recurrent pituitary adenomas after surgery?
Why may fertility be reduced after surgery to remove a pituitary adenoma?
What is pituitary apoplexy?
Rapid pituitary enlargement from a bleed into a tumour
How is the release of prolactin controlled?
It is under tonic inhibition by hypothalamic dopamine
What are some physiological causes of hyperprolactinaemia?
Pregnancy, breastfeeding, stress
What is the most common cause of hyperprolactinaemia?
What are some examples of drugs which may cause hyperprolactinaemia?
Metoclopramide, anti-psychotics, oestrogens, ecstasy/MDMA
What other endocrine abnormality may cause hyperprolactinaemia as a result?
Hyperprolactinaemia tends to present earlier in which gender?
If the lowest GH level during an OGTT is above what value, acromegaly can be diagnosed?
Both bromocriptine and cabergoline are associated with what severe side effect? How should this be monitored?
Pulmonary/cardiac/retroperitoneal fibrosis - monitor with ECHO
What is the second line treatment for a prolactinoma?
When should the GH antagonist pegvisomant be used in the treatment of acromegaly?
In those who are intolerant of a somatostatin analogue
What hormone, released from the hypothalamus, increases secretion of growth hormone from the anterior pituitary gland?
Growth hormone releasing hormone
What hormone, released from the hypothalamus, decreases secretion of growth hormone from the anterior pituitary gland?