Pituitary Physiology Flashcards Preview

SM Endocrine > Pituitary Physiology > Flashcards

Flashcards in Pituitary Physiology Deck (50):
1

What are the pituitary and peripheral steroid hormones

ACTH and cortisol

2

What are the pituitary and peripheral thyroid hormones

TSH and thyroxine

3

What are the pituitary and peripheral sex hormones

LH/FSH and testosterone or oestradiol

4

What are the pituitary and peripheral growth hormones

GH and IGF-1

5

What are the pituitary and peripheral steroid hormones

Only pituitary hormone which is prolactin

6

What can be compressed if a pituitary tumour grows extensively

Cranial nerves
Optic chiasma
Internal carotid arteries
Sphenoid sinus

7

By what route do we usually remove a pituitary tumour

Though the sphenoid sinus

8

If we think the pituitary is secreting too much hormone, what test do we do

One to try and suppress the hormone

9

If we think the pituitary is secreting too little hormone, what test do we do

One to try and stimulate the hormone

10

How do we know if there is a problem in a dynamic test

There will be no response to either suppression or stimulation of the hormone

11

How can we do a dynamic pituitary test

Insulin stress test

12

Describe the normal result of a stress test to insulin

The blood glucose will decrease dramatically for the first half hour before insulin, growth hormone and cortisol will all increase to compensate and react to the hypoglycaemic environment

13

What patients should not be subjected to an insulin stress test

Those with epilepsy or ischaemic heart disease

14

What should be used instead of an insulin stress test in patients with epilepsy or ischaemic heart disease

prolonged Glucagon test

15

How can we test ADH

Deprive the patient of water and make them dehydrated

16

How can we diagnose Diabetes Insipidus

If there is an abnormal Urine/serum Osmolality is less than 2, 8 hours after a water deprivation test

17

What is the name of a pituitary tumour

Microadenoma

18

What is the name of pituitary tumour >1cm

Macroadenoma

19

What are the chances of a non-functioning pituitary being benign

90%

20

Do non-funcitoning pituitary adenomas produce hormones

No

21

Why are non functioning adenomas a problem

They can wipe out the cells of the pituitary that do produce hormones

22

What can a non functioning pituitary adenoma cause

Hypoadrenalism
Hypothyroidism
Hypogonadism
Growth hormone deficiency

23

What is bitemporal hemianopia

When the temporal visual field is obliterated due to a pituitary tumour

24

What are some physiological causes of raised prolactin

Breast feeding
Pregnancy
Stress
Sleep

25

What drugs can cause an increase of prolactin

Dopamine antagonists
Antipsychotics
Antidepressants

26

What is elevated in an underachieve thyroid

TRH and TSH

27

If there is elevated, TRH what can occur

Increased stimulation of prolactin

28

What are some examples of cases where there will be an increase in prolactin

Hypothyroidism
Road accidents or iatrogenic causes of stalk lesion

29

What are some of the clinical signs in a female of increased prolactin

Galactorrhoea
Menstrual irregularity
Ammenorrhoea
Infertility

30

What are some of the clinic signs in a male of increased prolactin

Impotence
Visual field abnormalities
Headache
Anterior pituitary malfunction

31

Males will present earlier than females with increased prolactin

No - they always present late

32

What are the main investigations for prolactinoma

Prolactin concentrations
MRI pituitary
Visual fields
Pituitary function tests

33

What should also be checked when checking for prolactin in the serum

Thyroid function test

34

What are the 3 main dopamine agonists to treat prolactinoma

Bromocriptine
Quinagolide
Cabergoline

35

What do dopamine agonists do

reduce prolactin levels and can make tumours shrink

36

What dopamine agonist is usually used in prolactinoma and why

Cabergoline (Dostinex)
it has the least side effects

37

What is the cause of acromegaly

Growth hormone excess

38

What are some features of acromegaly

thickened and soft skin, large jaw, sweaty, large hands

39

What are some side effects of acromegaly

Hypertension, cardiac failure
Headaches
Snoring/ sleep apnoea
Diabetes mellitus
Early CV death
colonic polyps and colon cancer

40

How can we make a diagnosis of acromegaly

GTT suppression test
- GH will have no change after glucose

41

What other tests should be done for suspected acromegaly

Visual field
CT or MRI pituitary scan
Pituitary function tests

42

What are the treatment options for acromegaly

Pituitary surgery
External radiotherapy to pituitary fossa
Rest GTT

43

What are some side effects of somatostatin analogues

Local stinging
Short term include flatulence, diarrhoea and abdominal pains
Long term include gastritis and gallstones

44

What are the 2 more commonly used somatostatin analogues in acromegaly

Sandostatin LAR and Lanreotide autogel

45

Why is Pegvisomant hardly ever used

It is extremely expensive and most patients will respond to other treatment

46

What should be involved in an acromegaly follow up

Other pituitary hormones should be checked
Cancer surveillance
Cardiovascular risk factors
Sleep apnoea

47

Dopamine inhibits release of prolactin. True or false

True

48

What does ACTH do to the adrenal glands

Stimulates them to produce cortisol

49

What is the first line treatment for prolactinoma

Dopamine agonists

50

What is the most common cause of an acromegalic headache

Vascular effects such as increased blood flow