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Flashcards in PITUITARY STUFF Deck (38):
1

what 2 hormones are stored in the pituitary?

vasopress and OXT

2

if there is too much hormone what sort of dynamic test should you do?

do a test that tries to suppress it

3

if there is too little hormone what sort of dynamic test should you do?

do a test that tries to stimulate the hormone

4

pituitary tumour less than or equal to 1cm

microadenoma

5

pituitary tumour more than 1cm

macroadenoma

6

causes of raised prolactin

breast feeding
pregnancy
stress
sleep

dopamine antagonists
antidepressents
coccaine

7

pathologic causes of raised prolactin

hypothyroidism
stalk lesion -RTA
prolactinoma

8

clinical signs and symptoms of increased prolactin in females?

early presentation
menstrual irregularity
infertility
ammenorrhoea

9

clinical signs and symptoms of increased prolactin in females?

late presentation
impotence
visual field abnormal
headache
anti pit malfunction

10

investigations for prolactinoma ?

prolactin conc
MRI pituitary
visual fields
pituitary function tests

11

medial treatment for prolactinoma?

dopamine agonists:
- bromocriptine -3x day
-Quinagolide- 1x day
-Cabergoline-the best 2x week

12

excess GH

acromegaly

13

thickened soft tissues
large jaw
massive hands and feet
headaches
hypertension
heart failure
snoring
sleep apnoea
diabetes

acromegaly

14

how do you diagnose acromegaly?

IGF-1- age and sex matched
GTT- suppression test- no suppression= positive

15

treatment for acromegaly?

surgery (most successful)
external radiotehrapy
retest GTT

if GH>1ug/L then need drug therapy:
-dopamine agonist-cabergoline
-somatostatin analogues-octreotide
-GH antagonist-pegvisomant

16

what type of drug is cabergoline?

dopamine antagonist

17

what type of drug is octreotide

somatostain analogue

18

what type of drug is pegvisomant?

GH antagonist

19

do somatostatin analogues shrink the tumour?

yes

20

what are the side effects of somatostatin analogues?

local stinging
flatulence
diarrhoea
abdominal pain

gastritis
gall stones!!

21

how are GH antagonists given?

SC injection every day

22

do G antagonists shrink tumour size?

no

23

excess cortisol

cushings syndrome

24

signs/symptoms of cushings?

protein loss
proximal myoptahy
central obesity
moon face
buffalo hump
depression/psych problems
axcess androgen-acne, funny periods
frontal balding in women
conjunctival odema
osteoporosis
poor wound healing
easy bruising
thin skin

25

definitive test for cushing?

low dose dexamethasone

26

what other screening tests can you do for cushings?

overnight 1mg dexamethasone suppression test

urine free cortisol

diurinal cortisol variation

27

causes of cushings?

pituitary problems
adenoma of adrenal
ectopid-thymus, lung, pancreas

pseudo-alcohol depression
steroid medication

28

what is this cause of cushings?

low dose dexa test- abnormal
ACTH

pituitary

29

what is this cause of cushings?

low dose dexa test- abnormal
ACTH

adrenal

30

what is this cause of cushings?

low dose dexa test- abnormal
ACTH >300

high dose dexam suppression- nil

ectopic

31

surgery options for cushings?

pituitary-hypophysectomy and external radiation

adrenal- adrenalectomy

ectopic- remove source or bilateral adrenalectomy

32

drug treatment fro cushings?

metyrapone (if all other treatments fail)

ketoconazole

pasireotide

33

signs/symptoms of anterior hypopituitarism?

menstrual irregularities
infertility
gynaecomastia
abdominal obesity
loss of facial hair
loss of pubic and armpit hair
dry skin and hair
growth retardation

34

replacement therapy for hypopituitarism?

thyroxine
hydrocortisone
ADH
GH
sex steroids

35

how is testosterone replacement therapy given?

IM injection every 3-4 weeks

36

risks of testosterone replacement therapy?

prostate enlargement
hepatitis
polycythaemia

37

what test do you do to diagnose diabetes insipidus?

water deprivation test

38

treatment for diabetes insipidus?

desmospray

desmopressin oral tablets

desmopressin sublingual tablets

desmopressin injection