🧠 Pituitary & Thyroid Memory Radar

Question 1

What are the 5 main anterior pituitary hormones to remember for tumours?

Answer 1

GH, Prolactin, ACTH, TSH, LH/FSH

🎩 “Let’s Get That Man A Prolactinoma”
(Because if he’s got bitemporal hemianopia and galactorrhoea, maybe he needs one)

Let’s → LH/FSH (gonadotroph)
Get → GH (somatotroph)
That → TSH (thyrotroph)
Man → MSH (technically from pars intermedia—very rare)
A → ACTH (corticotroph)
Prolactinoma → Prolactin (lactotroph) ← most common

Question 2

Order of hormones for GAPTAP functioning adenomas:

Answer 2

“GAP TAP”
GH
ACTH
Prolactin
TSH
A (LH/FSH)
P (non-functioning/Plurihormonal)

Question 3

What test is used to diagnose acromegaly?

Answer 3

Oral glucose tolerance test (OGTT) – GH should suppress, but doesn’t in acromegaly

Question 4

What’s the order of hormone loss in hypopituitarism?

Answer 4

LH → GH → TSH → ACTH → FSH

Question 5

What does the insulin stress test check?

Answer 5

ACTH and GH reserve (normal = rise in both)

Question 6

What’s the key sign of cranial diabetes insipidus (DI)?

Answer 6

Polyuria + low urine osmolality that corrects with desmopressin

Question 7

What are the thyroid function test patterns in:

Graves’ disease

Hashimoto’s

TSHoma

Answer 7

Graves = ↓TSH, ↑T3/T4, +TRAb

Hashimoto’s = ↑TSH, ↓T4, +Anti-TPO

TSHoma = ↑TSH, ↑T3/T4

Question 8

What is amiodarone-induced thyrotoxicosis and what types exist?

Answer 8

Hyperthyroidism from amiodarone.

Type 1 = iodine excess (like Graves)

Type 2 = destructive thyroiditis

Question 9

🧠 Easy metaphor for functioning and non functioning pituitary tumours..

Answer 9

Imagine the pituitary as a group of employees. A functioning tumour is like an overworked staff member spamming emails (hormones) to everyone—chaos!

A non-functioning tumour is like a giant intern who sits on everyone else, stopping them from doing their job (hormone suppression + vision problems).

Question 10

👀 Explain functioning and non functioning pituitary adenoma in clinical terms.

Answer 10

Functioning:
- Hormone-specific symptoms (e.g. galactorrhoea, acromegaly).
- Diagnosed via high hormone levels.
- Treated based on hormone type (e.g. dopamine agonists for prolactinoma).

Non-functioning:
No hormone excess, but vision loss, headache, and multiple hormone deficiencies.
Often diagnosed due to mass effect or low pituitary hormones.
Often diagnosed due to mass effect or low pituitary hormones.

Question 11

What’s the difference between a functioning and non-functioning pituitary tumour?

Answer 11

Functioning = hormone-producing tumour
→ e.g. prolactinoma = ↑ prolactin.

Non-functioning = no hormone production
→ causes symptoms by compression (mass effect), not excess hormone
Think:
🧠 Functioning = spammer
🧱 Non-functioning = squasher