Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clinical Conditions of MEH > Session 8 - Pituitary Disorders > Flashcards

Session 8 - Pituitary Disorders Flashcards

(80 cards)

Start Studying
1
Q

State the 2 types of pituitary tumours (adenomas)

A
  • Non-functioning pituitary adenoma
    tumour cells themselves do not produce any hormone
  • Functioning adenoma (rarer)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does non-functioning pituitary adenomas result in?

A

Hyposecretion
- Inadequate or nil production of one or more of the pituitary hormones due to physical pressure from the growing tumour on the glandular tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the clinical presentations of non-functioning pituitary adenomas?
Why do they occur?

A
  • Headaches
  • Visual problems; visual loss(pressure on optic chiasm)/ / double vision (lateral growth of tumour)
  • Vomiting
  • Nausea

they occur due to pressure on the surrounding structures in the vicinity of the tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the most common cause of Pituitary malfunction/disorders?

A

A pituitary benign tumour (Adenoma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does functioning pituitary adenoma result in?

A

Hypersecretion

- Overproduction of one or more of the pituitary hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the clinical symptoms of functioning pituitary adenoma?

A
  • Corresponds to the systemic effects of the over secreted hormone
  • may or may not show some degree of hormonal regulation in terms of negative feedback
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is the investigation and diagnosis of a suspected pituitary tumour carried out?

A
  • MRI scan to show the anatomy, size and topographical location of the tumour
  • Assessment of visual field defects
  • Assessment of endocrine function to determine whether there is a hormonal excess or deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is assessment of endocrine function carried out in order to assess pituitary function?

A
  • Measuring hormone in the blood (Blood test)

- Staining sections from a biopsy of the tumour with antibodies for the relevant hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Sate the 3 types of axis that are basal blood test sufficient in order to assess pituitary function

A
  • Thyroid axis
  • Gonadal axis
  • Prolactin axis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

State the 2 types of axis that may need dynamic blood test

A
  • HPA axis

- GH axis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which hormones are tested for in the blood fo the thyroid axis?

A

T4

TSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which hormones are tested for in the blood for Gonadal axis?

A
  • LH
  • FSH
  • Testerone: men
  • Oestrogen: women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which hormones are tested for in the blood for Prolactin axis?

A

Serum prolactin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which hormone is tested for in the blood for HPA axis?

A

Cortisol

  • 9 am
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which hormone is tested for in the blood for GH axis?

A
  • GH

- IGF1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 2 types of tests that make up the dynamic blood test assessment?

A

Stimulation test

Suppression test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does a stimulation dynamic blood test look for?

A

Suspected hormone deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does a suppressed dynamic blood test look for?

A

Suspected hormone excess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

State the 2 types of stimulation tests used to assess deficiency in the APH (Adrenal) axis

A
  • Synacthen test

- Insulin stress test: response to hypoglycemic stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

State the type of suppression test used to assess hormone excess in the APH(Adrenal) axis

A

Dexamethasone (suppressing ACTH axis with steroids)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

State the type of stimulation test used to assess deficiency in the GH axis

A

Insulin stress test - response to hypoglycemic stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

State the type of suppression test used to assess hormone excess in the GH axis

A

Glucose tolerance test - suppresses GH axis with glucose load

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is hypopituitarism?

A

Insufficient pituitary hormone production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the most common cause of hypopituitarism?

A

Pituitary adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the rarer causes of pituitary adenoma?
- Radiation therapy - Inflammatory disease - Head injury
26
What is the first hormone to be affected as a result of pituitary adenoma on the anterior pituitary gland?
Growth hormone GH
27
What is the second hormone to be affected as a result of pituitary adenoma on the anterior pituitary gland?
LH/FSH - Gonadotropins
28
What is the third hormone to be affected as a result of pituitary adenoma on the anterior pituitary gland?
TSH/ACTH
29
What is panhypopituitarism?
Deficiency of all the anterior pituitary hormones
30
When is the secretion of ADH and Oxytocin from the posterior pituitary affected?
If the tumour affects the hypothalamic function or alternatively if an inflammatory process is involved
31
What are the symptoms of Growth Hormone deficiency in adults?
- quite subtle - a decrease in tolerance to exercise - decreased muscle strength - increased body fat - reduced sense of 'wellbeing'
32
Why is a growth hormone deficiency difficult to diagnose?
GH secretion is pulsatile | - therefore a combination of direct and indirect measurements are required
33
Why does a growth deficiency in adults occur?
Mass effects from a pituitary adenoma
34
What does growth hormone deficiency in childhood result in?
Pituitary Dwarfism
35
Why is Pituitary dwarfism known as a proportionate type of dwarfism?
All body parts are in proportion to each other - no abnormalities in size in relation to other body parts
36
What type of growth hormone deficiency is seen in Pituitary Dwarfism?
Complete or Partial deficiency
37
What is the cause of GH deficiency in children?
- Idiopathic (of unknown cause) | - in some cases, there have been specific gene mutations and autoimmune inflammation
38
Below what percentile on the standard growth charts are individuals with Pituitary Dwarfism most likely to be placed? Why is this?
Below 3rd percentile | - because the growth rate is slower than expected for age
39
What are the effects on the sexual development of an individual with Pituitary Dwarfism?
Delayed or no sexual development
40
What effect does GH deficiency have of fetal growth?
little effect
41
What are the effects of GH deficiency on growth and stature from around 1 year of age until mid-teens?
Poor growth | Short stature
42
What type of treatment is given to an individual with | growth hormone deficiency?
Growth Hormone Therapy | - Human GH manufactured by recombinant DNA technology
43
What is Hypogonadism?
Gonadotropin deficiency
44
What is the cause of Hypogonadism?
Mass effect from a pituitary adenoma
45
Effect of gonadotropin deficiency in women of reproductive age
- lack of libido - infertility - frequent menstrual period (oligomenorrhea) - abnormal absence of menstruation (amenorrhea)
46
Effect of gonadotropin deficiency in men
- decrease libido - impotence - enlarged breast tissue - lack of pubic hair - low testosterone
47
Effects of gonadotropin in children
Delayed puberty
48
What can cause a deficiency in TSH/ACTH?
Pituitary adenoma
49
Clinical features of TSH deficiency
- low thyroid hormone - cold - weight gain - tiredness - slow pulse - low T4 - non-elevated TSH
50
Clinical features of ACTH deficiency
- low cortisol (most dangerous) - tired - dizzy - low BP - low sodium
51
What are the causes of ADH deficiency?
- A hypothalamic tumour or a pituitary tumour that has extended up into the hypothalamus - Cranial radiotherapy - pituitary surgery autoimmune infiltration - infections such as meningitis
52
What are the results of ADH defciency?
- Increased sensation of thirst (Polydipsia) | - Excess excretion of dilute urine resulting in dehydration
53
What is the name of the type of diabetes that is linked to ADH deficiency?
Diabetes Insipidus | - the cranial form
54
What is the difference between cranial DI and nephrogenic DI?
Cranial DI - vasopressin deficiency - pituitary disease | Nephrogenic DI- vasopressin resistance- kidney disease
55
What are the types of pathology that causes cranial DI?
- Inflammation - Infiltration - Malignancy - Infection
56
What are the consequences of untreated DI?
- Severe hydration - Very high sodium level (hypernatraemia) - Reduced consciousness - Coma - Death
57
What is the treatment for Cranial DI?
``` Synthetic vasopressin(ADH): desmopressin - either as nasal spray, tablets or injections ```
58
What is Hyperpituitarism?
Excess pituitary hormone production from a hypersecreting adenoma
59
Name the 3 main conditions caused by excess pituitary hormone production from a hypersecreting adenoma
- Prolactin Excess - Growth Hormone - ACTH excess
60
What is Hyperprolactinaemia?
An abnormally high prolactin level in the blood
61
What is the most common cause of hyperprolactinaemia?
Prolactinoma- a pituiatry adenoma that secrets prolactin
62
Why does hypogonadism occur as a result of hyperprolactinaemia?
- higher levels of dopamine in the hypothalamus - inhibits GnRH secretion from the hypothalamus - FSH and LSH secretion inhibited from the anterior pituitary gland
63
Symptoms of hyperprolactinaemia
- Galactorrhea (unexplained milk production (rare in men)) - Gynecomastia (hard breast tissue) - Hypogonadism (the diminished activity of testes and ovaries) - Amenorrhea (cessation of the menstrual cycle) - Erectile dysfunction
64
What might be the cause of hyperprolactinaemia if serum prolactin was <5000 compared to > 5000?
<5000- non-functioning pituitary tumours | >5000- Prolactinoma (functioning pituitary adenoma)
65
What is used to treat prolactinomas which can cause hyperprolactinaemia?
Dopamine agonists: D2 receptor | - Cabergoline
66
What is uses to treat non-functioning pituitary tumours which can cause hyperprolactinaemia?
Surgery | - trans-sphenoidal
67
What are the signs/symptoms of an individual with growth hormone excess?
- broad nose - coarse facial features - thick lips - prominent supraorbital ridge - enlargement of hands and feet - skin greasy with excessive sweating - deepening of voice
68
State the disorder in adulthood and childhood in which growth hormone in excess leads to respectively
Adulthood - Acromegaly (large extremities) Childhood - Gigantism
69
What is Gigantism caused by?
Pituitary Adenoma | - excess secretion of growth hormone prior to epiphyseal growth plate closing
70
What is Acromegaly caused by?
Pituitary Adenoma | -excess secretion of growth hormone after epiphyseal growth plates are closed
71
Give 3 changes in physical appearance that could occur in an individual as a result of having Acromegaly for several years
Large... - hands - feet - lower jaw
72
What are the long term complications of untreated acromegaly?
- Premature cardiovascular death - Increased risk of colonic tumours - Increased risk of thyroid cancer - Disfiguring body changes that may be irreversible - Hypertension and diabetes
73
What are the biochemical tests to confirm Acromegaly?
- Oral glucose tolerance test (OGTT) with GH response - Failure to suppress GH - Elevated IGF-1 level - Elevated mean GH - growth hormone day curve
74
What are the treatments for Acromegaly?
- Surgery to remove the adenoma - Radiation therapy - Drug therapy Reduce GH secretion or Block GH receptor
75
What is the name of the surgery used to treat Acromegaly?
Trans-sphenoidal hypophysectomy surgery
76
How is Drug therapy used to treat Acromegaly?
- Reduce GH secretion by giving a dopamine agonist or somatostatin analogues - Block GH receptors by giving pegvisomant
77
How is radiation therapy used to treat Acromegaly?
- External beam: Multiple short bursts over several weeks | - Gamma knife: High concentration over a single time
78
What is the name of the syndrome caused due to excess endogenous secretion of ACTH from the anterior pituitary gland?
Cushing Syndrome
79
What is pituitary apoplexy?
Stroke | -A sudden vascular event in a pituitary tumour
80
What are the clinical representation of pituitary apoplexy?
- Sudden onset headache - Double vision - Cranial nerve palsy - Visual field loss - Hypopituitarism: cortisol deficiency most dangerous

Clinical Conditions of MEH (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions