Term
| What is the diagnosis of hyperpigmentation and visual disturbances after a Bilateral Adrenalectomy and how is it prevented |
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Definition
Nelson's Syndrome: adrenalectomy relieves negative feedback on pituitary, which can induce growth of a small ACTH tumor
Prevention: Irradiate pituitary before removing adrenals |
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Term
| What are the major structures that can be obstructed by pituitary growth |
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Definition
Laterally: Cranial nerves III, IV, V, VI, and Carotids
Superiorly: Optic Chiasm |
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Term
| Which of the pituitary hormones are peptide and which are glycoproteins |
|
Definition
Peptide: ACTH, GH, PL
GLycoprotein: TSH, FSH, LH |
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Term
| What is the most likely cause of Empty Sella Syndrome? |
|
Definition
| Herniated Sella with CSF accumulation compressing the pituitary |
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|
Term
| What is the most likely cause of Panhypopituitarism |
|
Definition
| Large pituitary tumor compressing pituitary parenchyma |
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|
Term
| What is an example of a primary and secondary cause of hyperthyroidism |
|
Definition
Primary: Thyroid Hyperplasia
Secondary: Pituitary Tumor Secreting TSH |
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Term
| What is the factor the exerts most of the effect in producing Acromegaly |
|
Definition
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|
Term
| What are some signs of GH overproduction |
|
Definition
Enlarged hands and feet
Sweating
Enlarged Facial Bones
Pronathism |
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|
Term
| What is the major cause of death in patients with excessive GH production |
|
Definition
|
|
Term
| How is GH overproduction diagnosed and treated |
|
Definition
Diagnois:Screen for IGF-1
Confirm with Glucose tolerance test
Follow with MRI
Treatment: Surgery, Radiation adjunct, 2nd line-Somatostatin |
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|
Term
| When are cortisol levels the highest and lowest |
|
Definition
| Highest in the morining lowest before sleeping |
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|
Term
| What is the complication of ACTH underproduction |
|
Definition
|
|
Term
| What are some signs of Cushings Syndrome |
|
Definition
Central obesity
Buffalo Hump
Purple Striae
Moon Face
HPTN |
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|
Term
| How is ACTH overproduction diagnosed and treated |
|
Definition
Diagnosis: 24-hr Urinary Cortisol, Measure ACTH, Less Common: Hypoglycemia and CRH Injection
Treatment: Surgery, Radiation Adjunct, Bilateral Adrenalectomy, Glucocorticoid inhibitor drugs |
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|
Term
| What is the diagnosis and treatment of TSH overproduction |
|
Definition
Diagnosis: Check Thyroid and TSH levels: both high is suggestive
Treatment: Surgery, Radiation Adjunct |
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|
Term
| What pituitary tumor sometimes secretes multiple hormones and what are these hormones |
|
Definition
| Adenoma secreting TSH, FSH and LH (Glycoproteins Hormones) |
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|
Term
| What are the clinical signs of a gonadotroph secreting tumor |
|
Definition
| Hypogonadism: Amenorrhea, Impotence, Infertility |
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|
Term
| What is the treatment of a gonadotroph secreting pituitrary adenoma |
|
Definition
| Surgery, Radiation adjunct |
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|
Term
| Why does hypersecretion of gonadotropins contribute to Hypogonadism? |
|
Definition
| Hypersecretion removes the pulsitile stimulus required by the sex organs for proper functioning |
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|
Term
| What are the clinical signs of Prolactin Hypersecretion |
|
Definition
Galactorrhea
Amenorrhea
Sexual Dysfunction
Infertility |
|
|
Term
| What are the tests that should be run when a hyperprolaction production is suspected? |
|
Definition
Pregnancy
TSH
Prolactin
Pituitary History Review(Stalk Effect)
Renal Function
Meds |
|
|
Term
| What is the treatment for prolactin overproduction? |
|
Definition
Primary: Bromocryptine
Secondary: Surgery only if patient is unresponsive to the Dopamine Agonist |
|
|
Term
| What are the signs and symtoms of siADH and how would you treat this condition |
|
Definition
Nausea, Lethergy, Seizures, Coma
Treatment: Water Restriction, maybe Hypertonic Saline |
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|
Term
| What are the signs/symptoms and Treatment of Disabetes Insipidous |
|
Definition
Thirst, Cold Water Craving, Excessive Urination
Treatment: ddAVP Nasal or Injection |
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|
Term
| What are the two types of Diabetes insipidus |
|
Definition
Central: ADH underproduction
Nephrogenic: Unresponsive to ADH |
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|
Term
| How do you diagnose and treat GH insufficiency |
|
Definition
Diagnosis: GHRH and Arginine Stimulation or Insulin-induced Hypoglycemia Stimulation
Treatment: Exogenous GH |
|
|
Term
| What is the Diagnosis and Treatment of ACTH underproduction |
|
Definition
Diagnosis: Cosyntropin Stimulation, CRH Stimulation, Insulin Hypoglycemia Stimulation
Treatment: Steroid Replacement |
|
|
Term
| When would ACTH underproduction still show responsiveness to ACTH stimulation? |
|
Definition
| Acute event of ACTH underproduction |
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|
Term
| What is the diagnosis and treatment of TSH underproduction |
|
Definition
Diagnosis: TSH and Thyroid Levels
Treatment: Exogenous Thyroid |
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|
Term
| What is the diagnosis and treatment of FSH and LH underproduction? |
|
Definition
Diagnosis: Measure Estrogen and Testosterone then measure gonadotropins
Treatment: Sex steroids, if want baby: FSH/LH or GnRH Injections to restore fertility |
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|
Term
| What is the first sign of sheenan syndrome and what would be your first approach to treatment? |
|
Definition
No Lataction after child birth
Give Cortisol to prevent severe complications |
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