Term
| Dysfuntion of the pituitary gland can result from a problem in the gland itself or from a problem in the |
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Definition
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Term
| an organ in the brain that secrets factors that can directly inhibit or stimulate the pituitary |
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Definition
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Term
| a pathologic state caused by excess production of one or more of the anterior pituitary hormones |
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Definition
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Term
| hormones that are most often produced in excess |
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Definition
| growth hormone, prolactin, follicle stim hormone, luteinizing hormone, adrenocorticotrophic hormone |
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Term
| GH is responsible for the growth and development of the body's |
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Definition
| muscles, bones and other tissues |
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Term
| overproduction of GH can lead to |
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Definition
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Term
| overproduction of prolactin causes |
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Definition
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Term
| most common factor in hyperpituitarism is the presence of a |
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Definition
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Term
| a benign tumor composed of epithelial tissue |
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Definition
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Term
| adenomas that are larger than 10 mm |
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Definition
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Term
| adenomas that are smaller than 10 mm |
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Definition
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Term
| adenomas tend to occur most commonly in women that are in their |
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Definition
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Term
| pitutitary adenomas that secrete hormones may cause |
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Definition
| amenorrhea, galactorrhea, hyperthyroidism, cushing syndrome, gigantism or acromegaly |
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Term
| GH in addition to regulating tissue growth mobilizes |
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Definition
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Term
| excess levels of GH elevate ______ in the blood stream |
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Definition
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Term
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Definition
| coronary artery disease and cerebrovascular disease over time |
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Term
| Excess GH also antagonizes ______ and interferes with its effects leading to _____ and possibly _______ |
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Definition
| insulin, hyperglycemia, DM |
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Term
| excess prolactin can cause |
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Definition
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Term
| prolactinemia is characterized by |
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Definition
| abnormal lactation, decreased vaginal lubrication, impotence and decreased libido in men, depression, anxiety, visual loss |
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Term
| gigantism occurs in _______ while the ______ are still growing |
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Definition
| early childhood or puberty, long bones |
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Term
| the long bones consists of ____ which are at the _____ portions of the bone |
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Definition
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Term
| the middle or shaft of the bone |
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Definition
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Term
| Before the epiphyseal plates on the ends of the bones close the diaphysis of the bone may continue to grow great lengths when stimulated by |
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Definition
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Term
| symptoms of acromegaly usually appear in the |
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Definition
| 4th or 5th decade of life |
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Term
| acromegaly affects women and men |
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Definition
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Term
| Because the epiphyses prevent longitudinal growth of bones, with acromegaly bones grow in |
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Definition
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Term
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Definition
| cardiovascular, digestive, nervous and genitourinary system |
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Term
| may be the first sign of hyperpituitarism |
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Definition
| visual deficits and headache |
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Term
| visual problems are most often a result of pressure on ______ where the are joined near the _____ |
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Definition
| optic nerves, pituitary gland |
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Term
| physical features of hyperpituitarism |
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Definition
| enlargement of hands, feet and paranasal and frontal sinuses and deformities of the spine and mandible, soft tissues may become enlarged, especially the tongue, liver and spleen. |
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Term
| physical features caused by hyperpituitarism may lead to |
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Definition
| speech impediments, coarse or distorted facial features, abdominal distention, sleep apnea |
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Term
| people with acromegaly may also report |
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Definition
| excessive perspiration, oily skin, peripheral neuropathies, degeneration of the joints, proximal muscle weakness |
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Term
| pt with gigantism and acromegaly initially have increased _____ progressing rapidly to complaints of ______ |
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Definition
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Term
| in acromegaly and gigantism the skilled examiner may detect |
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Definition
| organomegaly, htn, dysphagia, a deep voice |
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Term
| those patients who also have elevated prolacting may have |
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Definition
| galactorrhea in women or hypogonadism in men |
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Term
| the diagnosis of hyperpituitarism is based on |
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Definition
| physical assessment, radiographic studies, laboratory findings |
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Term
| radiographic films of the skull may show a large ______ and increased _______ |
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Definition
| sella turcica, bone density |
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Term
| angiography may also be of use to rul out any vascular abnormalities such as |
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Definition
| aneurysms or arteriovenous malformation |
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Term
| In pts with possible hyperpituitarism, levels of _______ are measured |
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Definition
| anterior pituitary hormones |
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Term
| It is normal for ______ to be slightly elevated in postmenopausal women |
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Definition
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Term
| the most definitive test for acromegaly |
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Definition
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Term
| used to rule out problems related to dysfunction of the adrenal glands |
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Definition
| dexamethasone suppression test |
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Term
| soft tissue hypertrophy can be |
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Definition
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Term
| treatment options to prevent further changes from gigantism or acromegaly |
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Definition
| surgery, radiation and drug therapy |
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Term
| surgical removal of the adenoma or pituitary itself |
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Definition
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Term
| for pts diagnosed with pituitary tumors _____ is the treatment of choice |
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Definition
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Term
| most commonly used surgical method |
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Definition
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Term
| a microsurgical procedure performed under general anesthesia with the patient in the semi fowlers position |
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Definition
| transsphenoidal hypophysectomy |
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Term
| in transsphenoidal hypophysectomy an incision is made at the inner aspect of the ______ through the ______ and the sella turcica is entered through the _____ |
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Definition
| upper lip, maxillary bone, sphenoid sinus |
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Term
| if the entire pituitary is removed, the patient will require lifelong replacement of |
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Definition
| glucocorticoids, thyroid hormone, sex hormones |
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Term
| sometimes used if a tumor is especially large or is invading other structure |
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Definition
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Term
| a more invasive procedure that involves the removal of a portion of the frontal bone of the skull |
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Definition
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Term
| after radiosurgery pt usually require |
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Definition
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Term
| drugs that are effective in treatment against acromegaly |
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Definition
| somastatin analogs, dopamine agonists and GH receptor antagonists |
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Term
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Definition
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Term
| octreotide is also called |
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Definition
| sandostatin, sandostatin depot |
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Term
| the most commonly prescribed drug for pts with acromegaly |
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Definition
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Term
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Definition
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Term
| Sandostatin depo is longacting and given |
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Definition
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Term
| common side effects of octreotide, acetate |
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Definition
| headache, changes in cardiac conduction, nausea, vomiting, diarrhea abdominal pain, gallstones, reduction in insulin release, hyper or hypoglycemia, transient pain at the injection sight |
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Term
| because octreotide suppresses insulin secretion, the pt's _____ must be monitored |
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Definition
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Term
| dopamine receptor agonists such as _______ suppress the secretion of GH |
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Definition
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Term
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Definition
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Term
| pegvisomant is ofte used after |
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Definition
| radiotherapy and pituitary surgery |
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Term
| side effects of bromocriptine |
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Definition
| headache, dizziness, drowsiness, confusion, nausea, vomiting, dry mouth, urticaria |
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Term
| pts with hyperpituitarism need to know that may body changess occurs such as |
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Definition
| visual disturbances and visceral enlargement are not reversible |
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Term
| postop hyperpituitarism care involves monitoring |
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Definition
| neurologic status and vision with special attention to LOC, pupil size/equality, and vital signs |
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Term
| changes in data that may indicat edema caused by the manipulation of tissues or intracranial bleeding are |
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Definition
| decreasing alertness, slow pupil response to light and decreased or asymmetric muscle strength |
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Term
| notify surgeon if _____ drainage occurs |
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Definition
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Term
| _____ supports the diagnosis of a CSF leak |
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Definition
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Term
| indications of meningitis |
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Definition
| elevated WBC, sudden rise in temp, headache, nuchal rigidity |
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Term
| when meningeal inflammation is present the pt experiences |
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Definition
| severe head or neck pain when touching chin to chest |
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Term
| replacement therapy typically includes |
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Definition
| adh, cortisol and thyroid medication |
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Term
| if gingival incision was done, tooth brushing is not allowed until |
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Definition
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Term
| be especially alert for stiffness of the neck and headache because these are symptoms of |
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Definition
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