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8 Cards in this Set
- Front
- Back
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Pituitary tumours |
Most common cause of pituitary disease 10% of intracranial neoplasma- mostly benign, slow-growing- adenomas Micro = <10mm Macro = >10mm Can cause: - Hypersecretion - Inadequate production of other hormones - Local effects on related substances e.g. headaches, visual changes |
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Types of adenomas... |
Prolactinoma (most common- causes hyperprolactinaemia GH-secreting- causes acromegaly ACTH-secreting- causes Cushing's Non-secreting- causes mechanical symptoms, hypopituitarism |
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Investigations for pituitary disease |
Signs & symptoms Endocrine investigations- baseline hormone levels, dynamic (stimulatory- e.g. TRH should stimulate TSH/T4, or suppressive e.g. oral glucose tolerance test, high plasma glucose should suppress GH release) Imaging of tumour |
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Management of pituitary disease due to a tumour |
- Pharmacologcal - Surgery- BUT can cause hypopituitarism & damage optic pathways - Radiotherapy |
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Specific pituitary conditions - Hyperprolactinaemia |
Usually due to prolactinoma = loss of fertility, reduced libido, galactorrhoea- Treatment- dopamine receptor agonists, inhibit prolactin secretion & shrink tumour Surgery/radiotherapy if tumour is resistant to drug therapy |
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Specific pituitary conditions - Acromegaly |
Excessive GH in adulthood, usually due to GH-secreting tumour Treatment = surgical removal, radiotherapy - Somatostatin analogues inhibit GH release - Bromocriptine (dopamine receptor agonist) also used as some adenomas have expression of dopamine receptors |
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Specific pituitary conditions - Cushing's Syndrome |
Excessive glucocorticoid activity Endogenous or exogenous Main cause = ACTH-secreting ant pituitary tumour = Cushing's disease Treatment = tumour removal, radiotherapy |
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Specific pituitary conditions - Hypopituitarism |
Deficiency of 1 or more pituitary hormones Pan-hypopituitarism = deficiency of all pituitary hormones - Usually due to pituitary adenoma, surgery/radiotherapy, or severe head trauma which causes damage to pituitary stalk Treatment = hormone replacement |
