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14 Cards in this Set
- Front
- Back
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Posterior pituitary hormones |
ADH Oxytocin (the rest are released from anterior pituitary gland) |
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Pituitary Adenoma |
Benign tumor of anterior pituitary cells May be functional (hormone-producing) or nonfunctional Nonfunctional tumors often have *mass effect (bitemporal hemianopsia due to compression of optic chiasm, hypopituitarism due to compression of tissue, headache) |
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What visual mass effect issue arises due to pituitary adenoma |
bitemporal hemianopsia (due to compression of optic chiasm) (loss of peripheral vision) |
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Prolactinoma |
a pituitary adenoma Presents as galactorrhea and amenorrhea (females) or decreased libido + headache (males) Most common type of pituitary adenoma |
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What is the most common type of pituitary adenoma |
Prolactinoma |
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Treatment for prolactinoma |
Dopamine *agonists (bromocriptine, cabergoline) or surgery for larger lesions |
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Growth hormone cell adenoma |
Gigantism in children Acromegaly in adults Secondary diabetes mellitus often present (GH induces gluconeogenesis) Dx'd via elevated GH and IGF-1 elvels, along w/ lack of GH suppression by oral glucose Treatment = octreotide |
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Acromegaly |
from growth hormone cell adenoma - enlarged bones of hands, feet, jaw - Growth of visceral organs leading to dysfunction (e.g. cardiac failure) - Enlarged tongue |
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Treatment for growth hormone cell adenoma |
octreotide (somatostatin analog that suppresses GH release) (think octreotide treats acromegaly) |
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Hypopituitarism |
Insufficient production of hormones by the anterior pituitary gland Causes of it: - Pituitary adenomas (adults) or craniopharyngioma (children) -- due to mass effect or pituitary apoplexy (bleeding into an adenoma) - Shehaan syndrome -- pregnancy related infarction of pituitary gland - Empty sella syndrome |
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Sheehan Syndrome |
A cause of hypopituitarism Pregnancy-related infarction of the pituitary gland Gland doubles in size during pregnancy, but blood supply doesn't increase much Presents as poor lactation, *loss of pubic hair*, and fatigue |
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Empty Sella Syndrome |
A cause of hypopituitarism Congenital defect of the sella Herniation of the arachnoid and CSF into the sella compresses and destroys the pituitary gland Pituitary gland is "absent" on imaging (empty sella) |
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Central vs Nephrogenic Diabetes Insipidus |
Central: -ADH deficiency - Due to hypothalamic or posterior pituitary pathology (tumor, trauma, infection) - Hypernatremia, polyuria/polydipsia - Water deprivation test fails to increase urine osmolality, but improved w/ desmopression (ADH analogue) Nephrogenic: -Impaired renal response to ADH - Hypernatremia, polyuria/polydipsia - Water deprivation test fails to increase urine osmolality, and NOT improved w/ desmopression (ADH analogue) - Due to inherited mutations or drugs (Lithium, demeclocycline) |
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Syndrome of Inappropriate ADH secretion (SIADH) |
Excessive ADH secretion Ectopic production (e.g. small cell carcinoma of lung), or CNS trauma, infection, drugs HypOnatremia, low serum osmolality mental status changes and seizures Hyponatremia leads to neuronal swelling and cerebral edema Treatment = free water restriction, demeclocycline (blocks effects of ADH) |
