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14 Cards in this Set
- Front
- Back
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3 ways in which a patient with a pituitary tumor will present
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symptoms of hormone hypersecretion
hypopituitarism due to compression neurologic symptoms related to mass effect |
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% of tumors that are "hormonally" silent, or non-functioning
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30-40%
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most common hormonally active pituitary tumors (2)
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prolactinomas (#1) and growh hormon secreting tumors
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size that differentiates between microadenomas and macroadenomas
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1 cm
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other potential causes of hyperprolactinemia (a lot)
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pregnancy/surgery/seizure
primary hypothyroidism kidney/liver failure medications (phenothiazines, TCAs, methyldopa, verapamil, cimetidine) chest wall or spinal cord lesions herpes breast stimulation cysts/infiltrative lesions |
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after obtaining elevated prolactin levels, lab workup for suspected prolactinoma
what is the imaging modality of choice when needed? |
TSH, HCG (in amenorrheic women), careful history
MRI |
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treatment of choice for prolactinomas
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medication: Bromocriptine or Cabergoline (dopamine agonists that normalize prolactin)
good, effective treatment |
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important complications of acromegaly
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CV (htn, hypertrophy, ischemic heart disease)
diabetes mellitus (decreased insulin sensitivity) |
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acromegaly prompts increased risk of what malignancy?
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colon cancer
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what is the definitive test for acromegaly?
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growth hormone level fails to suppress below 2ng/ml 60 minutes following oral glucose load
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initial blood test to run if suspected acromegaly
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IGf-1 (twice)
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treatment of choice for a pituitary tumor that produces growth hormone
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transsphenoidal surgery
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ACTH tumors cause ___
what test to diagnose? |
Cushing's disease
24 hour urine free cortisol |
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hemorrhage or infarct of the pituitary gland
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pituitary apoplexy
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