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24 Cards in this Set
- Front
- Back
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what are incidentalomas?
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adenomas with no clinical significance
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what are 3 questions to ask if a pituitary adenoma is found?
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is it prod excess hormone?
is it blocking the release of hormone? is it causing a mass effect? |
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what is the neuro sx of someone with a pituitary tumor
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loss of peripheral vision due to action on the optic chiasma.
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what is the most common functioning pituitary adenoma?
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prolactinoma
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what is a non-functioning pituitary adenoma?
what is most likely to be elevated and why? |
produces frags of hormones but not complete.
youll see increase in prolactin due to keep from dopamine from completely antagonizing prolactin |
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can some drrugs cause an increase in ant. pituitary hormones?
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yes
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what are the prolactin levels in a prolactinoma?
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>150
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what is the tx for non-functioning pituitary tumor?
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if not growing or causing a problem then monitor every 6 months.
if causing a problem then surgery |
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what kind of drug is used in prolactinoma?
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dopamine agonist
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what is the treatment of choice for prolactinoma?
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dopamine agonist
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what is cushings dz?
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overproduction of ACTH due to tumor in the ant. pituitary
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what are 2 test you can do for cushings dz?
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24 hr free cortisol test via urine and dexamethasone suppression test
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someone responds to low dose dex?
someone responds to high dose dex? someone cannot respond to dex at all? (all these ppl have levels of high ACTH) |
normal
cushings non-cushing tumor |
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are ACTH and cortisol are released in a pulsatile fashion??
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yes. this means you want a 24 hr level. a random single test is most likely not helpful.
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what are the tx options for cushings?
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surgery, mitotane, ketoconazole
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over production of GH results in what?
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acromegaly and gigantism
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what are 3 test for acromegaly?
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level of GH, level of IGF, and MRI for tumor
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if TSH is normal and T3/4 is high, what are some possibilities?
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tumor that makes TSH or thyroid hormone resistance
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what is the best tx for TSH-oma?
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octreotode/ lanreotide
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what should you think if someone has delayed puberty?
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LH-oma or kleinfelters
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If a pituitary tumor or injury to the pituitary is found or suspected it is ESSENTIAL to evaluate the patient for deficiencies of all other anterior pituitary hormones.
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blank
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what is kallmans syndorme?
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genetic disorder due that you see anosmia and hypogonadism. due to def in LH.
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Case 4. 16 y/o male is brought to your office by his father because of lack of pubertal development. The patient is relatively short for his age. Laboratory evaluation reveals Testosterone which is not detectable and LH level which is normal.
Does this represent primary or secondary |
secondary
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16 y/o male comes to see you because of delayed puberty. Physical exam reveals very small, firm testicles. Laboratory evaluation reveals a testosterone below detectable limits and an LH of 150.
Is this primary or secondary hypogonadism? What is the most likely diagnosis? |
primary
kleinflter ( 47-XXY) |
