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28 Cards in this Set
- Front
- Back
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What is the MC pituitary tumor? |
1. Benign adenoma |
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What is the size of a microadenoma? Macroadenoma? |
1. Microadenoma: <1 cm 2. Macroadenoma: >1 cm |
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What is the imaging of choice in the investigation of a pituitary tumor? |
1. MRI of brain |
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What type of testing do all pituitary tumors require? |
1. Functional testing 2. Hormonal functioning 3. Check visual fields 4. Imaging--- check optic chasm |
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What surgery is recommended to tx a pituitary tumor? |
1. Transphenoidal resection |
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What type of tumors need to be removed? |
1. Functional, except for prolactinomas |
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What is the tx protocol for nonfunctional tumors? |
1. Follow and observe |
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What are the ssx of a prolactinoma? |
1. Females-- galactorrhea, amenorrhea, infertility 2. Males--- gynecomastia, loss of libido |
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To what is the prolactin elevation proportional in a prolactinoma? |
1. Size of the tumor |
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How do you tx a prolactinoma? |
1. Bromocriptine 2. Cabergoline 3. Surgery is rare |
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What are the MCC of hyperprolactinemia? |
1. Dopamine antagonists 2. Metoclopramide 3. Anti-psychotics 4. Pituitary stalk compression |
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What are the ssx of acromegaly? |
1. Diaphoresis 2. Acrid smell 3. Coarse facial features 4. Change in glove and/or shoe size |
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How do you test for acromegaly? |
1. IGF-1 2. **Serial growth hormone** |
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How do you tx acromegaly? |
1. Transsphenoidal resection 2. Octreotide, pegvisomant 3. Radiation |
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What is the clinical presentation of a TSH-secreting tumor? |
1. Thyrotoxicosis 2. Patient may feel nervous and jittery |
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What will the labs be in a patient with a TSH-secreting tumor and chronic hypothyroidism? |
1. High TSH 2. Free T4 low |
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What should you think when you see high TSH and high T4? |
1. Don't think TSH-secreting neoplasm 2. Trust the TSH 3. Check meds---levothyroxine |
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What will be the TSH level if hypothyroidism is being undertreated? |
1. TSH will be high |
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What effect will levothyroxine have on T4 if taken too close to a thyroid panel? |
1. T4 will be high |
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High TSH+low T4=??? |
1. Primary thyroid disease |
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High TSH+normal T4=??? |
1. Primary thyroid disease |
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What are the ssx of Cushing disease? |
1. Obesity 2. Striae 3. Ecchymoses 4. Hyperglycemia 5. Atherosclerosis |
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How do you dx Cushing disease? |
1. 24 hr. urine free cortisol 2. Dexamethasone suppression test |
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Cushing disease is ACTH dependent/independent? |
1. Dependent |
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What is ACTH dependent Cushing sydnrome? |
1. Cortisol overproduced due to ectopic ACTH 2. Can be due to neoplasm |
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How do you distinguish between ACTH dependent/independent Cushing syndrome? |
1. Dexamethasone suppression 2. Will not suppress ectopic ACTH production |
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What is the functionality of the pituitary in empty sella syndrome? |
1. Can be normal or partial |
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What can sellar extension of non-pituitary tumors cause? |
1. Elevated prolactin or DI due to stalk commpression 2. Visual field defects 3. Pituitary insufficiency |
