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34 Cards in this Set
- Front
- Back
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What is a pituitary adenoma? |
1. Benign tumor of anterior pituitary cells |
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How does a nonfunctional pituitary adenoma present? |
1. Mass effect--- 2. Bitemporal hemianopsia 3. Hypopiutitarism 4. Headache |
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How will a prolactinoma present in females? Males? |
1. Galactorrhea and amneorrhea in females 2. Decreased libido and headache in males |
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How do you tx prolactinomas? |
1. Dopamine agonists 2. Surgery |
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What are the consequences of a GH cell adenoma? |
1. Gigantism 2. Acromegaly 3. 2o DM |
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How do you dx GH cell adenoma? |
1. Elevated GH and IGF-1 2. Lack of GH suppression by oral glucose |
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How do you tx a GH cell adenoma? |
1. Octreotide 2. GH receptor antagonists 3. Surgery |
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When do the ssx of hypopituitarism present? |
1. When >75% of pituitary parenchyma has been lost |
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What are the MCC of hypopituitarism? |
1. Pituitary adenomas (adults) 2. Craniopharyngioma (children) 3. Sheehan syndrome |
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What is Sheehan syndrome? |
1. Pituitary grows in size during pregnancy, but blood supply does not 2. Infarction ensues during parturition |
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What are the ssx of Sheehan syndrome? |
1. Loss of pubic hair (androgens) 2. Poor lactation 3. Fatigue |
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What causes empty sella syndrome? |
1. Congenital defect of the sella 2. Herniation of the arachnoid and CSF into the sella compresses and destroys the pituitary gland |
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What causes central DI? |
1. Hypothalamic or posterior pituitary pathology |
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What are the clinical features of central DI? |
1. Polyuria and polydipsia 2. Hypernatremia and high serum osmolality 3. Low urine osmolality and specific gravity |
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How do you dx central DI? |
1. Water deprivation test 2. Urine osmolality is NOT increased |
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How do you tx central DI? |
1. Desmopressin |
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What causes nephrogenic DI? |
1. Inherited mutations or drugs |
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How do you separate nephrogenic from central DI? |
1. In nephrogenic DI, there is no response to desmopressin |
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What is the MCC of SIADH? |
1. Ectopic production of ADH--- 2. CNS trauma 3. Pulmonary infection 4. Drugs |
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What are the ssx of SIADH? |
1. Hyponatremia and low serum osmolality 2. Mental status changes and seizures |
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How do you tx SIADH? |
1. Free water restriction |
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What are the MCC of primary hyperparathyroidism? |
1. Parathyroid adenoma 2. Sporadic parathyroid hyperplasia 3. Parathyroid carcinoma |
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What are the SSX of primary parathyroidism? |
1. 'Moans, bones, stones, and groans' |
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What are the lab findings in primary parathyroidism? |
1. Increased serum PTH 2. Increased serum Ca 3. Decreased serum phosphate 4. Increased urinary cAMP 5. Increased serum alk phos |
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How do you tx primary parathyroidism? |
1. Surgical removal of affected gland |
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What ist he MCC of secondary parathyroidism? |
1. Chronic renal failure |
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What are the lab findings of secondary parathyroidism? |
1. Increased PTH 2. Decreased serum Ca 3. Increased serum phophate 4. Increased alk phos |
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What is the pathogenesis of secondary parathyroidism? |
1. Increased serum phosphate binds free Ca 2. Decreased Ca stimulates all four parathyroid glands 3. Increased PTH leads to bone resorption |
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What are the MCC of hypoparathyroidism? |
1. Autoimmune damage to parathyroid glands 2. Surgical excision 3. DiGeorge syndrome |
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What are the ssx of hypoparathyroidism? |
1. Numbness and tingling (circumoral) 2. Tetany--Trosseau sign, Chovste sign |
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What are the lab results in hypoparathyroidism? |
1. Low PTH 2. Low Ca |
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What causes pseudohypoparathyroidism? |
1. End-organ resistance to PTH 2. Due to defect in Gs |
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What are the lab results in pseudohypoparathyroidism? |
1. Hypocalcemia 2. Increased PTH |
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What are the ssx of pseudohypoparathyroidism? |
1. Short stature 2. Short 4th and 5th digits |
