Endocrine system Anatomy Pathology of pituitary gland
10 important questions on Endocrine system Anatomy Pathology of pituitary gland
What is the most common cause of pituitary insufficiency?
What are the results of insufficient function of the anterior pituitary lobe? And in children?
- Decreased production of growth hormone
- Insufficient function of thyroid, adrenals and gonades (testicles and ovaries)
- tiredness
- obstipation
- weightloss
- intolerance for cold
- decreased libido
- no menstruation
in children
- delayed puberty
- insufficient development of secondary sexual characteristics
- decreased height
What two classes of pituitary tumors are there?
- Hormonal inactive (non-producing) pituitary tumors
- hormone-producing pituitary tumors
- prolactin-producing
- Growth hormone-producing
- ACTH-producing
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Which disease is the result of an ACTH-producing pituitary tumor?
symptoms:
- high blood pressure
- diabetes mellitus
- osteoporosis
- depression
How are patient's with Cushing's disease treated?
- Surgical removal of the ACTH-producing pituitary tumor (succes rate 70-80%)
- radiation therapy
- Surgical removal of both adrenal glands
What is Acromegaly and how is it caused?
Definition: Akron (extremities), Megal- (great)
Symptoms:
- high blood pressure
- diabetes mellitus
- increased swetting
- headaches
- tingling in the hands
- arthrosis (wear and tear of joints)
Why should acromegaly always be treated?
- Increased risk of cardiovascular diseases
- slicht increased risk to develop malignant tumors (e.g. Colon cancer)
- reduced life expectancy
How are patients with acromegaly treated?
- Surgical removal of the pituitary tumor (success are 90% for small tumors, 50% for large tumors)
- radiation therapy (new method: 'gamma knife' radio surgery)
- medical treatment
- inhibition of GH production: somatostatin-analogs (octreotide = Sandostatin), dopamine agonists
- Inhibition of GH action: GH-receptor antagonist (pegvisomant)
What about Prolactin-producing pituitary tumors (prolactinoma)? What are the symptoms?
in woman:
- secretion of breast milk
- disturbances of the menstrual cycle
- fertility problems
- decreased libido
- impotence
- breast development
Symptoms prolactinoma (2):
in both women and men
- Visual field defects and headaches
- symptoms caused by decreased production of other pituitary hormones
How are the patients treated with patients with a prolactinoma?
- Surgical removal of the prolactin-producing pituitary
- medical treatment (dopamine agonists)
- bromocriptin (parlodel)
- quinagolide (norprolac)
- cabergoline (dostinex)
- Radiation therapy
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