This is a sample of our (approximately) 11 page long Endocrinology notes, which we sell as part of the Medicine and Surgery Notes collection, a 2.1 package written at Bristol University in 2011 that contains (approximately) 143 pages of notes across 7 different documents.
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Medicine & Surgery
Endocrinology Disorders of the Pituitary
Causes of Pituitary Disorders
Hypersecretion - functioning tumours or drugs
Deficient Hormone GH
Growth retardation in children, excessive tiredness, muscle weakness Hypogonadism - reduced body hair, FSH/LH low libido, impotence in men, amenorrhoea, dyspareunia and hot flushes in women Weight gain, decreased energy, TSH sensitivity to cold, constipation, dry Pale appearance, weight loss, low BP, ACTH dizziness, tiredness Thirst and polyuria VP Hyposecretion - craniopharyngeoma, non-functioning pituitary tumours, radiotherapy, trauma, empty sella syndrome
Hypopituitarism Deficiency of hypothalamic releasing hormones Isolated deficiency of GH, LH, ACTH, TSH & vasopressin
Growth Failure Short Stature
Thyroid function test - hypothyroidism
IGF-1 - GH undersecretion
Assessment of bone age
Karyotyping female - turner's syndrome Treatment Hypothyroidism - levothyroxine GH insufficiency - somatrophin injections
Acromegaly & Giantism GH excess due to a pituitary tumour
Changes in appearance
Visual fields defects/headaches
Sweating Investigations GH levels Glucose tolerance test - diagnostic if there is no suppression of GH IGF-1 - almost always raised Visual field exam - bitemporal hemianopia MRI scan - pituitary adenoma Prolactinaemia Management & Treatment Surgery - trans-sphenoidal Pituitary radiotherapy after surgery Medical therapy o Somatostatin receptor agonist - octreotide o Dopamine agonists o GH antagonists - normalises IGF-1 levels
Caused by a small prolactin producing tumour , PCOS, primary hypothyroidism Applies pressure on the optic nerve resulting in bitemporal hemianopia Amenorrhea, breast milk production, loss of libido, headaches, oesteoporosis due to hypoestrogenism Investigations Visual fields Hypothyroidism must be excluded Anterior pituitary function - tumours MRI scan of pituitary Treatment Must be treated to avoid the long term effects of oestrogen deficiency
Medical o Dopamine agonist - cabergoline/bromocriptine
Radiotherapy o Controls the growth but is slow in effect
Thyroid Disease Produces thyroxine, T4 and triiodothyronine, T3 These regulate the rate of metabolism and affect growth and rate of function of many systems Iodine and tyrosine are both used to for T 3 and T4 T4 is converted to T3 and reverse T3 by de-iodination T3 is rapidly excreted due to poor binding and further de-iodination Regulation Regulated by TRH from the hypothalamus
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