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Pituitary Disorders 2023

Horizontales
Associated with Normal Intelligence, GH deficiency, abnormal stature
Frontal; prominent forehead
And infertility in men 2/2 prolactinoma
Greater than 1cm, impingement of optic chiasm
HTN, cardiomegaly, Insulin Resistance; "doughy" hands
Inability to suppress ADH; euvolemic hyponatremia
Can cause Diabetes Inspidus, approach to remove tumor
Treatment of choice Diabetes Insipidus
Long-acting, dopamine agonist of choice, reduction of IGF-1
Long-acting, Octeotride/ Lanreotide, first line for persistent disease
Storage of vasopressin notable on MRI of posterior pituitary
Acromegaly
Verticales
Pituitary adenomas which secrete active hormones
Posterior Pituitary: ADH, conservation of free water
Hyponatremia, decreased plasma osmolality
Breastfeeding, Trust/Empathy, Role in patients with Autism
Compression of nearby structures; tumor
Somatotroph adenoma; Before closure of epiphyses, rapid linear growth
Craving for ice water, large volume polyuria
Central pontine, potential risk associated with rapid correction of SIADH
Sudden hemorrhage into adenoma; headache and diplopia
MC, Lactroph adenoma: Amenorrhea, galactorrhea
Positive loop feedback, excess oxytocin
Pituitary macroadeoma >1 cm; bitemporal hemianopia visual field change