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    Bianca Ilie
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    The document discusses various topics related to the pituitary gland and disorders of the endocrine system. It addresses the classification of pituitary cells, imaging techniques used to investigate the pituitary such as MRI and PET scans, differential diagnoses for pituitary lesions, and conditions like McCune Albright Syndrome, empty sella syndrome, and SIADH. Treatment options discussed include desmopressin for diabetes insipidus, slowly correcting hyponatremia in SIADH, and radiotherapy techniques for pituitary tumors.

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    The document discusses various topics related to the pituitary gland and disorders of the endocrine system. It addresses the classification of pituitary cells, imaging techniques used to investigate the pituitary such as MRI and PET scans, differential diagnoses for pituitary lesions, and conditions like McCune Albright Syndrome, empty sella syndrome, and SIADH. Treatment options discussed include desmopressin for diabetes insipidus, slowly correcting hyponatremia in SIADH, and radiotherapy techniques for pituitary tumors.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Scarica in formato PDF, TXT o leggi online su Scribd
    Segnala contenuti inappropriati
    22 visualizzazioni16 pagine

    Slide Stud 2

    Caricato da

    Bianca Ilie
    The document discusses various topics related to the pituitary gland and disorders of the endocrine system. It addresses the classification of pituitary cells, imaging techniques used to investigate the pituitary such as MRI and PET scans, differential diagnoses for pituitary lesions, and conditions like McCune Albright Syndrome, empty sella syndrome, and SIADH. Treatment options discussed include desmopressin for diabetes insipidus, slowly correcting hyponatremia in SIADH, and radiotherapy techniques for pituitary tumors.

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    di 16

    30.10.

    2012

    Laboratory and paraclinical findings

    Laboratory and paraclinical findings


    Measurements of plasma vasopressin,
    copeptin and AQP2

    MRI

    30.10.2012

    Laboratory and paraclinical findings


    MRI

    Laboratory and paraclinical findings


    MRI

    30.10.2012

    Triphasic evolution in pituitary stalk section

    If excess fluid is administered during the secound phase , severe hyponatremia can occur !!!

    Treatment
    The access to water should not be restricted, The elective medication of central DI is
    vasopressin analogue: desmopressin (desamino, D-8 arginine vasopressin; ddAVP).

    The therapeutic response presents a great interindividual variability.

    30.10.2012

    The Syndrome of Inappropriate Secretion of ADH (SIADH)

    Endocrine causes: hypothyroidism and adrenal insufficiency

    Treatment - SIADH
    Hyponatremia must be corrected slowly
    approximately 10 mEq/L during 24 hours risk of osmotic demyelination !!
    central pontine myelinolysis pseudobulbar palsy

    30.10.2012

    Classification of pituitary cells


    Somatotrophs ~ 50% , secrete GH; Lactotrophs - 10-25%, secrete PRL; Corticotrophs -15-20%, synhesize POMC; Gonadotrophs -10-15%, for LH, FSH; Tireotroph - 3-5%, secrete TSH; Folliculostellate cells - nonsecreting cells.

    LH FSH

    TSH

    Hesx1

    Lhx3 Lhx4

    Prop1

    Pit1
    GH

    Pitx1
    ACTH PRL

    Tpit

    30.10.2012

    McCune Albright Syndrome

    30.10.2012

    Optic chiasm syndrome

    30.10.2012

    30.10.2012

    Imagistical investigations
    Positron emission tomography (PET), Scintigraphy with radioactive octreotid (octreoscan) Single photon-emission computed tomography SPECT

    Sella turcica X-ray lateral incidence

    30.10.2012

    Differential diagnosis
    Other pituitary lesions or supra- and parasellar tumors:
    Cysts Rathke's cleft, arachnoid, and dermoid cysts

    Arteriovenous fistulae of the cavernous sinus. Pituitary abscesses Lymphocytic hypophysitis, sarcoidosis, histiocytosis.

    10

    30.10.2012

    Empty sella syndrome

    GH peptide - 191 AA

    T GH = 20-50 minute

    11

    30.10.2012

    GH receptors

    The metabolic effects of GH:

    12

    30.10.2012

    13

    30.10.2012

    14

    30.10.2012

    Clinical manifestations
    Thickness of the skin, increased oiliness and sweating, acne, acanthosis nigricans, cutis verticis gyrata.

    Clinical manifestations
    Musculo-skeletal signs
    paresthesia of the limbs, arthralgia, osteoarthritis, carpal tunnel syndrome, proximal myopathy, jaw arthritis.

    15

    30.10.2012

    Conventional radiotherapy

    Radiosurgery

    16

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