of cortisol by adrenals for stress response TSH deficiency TH regulates

Of cortisol by adrenals for stress response tsh

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of cortisol by adrenals for stress response TSH deficiency → TH regulates metabolism GH deficiency → promotes growth, promotes protein synthesis, carbohydrate metabolism ○ Hyperpituitarism Causes: primary adenoma- caused by a benign slow growing anterior pituitary adenoma-- visual disturbances often begin in one eye & progress to the other (blurry vision) Hypersecretion of GH, FSH, & LH is common Increased tumor size causes headache, fatigue, neck pain or stiffness, & seizures
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Gonadotropic hyposecretion results in menstrual irregularity, decreased libido, & receding secondary sex characteristics in both men & women. GH secreting pituitary adenoma effects in children & adults In children → gigantism In adults → acromegaly ■ Treatment Goal of treatment is to protect the individual from effects of tumor growth & to control hormone hypersecretion while minimizing damage to appropriately secreting portions of the pituitary Children (gigantism) - surgical removal of adenoma Adults (acromegaly) - surgical removal of adenoma, radiation therapy, pharmacologic therapy (somatostatin), growth hormone receptor antagonist Alterations in growth hormones ○ Acromegaly Results from continuous exposure to high levels of growth hormone (GH) & insulin-like growth factor 1 (IGF-1). It is almost always caused by GH-secreting pituitary adenoma (hyperpituitarism) ■ Pathophysiology ● Hyperpituitarism Increased growth hormone (GH) causes acromegaly Hyperglycemia results → Diabetes mellitus occurs when the pancreas cannot secrete enough insulin to offset the effects of GH Excessive levels of GH & IGF-1 also affect the cardiovascular system → HTN & left ventricular heart failure are seen in ⅓-½ of persons with acromegaly Can cause mild hyperphosphatemia Hypopituitarism can occur as the adenoma gets larger due to compression of surrounding hormone secreting cells Hyperprolactinemia can occur in 30%-40% of persons with acromegaly Clinical Manifestations Usually occurs in adults 40-59 years Slowly progressive disease & if untreated it is associated with a decreased life expectancy Increase in connective tissue and extracellular matrix
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Gradual onset Enlarged tongue, interstitial edema, overactive sebaceous & sweat glands, coarse skin & body hair Bone proliferation of vertebrae Enlargement of small bones of hands, feet, face, and skull, broad nose, protruding lower jaw, slanting forehead Nerves may be entrapped by bony or soft tissue growth leading to peripheral nerve damage Weakness, muscular atrophy, foot drop, sensory changes in hands Barrel-chested appearance & increased cartilage in joints ○ Gigantism ■ Pathophysiology ● Hyperptiuitarism In children → gigantism Bone growth d/t non-closure of epiphyseal plates Clinical Manifestations Excessive skeletal growth (8-9 feet) ○ Dwarfism ■ Pathophysiology ● Hypopituitarism Growth hormone deficiency Clinical Manifestations Short stature, dwarfism In adults- osteoporosis, reduced lean body mass- not adequate protein
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