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6 Cards in this Set

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Amenorrhea: Differential, investigations
1. Differential: pregnancy, hypothalamus (stress/anorexia, postOCA, lesion), pituitary (prolactinoma, macroadenoma with stalk effect, Sheehan's syndrome), ovaries (PCOS, premature ovarian failure), endometrium (asherman's syndrome)
2. Investigations: betaHCG,sTSH,prolactin,LH,FSH,estradiol,pelvic U/S,testosterone (PCOS)
Prolactinoma: Clinical Features, Investigations for High Prolactin, Treatment
1. Clinical Features: galactorrhea, amenorrhea, headache/vision problems, infertility, erectile dysfunction, hypogonadism
2. Investigations: baseline prolactin, betaHCG, sTSH, creatinine, AST, review medications
3. Treatment: dopamine agonist (cabergoline,norprolac,bromocriptine)
Pituitary Mass: Presentation, Investigations, Diagnosis, Treatment
1. Presentation: mass effect, hyperfunction, hypofunction
2. Investigations: ACTH, 8am cortisol, GH, IGF-1, prolactin, sTSH, free T4, LH, FSH, estradiol, MRI
3. Diagnosis: mass effect (cranial nerves II-VI, visual field testing, MRI), hyperfunction (baseline hormones, suppression testing, rule out other causes), hypofunction (baseline hormones, triple bolus stimulation test)
4. Treatment: mass effect (drugs, surgery, radiation), hyperfunction (drugs, surgery, radiation), hypofunction (hormone therapy)
Acromegaly: Clinical Features, Investigations
1. Clinical Features: bone+tissue growth, metabolic syndrome, heart disease, carpel tunnel, sleep apnea, osteoarthritis, colon polyps
2. Investigations: GH, IGF-1, glucose suppression test
Cushing's syndrome: Clinical Features, Differential, Investigations
1. Clinical Presentation: central obesity, abnormal fat deposition, metabolic syndrome, bruising, weakness, osteoporosis
2. Differential: increased ACTH (pituitary tumour, ectopic tumour), decreased ACTH (adrenal, exogenous steroid use)
3. Investigations: 24hr urine cortisol, dexamethasone suppression test
Hypofuntional pituitary: Clinical Assessment, Investigations
1. Clinical Assessment: short stature (GH), ED/amenorrhea/infertility (LH+FSH), wt gain/cold intolerance/constipation/fatigue(TSH), wt loss/hypotension/nausea+vomiting (ACTH)
2. Investigations: 8am cortisol, ACTH, sTSH, free T4, GH, IGF-1, LH, FSH, estradiol, testosterone, prolactin, triple bolus test