Pituitary adenoma physical examination: Difference between revisions

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Latest revision as of 19:45, 2 October 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]

Overview

The presence of altered mental status, hyperthermia, tachycardia, tachypnea and visual field defect (bitemporal hemianopsia) on physical examination is suggestive of pituitary adenoma.

Physical Examination

Appearance of the Patient

Based on the size of the adenoma and type of the hormone that is being secreted patient may appear lethargic, nauseated, drowsy, obese, thin, or diaphoretic. However, patient may also appears well.

Vitals

Temperature

Hyperthermia may be present

Pulse

Rate

Tachycardia may be present

Rhythm

The pulse is regular

Strength

The pulse may be bounding

Blood Pressure

Hypertension may be present

Respiratory Rate

Tachypnea may be present

Neurologic

Mental status may be altered
Hyperactive reflexes may be present
Deficits in cranial nerves I, II, III, and VI may be present

Eyes

Visual field defect (bitemporal hemianopsia) maybe be present

Chest

Breasts may be enlarged

References

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+__NOTOC__
 {{Pituitary adenoma}}
+{{CMG}} {{AE}} {{AAM}}
-{{CMG}}
 ==Overview==
+The presence of [[altered mental status]], [[hyperthermia]], [[tachycardia]], [[tachypnea]] and [[visual field defect]] ([[bitemporal hemianopsia]]) on [[physical examination]] is suggestive of pituitary adenoma.
+==Physical Examination==
+===Appearance of the Patient===
+*Based on the size of the adenoma and type of the hormone that is being secreted patient may appear [[lethargic]], [[Nausea and vomiting|nauseated]], [[Drowsiness|drowsy]],  [[obese]], thin, or [[diaphoretic]]. However, patient may also appears well.
-'''Pituitary adenomas''' are [[tumor]]s that occur in the [[pituitary gland]], and account for about 10% of intracranial [[neoplasia|neoplasms]]. They often remain undiagnosed, and small pituitary tumors are found in 6 to 24 percent of adults at autopsy.
+===Vitals===
-Pituitary adenomas arise within the anterior lobe (adenohypophysis) of the gland . Tumors less than 1 cm are called micro adenomas. Clinical symptoms depend on whether the tumor is secreting or nonsecreting. Nonsecreting adenomas grow and compress adjacent structures, most commonly causing a bitemporal hemianopsia due to chiasmatic compression. Lateral extension into the cavernous sinuses can result in cranial nerve palsies.
+====Temperature====
-==History and symptoms==
+*[[Hyperthermia]] may be present
-The diagnosis is generally entertained either on the basis of visual difficulties arising from the compression of the [[optic nerve]] by the tumor, or on the basis of manifestations of excess hormone secretion: the specifics depend on the type of hormone. The specific area of the visual pathway at which compression by these tumours occurs is at the [[optic chiasma]].
-The diagnosis is generally entertained either on the basis of visual difficulties arising from the compression of the [[optic nerve]] by the tumor, or on the basis of manifestations of excess hormone secretion: the specifics depend on the type of hormone. The specific area of the visual pathway at which compression by these tumours occurs is at the [[optic chiasma]].
-The anatomy of this structure causes pressure on it to produce a defect in the temporal visual field on both sides, a condition called [[bitemporal hemianopsia|bitemporal hemianopia]].
+====Pulse====
+=====''Rate''=====
+*[[Tachycardia]] may be present
-Tumors which cause visual difficulty are likely to be ''macroadenomata'' greater than 10 mm in diameter; tumors less than 10 mm are ''microadenomata''.
+=====''Rhythm''=====
+*The pulse is regular
+=====''Strength''=====
+*The pulse may be bounding
+====Blood Pressure====
+*[[Hypertension]] may be present
+====Respiratory Rate====
+*[[Tachypnea]] may be present
+===Neurologic===
+*[[Altered mental status|Mental status may be altered]]
+*[[Hyperactive reflexes]] may be present
+* Deficits in [[Olfactory nerve|cranial nerves I]], [[Optic nerve|II]], [[Oculomotor nerve|III]], and [[Abducens nerve|VI]] may be present
-Some tumors secrete more than one hormone, the most common combination being GH and prolactin.
+===Eyes===
+*[[Visual field defect]] ([[bitemporal hemianopsia]]) maybe be present
-Prolactinomas are frequently diagnosed during pregnancy, when the [[hormone]] [[progesterone]] increases the tumor's growth rate.
+===Chest===
-Headaches may be present. The diagnosis is confirmed by testing hormone levels, and by radiographic imaging of the pituitary (for example, by [[CT scan]] or [[MRI]]).
+*[[Breasts]] may be enlarged
 ==References==
 {{Reflist|2}}
-[[cs:Adenom hypofýzy]]
-[[nl:Hypofysetumor]]
-[[sk:Adenóm hypofýzy]]
-[[sv:Hypofystumör]]
 {{WikiDoc Help Menu}}
 {{WikiDoc Sources}}
 [[Category:Disease]]
 [[Category:Endocrinology]]
+[[Category:Mature chapter]]
+ [[Category:Up-To-Date]]
 [[Category:Oncology]]
-[[Category:Mature chapter]]
+[[Category:Medicine]]
+[[Category:Neurology]]
+[[Category:Neurosurgery]]
+[[Category:Endocrinology]]

Pituitary adenoma physical examination: Difference between revisions

Latest revision as of 19:45, 2 October 2019

Overview

Physical Examination

Appearance of the Patient

Vitals

Temperature

Pulse

Rate

Rhythm

Strength

Blood Pressure

Respiratory Rate

Neurologic

Eyes

Chest

References

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