anterior pituitary 2

Question 1

clinical features of hypopituitarism

Answer 1

hypoglycemia, mid-line defects, micropenis, TSH/ACTH deficiency

Question 2

how to monitor TSH

Answer 2

• normal T4 or Free T4
• growth/development
• hypothyroid symptoms

Question 3

to check ACTH, is random cortisol helpful?

Answer 3

no!

Question 4

how to treat ACTH deficiency

Answer 4

hydrocortisone or prednisone, dexamethasone

Question 5

growth failure characteristic - Low growth velocity for age and pubertal stage is ____ percentile

Answer 5

< 10th-25th

Question 6

features of growth hormone deficiency

Answer 6

central incisor, forehead prominence, maxillary hypoplasia, truncal obesity

Question 7

GH deficiency is associated with ___ bone maturation

Answer 7

delayed

Question 8

bone age

Answer 8

<2 years chronological age

Question 9

how to diagnose GH deficiency

Answer 9

growth hormone stimulation test

Question 10

growth hormone stimulation test

Answer 10

measure rise in GH after administration of stimulus

Question 11

transcription factor important for pituitary development - leads to hypopituitarism

Answer 11

Pit 1 mutation

Question 12

arises from remnants of rathke’s pouch

Answer 12

craniopharyngioma

Question 13

craniopharyngioma is associated with _____

Answer 13

panhypopituitarism

Question 14

1 CAUSE of Hypopituitarism in Adults:

Answer 14

Pituitary Tumors

Question 15

50% of pituitary tumors are

Answer 15

prolactin secreting

Question 16

“stalk effect”

Answer 16

indirect manner in which non-functioning pituitary adenomas (or tumors that extend above the sella turcica) can sometimes cause an elevation in prolactin; these tumors are not prolactinomas because they are not directly making or secreting prolactin; rather, some of these tumors (especially the larger ones) can compress the infundibulum or “stalk” that sends dopamine down from the hypothalamus to the pituitary gland, thereby interrupting the normal tonic inhibition of dopamine on prolactin, thus resulting in higher prolactin levels

Question 17

sequence of hormones that are usually affected in acquired disease of hypopituitarism

Answer 17

GH loss, LH/FSH, TSH, ACTH, then prolactin is affected last (would increase)

Question 18

signs of FSH/LH deficiency in women

Answer 18

oligo- or amenorrhea, vaginal dryness, hot flashes

Loss of sexual hair, i.e. pubic and axillary

Question 19

signs of FSH/LH deficiency in men

Answer 19

men – loss of libido, erectile dysfunction, diminished strength

Loss of sexual hair, i.e. pubic and axillary

Question 20

signs of ACTH deficiency

Answer 20

fatigue, anorexia, weight loss, postural hypotension