anterior pituitary 2 Flashcards
clinical features of hypopituitarism
hypoglycemia, mid-line defects, micropenis, TSH/ACTH deficiency
how to monitor TSH
- normal T4 or Free T4
- growth/development
- hypothyroid symptoms
to check ACTH, is random cortisol helpful?
no!
how to treat ACTH deficiency
hydrocortisone or prednisone, dexamethasone
growth failure characteristic - Low growth velocity for age and pubertal stage is ____ percentile
< 10th-25th
features of growth hormone deficiency
central incisor, forehead prominence, maxillary hypoplasia, truncal obesity
GH deficiency is associated with ___ bone maturation
delayed
bone age
<2 years chronological age
how to diagnose GH deficiency
growth hormone stimulation test
growth hormone stimulation test
measure rise in GH after administration of stimulus
transcription factor important for pituitary development - leads to hypopituitarism
Pit 1 mutation
arises from remnants of rathke’s pouch
craniopharyngioma
craniopharyngioma is associated with _____
panhypopituitarism
1 CAUSE of Hypopituitarism in Adults:
Pituitary Tumors
50% of pituitary tumors are
prolactin secreting
“stalk effect”
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
sequence of hormones that are usually affected in acquired disease of hypopituitarism
GH loss, LH/FSH, TSH, ACTH, then prolactin is affected last (would increase)
signs of FSH/LH deficiency in women
oligo- or amenorrhea, vaginal dryness, hot flashes
Loss of sexual hair, i.e. pubic and axillary
signs of FSH/LH deficiency in men
men – loss of libido, erectile dysfunction, diminished strength
Loss of sexual hair, i.e. pubic and axillary
signs of ACTH deficiency
fatigue, anorexia, weight loss, postural hypotension
