Anterior pituitary - Hyposecretion Flashcards
Distinguish between primary and secondary disease states relating to pituitary function
Primary disease - malfunction of gland itself
Secondary disease - signalling malfunction between brain and gland
Define the term panhypopituitarism
Decreased production of all anterior pituitary hormones
What is the most common mutation in congenital panhypopituitarism?
Mutation in TF genes for normal pit. development
Recall 4 possible tumours that could cause panhypopituitarism
- Hypothalamic tumour (craniopharyngoma)
- Pituitary adenoma
- Pituitary cyst
- Secondary tumour, metastatic from elsewhere (eg. breast)
Explain the potential damage of radiotherapy on pituitary function
Can cause panhypopituitarism:
GH most vulnerable
TSH is relatively resistant
List 9 possible causes of panhypopitiutarism
- Congenital
- Tumour
- Radiotherapy
- Traumatic brain injury
- Infection (meningitis)
- Infiltrative disease (sarcoidosis)
- AI inflammation
- Pituitary apoplexy
- Sheehan’s syndrome
What is hypophysitis?
AI inflammation of pituitary
Explain the onset of Sheehan’s syndrome
Common in post-partum women
Peri-partum infarction following post-partum haemorrhage
Lactotrophic hyperplasia in pregnancy, then starved of blood –> irreversible damage
What is a pituitary apoplexy?
Bleed into the pituitary (usually haemorrhage, can be infarct)
Recall 5 symptoms of FSH/LH deficiency
- Reduced libido
- Secondary amenorrhea
- Erectile dysfunction
- Failure of lactation
- Failure to resume menses post-delivery
Recall 3 signs of congenital panhypopituitarism
- Deficient in GH and at least 1 other AP hormone
- Short stature
- Hypoplastic AP on MRI
Recall 3 symptoms of Sheehan’s syndrome
- Lethargy
- Anorexia and weight loss
- Deficiency in LH and FSH
What is a common first-presentation of a pituitary adenoma?
Pituitary apoplexy
Describe the effect of anti-coagulants on pituitary adenoma
Can precipitate pituitary apoplexy
Recall 2 general symptoms of pituitary apoplexy
- Severe, sudden onset headache
2. Visual field defects