Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

!!!!! BRS YR2 !!!!! > Endo - Hypopituitarism > Flashcards

Endo - Hypopituitarism Flashcards

1
Q

What is hypopituitarism?

A

lack of pituitary function that can cause secondary failure of other glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What other glands can hypopituitarism effect?

A

Thyroid, adrenal cortex, gonads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is primary hypothyroidism? Effects on hormone levels?

A

→ damage or lack of function of thyroid

→T4 / T3 decrease, TSH increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is secondary hypothyroidism? Effects on hormone levels?

A

→ damage to pituitary thyrotrophs

→ T3 + T4 decrease, TSH decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is primary hypoadrenalism? Effects on hormone levels?

A

→ damage or lack of function of adrenal cortex
→ low levels of cortisol
→ normal to high levels of ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is secondary hypoadrenalism? Effects on hormone levels?

A

→ damage to pituitary corticotrophs

→ ACTH decreases, cortisol decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is secondary hypogonadism? Effects on hormone levels?

A

→ damage to pituitary gonadotrophs

→ LH + FSH decreases, testosterone + oestrogen decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is primary hypogonadism? Effects on hormone levels?

A

→ damage or lack of function of gonads
→ low levels of testosterone + oestrogen
→ normal to high levels LH + FSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a very rare cause of hypopituitarism?

A

→ congenital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is congenital hypopituitarism caused by?

A

Mutations of transcription factor genes needed for anterior pituitary development e.g. PROP1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What symptoms does congenital hypo pituitarism present with?

A

→ deficiency of GH + at least 1 other AP hormone
→ short stature
→ hypoplastic (underdeveloped) AP gland on MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are 8 causes of acquired hypopituitarism?

Hint: TRIP TIPP

A

Traumatic brain injury
Radiation
Infection
Pituitary surgery

Tumours
Inflammatory (Hypophysitis)
Pituitary Apoplexy
Peri-partum Infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is total loss of anterior + posterior pituitary function called?

A

Panhypopituitarism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is most likely to cause panhypopituitarism?

A

Pituitary surgery + inflammation (hypophysitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does radiotherapy induce hypopituitarism?

A

→ pituitary + hypothalamus very sensitive to radiation
→ can be direct e.g. treating acromegaly
→ indirect eg treating nasopharyngeal carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What parts of the pituitary are most sensitive to radiation?

A

Somatotrophs + gonadotrophs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What hormone’s production can increase after radiotherapy? Why?

A

Prolactin

→ hypothalamic dopamine not produced due to radiation + damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How long can the risk of hypopituitarism persist after radiotherapy?

A

10 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How does hypopituitarism present with FSH/LH?

A

→ reduced libido
→ reduced pubic hair
→ secondary amenorrhoea (women)
→ erectile dysfunction (men)

20
Q

How does hypopituitarism present with ACTH + TSH?

A

→ fatigue

21
Q

How does hypopituitarism present with GH?

A

→ reduced quality of life

→ short stature in children

22
Q

How does hypopituitarism present with prolactin?

A

→ inability to breastfeed

23
Q

What is another name for peri-parturm infarction?

A

Sheehan’s syndrome

24
Q

What is the pathogenesis of Sheehan’s syndrome?

A

→ anterior pituitary enlarges during pregnancy due to lactotroph hyperplasia
→ haemorrhage / loss of blood during pregnancy = hypotension
→ pituitary infarction occurs (posterior usually not affected)

25
Q

What are symptoms of Sheehan’s syndrome?

A 
→ lethargy + anorexia + weight loss
(TSH, ACTH and GH deficiency)
→ failure to lactate
(prolactin deficiency)
→ failure to resume menstruation
(LH + FSH deficiency)
26
Q

What is pituitary apoplexy?

A

intra pituitary haemorrhage (or less commonly an infarction)

27
Q

What pre-existing condition is commonly associated with pituitary apoplexy?

A

Pituitary adenoma

28
Q

What can increase the likelihood of pituitary apoplexy?

A

Anti-coagulants

29
Q

What are symptoms of pituitary apoplexy?

A

→ severe sudden onset headache
→ visual field defect e.g. bitemporal hemianopia
(due to compressed optic chiasm)
→ cavernous sinus involvement may lead to diplopia (double vision,IV, VI) + ptosis (droopy eyelid, Ill)

30
Q

How do you diagnose hypopituitarism radiologically?

A

MRI

31
Q

Why is MRI better than CT at identifying hypopituitarism?

A

→ CT not very good at delineating pituitary gland

→ MRI can reveal specific pituitary pathology

32
Q

Why do you have to be careful when measuring cortisol?

A

Diurnal rhythm so depends on time of day

→ highest in the morning

33
Q

Why do you have to be careful when measuring T4?

A

Circulates with a half life of 6 days

34
Q

Why do you have to be careful when measuring FSH/LH?

A

Cyclical in women

35
Q

Why do you have to be careful when measuring GH + ACTH?

A

pulsatile release

36
Q

How do you measure GH + ACTH release to determine a functioning pituitary?

A

Induce hypoglycaemia stress w INSULIN

→ causes GH + ACTH release

37
Q

What is the name of the test that measures GH + ACTH?

A

Dynamic Pituitary Function Test

38
Q

What anterior pituitary hormone isn’t treated?

A

Prolactin deficiency

39
Q

How is GH deficiency treated?

A

Daily injection (administered after DPF test and QOL questionnaire)

40
Q

How is the response to GH treatment measured?

A

→ improvement in QOL

→ plasma IGF-1

41
Q

How is TSH deficiency treated?

A

Daily Levothyroxine, aiming for fT4 above the middle of reference range

42
Q

How is ACTH deficiency treated?

A

Replace cortisol with synthetic glucocorticoids

prednisolone or hydrocortisone

43
Q

What are the sick day rules for ACTH deficiency?

A

Take double dose of glucocorticoids

→ when sick body normally produces more cortisol

44
Q

How is FSH/LH deficiency treated in men (no fertility)?

A 
replace testosterone (topical gel or intra muscular)
→ does not restore sperm production
45
Q

How is FSH/LH deficiency treated in men (who want fertility)?

A

Gonadotrophin injections
→ best if hypogonadism is after puberty
→ may take 6-12 months til sperm

46
Q

How is FSH/LH deficiency treated in women (who want fertility)?

A

Carefully timed gonadotrophin injections (IVF) can induce ovulation

47
Q

How is FSH/LH deficiency treated in women (no fertility)?

A

→ oestrogen (oral tablets or topical gel)

→ progesteron if uterus intact (to prevent endometrial hyperplasia)

!!!!! BRS YR2 !!!!! (72 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions