ENDO-hypopituitarism/anterior Pituitary Dysfunction

Question 1

What are the 5 (6) hormones released by the anterior pituitary

Answer 1

-Growth hormone (somatotropin)
-Prolactin
-Thyroid stimulating hormone (TSH) (thyrotrophin)
-Luteinising hormone (LH)//(FSH)
-ACTH, corticotrophin

Question 2

What can fail due to primary/secondary disease?

Answer 2

Thyroid
Adrenal cortex
Gonads
— extra info: primary= gland fail. Secondary=no signal from hypothalamus/anterior pituitary

Question 3

What is Primary/secondar hypothyroidism

Answer 3

Primary hypothyroidism
Autoimmune, destroy thyroid gland-T3/4 fall. TSH increase.

Secondary hypothyroidism
Pituitary tumour damaging thyrotrophs
Can’t make TSH
TSH falls
T3/4 falls

Question 4

What is primary/secondary hypoadrenalism

Answer 4

Primary
Autoimmune- destroy adrenal cortex. Cortisol fall, ACTH increase

Secondary
Pituitary tumour damaging coticotrophs.
No ACTH made, ACTH falls, cortisol falls.

Question 5

What is primary/secondary hypogonadism

Answer 5

Primary
Destruction- testes (mumps)//ovaries(chemo)
Testosterone/oestrogen fall, LS/FSH increase

Secondary
Pituitary tumour- damaging gonadotrophs, no LH/FSH made. LS/FSH falls. Testosterone/oestrogen falls

Question 6

Cause of hypopituitarism

Answer 6

-Congenital
-deficient in GH and 1+ anterior pituitary hormone
-hypoplastic (underdeveloped) anterior pituitary gland
-Acquired (ie. Tumour, radiation, infection , haemorrhage, Sheehan’s syndrome)

Question 7

Name for loss of anterior and posterior pituitary function

Answer 7

Panhypopituitarism

Question 8

Radiotherapy induced hypopituitarism

Answer 8

-Pituitary and hypothalamus sensitive to radiation
-GH+Gonadotrophins are the most sensitive
-annual assessments up to 10 years after

Question 9

Presentation of hypopituitarism. FSH/LH

Answer 9

Reduced libido
Secondary amenorrhoea
Erectile dysfunction
Reduced pubic hair

Question 10

Presentation of hypopituitarism. Fatigue?

Answer 10

TSH/ACTH

Question 11

Presentation of hypopituitarism. GH

Answer 11

Reduced quality of life.
Short stature only in children

Question 12

Presentation of hypopituitarism. PRL

Answer 12

Cannot breastfeed

Question 13

What is Sheehan’s syndrome

Answer 13

Anterior pituitary enlarges in pregnancy.
Post partum haemorrhage -> pituitary infarction.

Lethargy, anorexia, weight loss.
TSH/ACTH/GH deficiency.
No lactation
No menses
Posterior pituitary fine