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Endocrine-Week 1/2 > Hypopituitarism > Flashcards

Hypopituitarism Flashcards

1
Q

Diminished or absent secretion of one or more pituitary hormones

A

Hypopituitarism

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2
Q

Potential causes of Hypopituitarism in children

A

Can be either Hypothalamic or Pituitary

  • Tumors (Adenomas, Craniopharyngiomas, metastases)
  • Trauma (brain injury, MVC, radiation, surgery)
  • Infiltration (TB, sarcoid, lymphoma)
  • Genetic mutations* (prop-1 or pit-1)
  • Idiopathic *
  • more common in children
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3
Q

What pituitary hormone deficiencies are used to diagnose pituitary deficits in CHILDREN?

A
  • GH
  • Prolactin
  • ADH
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4
Q

Signs/Symptoms of GH deficiency in CHILDREN

A
  • Short stature
  • Cherubic face (Prominent forehead & maxillary hypoplasia)
  • Delayed dentition (central incisor)
  • Delayed puberty
  • Truncal obesity
  • Microphallus (small penis)
  • Delayed bone age on x-ray (by at least 2 yrs)
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5
Q

Steps in diagnosing GH deficiency (in both adults and children)

A
  1. Screening by measuring IGF-1/GH
  2. Confirmation by GH stimulation test
    - Measure GH after administration of stimulus
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6
Q

Stimuli used to induce GH stimulation

A
  1. Insulin (hypoglycemia)
  2. CNS neuroactive agents (arginine, clonidine, glucagon)
  3. GHRH
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7
Q

Treatment of GH deficiency in children

A

recombinant human GH (rhGH)

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8
Q

Treatment of FSH/LH deficiency in children

A
  • Goal: puberty induction

Females: estrogen first, then progesterone

Males: testosterone

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9
Q

Treatment of TSH deficiency in children

A

Levothyroxine

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10
Q

Treatment of ACTH deficiency in children

A

Hydrocortisone, prednisone, or dexamethaxasone

  • may need to increase with illness/stress
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11
Q

What two treatments are necessary for growth/maturation in children with pituitary deficits?

A
  1. recombinant human GH

2. Levothyroxine

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12
Q

What genetic mutation is associated with pituitary dwarfism (therefore hypopituitarism) and hypothyroidism?

A

Pit-1 mutation

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13
Q

Tumor that occurs along pituitary stalk in suprasellar region; associated with panhypopituitarism

A

craniopharyngioma

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14
Q

Potential causes of Hypopituitarism in adults

A

Can be either Hypothalamic or Pituitary

  • ** Tumors (Adenomas, Craniopharyngiomas, metastases)
  • ** ischemic necrosis (apoplexy/sheehan’s)
  • Trauma (brain injury, MVC, radiation, surgery)
  • Infiltration (TB, sarcoid, lymphoma)
  • Genetic mutations* (prop-1 or pit-1)

** more common in adults

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15
Q

1 cause of Hypopituitarism in ADULTS

A

Tumors (non-functioning)

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16
Q

75% of Non-functioning Pituitary Tumors secrete what?

A

alpha-subunit of pituitary glycoprotein hormones, which has no biologic activity

17
Q

Signs/Symptoms of GH deficiency in ADULTS

A
  1. Inc. adipose

2. Reduced strength/muscle mass

18
Q

Signs of FSH/LH deficiency in ADULTS

A

Women:

  1. oligo/amenorrhea
  2. vaginal dryness, hot flashes
  3. Loss of pubic/axillary hair

Men:

  1. loss of libido and ED
  2. Loss of pubic/axillary hair
19
Q

Signs of TSH deficiency (similar to hypothyroidism) in ADULTS

A 
Fatigue
Cold intolerance
Constipation
Dry skin
Hair loss
20
Q

Signs of ACTH deficiency in ADULTS (similar to adrenal insufficiency)

A

Fatigue
Anorexia/Weight loss
Orthostatic hypotension

21
Q

Signs of prolactin deficiency in ADULTS

*usually in postpartum females

A

inability to lactate

22
Q

(darker/lighter) skin complexion is associated with panhypopituitarism

A

lighter

23
Q

Treatments for FSH/LH deficiency in ADULTS

A

Women:

  • Estrogen/Progestin pills/patches
  • LH/FSH injections for fertility

Men:

  • Testosterone gel,patch, etc.
  • LH/FSH injections for fertility
24
Q

Treatment for TSH deficiency in ADULTS

A

Levothyroxine

25
Q

Treatments for ACTH deficiency in ADULTS

A

Hydrocortisone, prednisone, or dexamethaxasone

  • may need to increase with illness/stress
26
Q

Sudden hemorrhage into pituitary gland accompanied by sudden SEVERE HA, DIPLOPIA, and HYPOTENSION

A

pituitary apoplexy

27
Q

Tx for pituitary apoplexy

A

Fluids + glucocorticoids + CV support

Endocrine-Week 1/2 (18 decks)

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