Brainscape's Knowledge GenomeTM

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


See full index

Endo > Hypopituitarism > Flashcards

Hypopituitarism Flashcards

1
Q

What is the function of the hypothalamus in the
endocrine system?

A

Regulating the release of hormones from the pituitary gland - control other endocrine glands

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

What is the difference between primary and
secondary hypopituitarism?

A

1° Hypopit - dysfunction of pituitary gland
2° Hypopit - dysfunction of the hypothalamus

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

What is Sheehan’s syndrome?

A

Condition where pituitary gland is damaged due to severe bleeding in childbirth

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

What is the function of growth hormone?

A

aka somatotrophin
stimulates growth and cell reproduction

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

What is the function of TSH?

A

aka thyrotrophin
stimulates thyroid to produce hormones

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

What is the function of LH and
FSH?

A

regulates the reproductive system

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

What is the function of ACTH?

A

aka corticotrophin
stimulates release of cortisol, hormone that helps with stress

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

What is the hypothalamo-pituitary portal system?

A

Specialised network of blood vessels connecting hypothalamus and pituitary, allows transport of hormones

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

What is the function of the
hypothalamo-pituitary portal system?

A

Stimulatory/ inhibitory factors travel in portal circulation to anterior pituitary.

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

Anterior pituitary hormones

A

GH, ACTH, LH, TSH, FSH, Prolactin

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

What are the causes of
anterior pituitary failure?

A

1° disease - gland itself fails
2° disease - no signals from hypothalamus or anterior pituitary

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

What are the clinical features
of primary hypothyroidism?

A

T3 and T4 levels fall,
while TSH levels increase.

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

What are the clinical features
of secondary hypothyroidism?

A

TSH levels fall due to
pituitary tumor damaging thyrotrophs, leading to a
decrease in T3 and T4 levels.
Treated with levothyroxine, dose adj to fT4

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

Primary hypoadrenalism

A

destruction of adrenal cortex (e.g. autoimmune)
cortisol falls, ACTH rises

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

Secondary hypoadrenalism

A

pituitary tumour damaging corticotrophs
Can’t make ACTH
ACTH falls, cortisol falls
treated with glucocorticoid replacement (prednisolone/hydrocortisone)

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

Primary hypogonadism

A

destruction of testes (mumps) or ovaries (chemotherapy)
Testosterone/oestrogen fall, LH & FSH increase (we don’t measure GnRH but that
would also be high)

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

Secondary hypogonadism

A

pituitary tumour damaging gonadotrophs
LH/FSH fall, Testosterone/oestrogen fall
management depends on whether restoration of fertility is needed

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

What are the causes of congenital hypopituitarism?

A

usually due to
mutations of transcription factor genes needed for
normal anterior pituitary development.

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

What are the 8 acquired causes of hypopituitarism?

A

TTRIIPSS: tumour, trauma, radiotherapy, infection, inflammation (hypophysitis), pituitary apoplexy, surgery, sheehan’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the clinical features of congenital
hypopituitarism?

A

short stature and hypoplastic
(underdeveloped) anterior pituitary gland on MRI.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the clinical features of acquired
hypopituitarism?

A

may include fatigue,
weight loss, decreased libido, infertility, menstrual
irregularities, and cold intolerance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is panhypopituitarism?

A

Total loss of anterior and posterior pituitary function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What may cause posterior pituitary dysfunction?

A

Certain processes, especially inflammation (hypophysitis) or surgery.

24
Q

What is radiotherapy-induced
hypopituitarism?

A

pituitary and hypothalamus are both sensitive to radiation.
prod pituitary/CNS tumour
The higher the radiotherapy dose (Gy), the higher the risk of HPA axis damage
GH and gonadotrophins most sensitive
Risk persists up to 10yrs post radiotherapy .: annual assessment needed

25
Q

Name a cause of anterior
pituitary damage (hypopituitarism).

A

radiotherapy, inflammation, or
surgery

26
Q

What are the clinical features
of hypopituitarism related to FSH/LH?

A

Reduced libido, secondary amenorrhea, erectile
dysfunction, and reduced pubic hair

27
Q

What are the clinical features
of hypopituitarism related to ACTH?

A

Fatigue
Not a salt-losing crisis
(renin-angiotensin).

28
Q

What are the clinical features
of hypopituitarism related to TSH?

A

Fatigue

29
Q

What are the clinical features
of hypopituitarism related to GH?

A

Reduced quality of life and short stature (only in
children)

30
Q

What are the clinical features
of hypopituitarism related to PRL?

A

Inability to breastfeed

31
Q

Sheehan’s syndrome?

A

Post partum bleeding -> hypotension -> pituitary infarction
lactotroph hyperplasia in pregnancy (larger anterior pituitary)

32
Q

What are the clinical features of Sheehan’s
syndrome?

A
  • lethargy, anorexia, weight loss (TSH, ACTH,GH deficiency)
  • failure of lactation (PRL deficiency)
  • amenorrhea post delivery (LH/FSH)
33
Q

What is the treatment for Sheehan’s syndrome?

A

HRT

34
Q

What is the best radiological way to visualize the
pituitary gland?

A

MRI

35
Q

What is pituitary apoplexy?

A

Haemorrhage into pituitary gland
sometimes due to blood thinners

36
Q

What are the clinical features of pituitary apoplexy?

A

severe sudden onset headache
bitemporal hemianopia
diplopia (double vision)
ptosis (droopy eyelid)
visual field defect
cavernous sinus involvement

37
Q

What is the treatment for pituitary apoplexy?

A

HRT and sometimes surgery

38
Q

Why does Sheehan’s syndrome not affect posterior pituitary function?

A

Blood supply for posterior pituitary is from a different pathway (neuronal), is not affected
High intravascular blood pressure .: protected against hypotension

39
Q

What are 3 of the other potential differential diagnoses for someone you suspect has Sheehan’s syndrome?

A

Anaemia (blood loss), Post-natal depression, Primary hypothyroidism

40
Q

What are 7 questions you would ask someone who you suspect has Sheehan’s syndrome?

A

history of depression, breastfeeding specifics, weight loss, visual problems, previous thyroid problems, family history, medication history (dopamine antagonists)

41
Q

What should be considered as a reason for pituitary apoplexy?

A

pituitary adenoma

42
Q

Why is caution needed when interpreting basal
plasma hormone concentrations for
hypopituitarism?

A

Cortisol levels vary depending on the time of day,
T4 has a circulating half-life of 6 days,
FSH/LH are
cyclical in women,
GH/ACTH are pulsatile.

43
Q

What is the dynamic pituitary function test for
diagnosing hypopituitarism?

A

ACTH and GH are stimulated by hypoglycaemia, measure IGF1.

44
Q

What 3 specific things may be found in hypopituitarism MRI?

A

Haemorrhage, Adenoma, Empty Sella Turcica

45
Q

How would you treat GH deficiency and why is it complicated?

A

Daily injection of GH, measure QoL and plasma IGF-1 // not essential - depends on QoL and expense

46
Q

How would you treat TSH deficiency?

A

Levothyroxine (T4), treat above middle ref range

47
Q

How would you treat ACTH?

A

Corticosteroids: Prednisolone (once daily - high cortisol and drops) or Hydrocortisone (3x daily - spikes of cortisol - short half life)

48
Q

What do ACTH steroid users report as a side effect?

A

Very low mood in the morning (low cortisol - tablet wears off)

49
Q

What is the risk of adrenal crisis for patients with
primary or secondary adrenal failure?

A

Patients with primary or secondary adrenal failure
are at risk of adrenal crisis triggered by intercurrent
illness.

50
Q

What risk do ACTH steroid users have to be aware of?

A

Adrenal Crisis, aka sick day rules: wear steroid user pendant, double dose of glucocorticoid, go to A&E

51
Q

What are the features of adrenal crisis?

A

Adrenal crisis features include dizziness, hypotension, vomiting, weakness, and can result in
collapse and death.

52
Q

How would you treat FSH/LH deficiency in men?

A

If fertility is not an issue - testosterone //
If fertility is important - gonadotrophin injections to induce spermatogenesis (6-12 months)

53
Q

Does replacing testosterone restore sperm
production?

A

No, as this is dependent on FSH.

54
Q

How would you treat FSH/LH deficiency in women?

A

If fertility is not important, oral oestrogen medication (HRT) //
If fertility is important then gonadotrophin injections aka IVF

55
Q

What two hormones are in HRT?

A

Oestrogen and Progesterone (to avoid endometrial hyperplasia secondary to oestrogen dose)

56
Q

Why is HRT given instead of oral contraceptives?

A

Oral contraceptives is a high unregulated oestrogen dose, HRT is a physiological level dose and has progesterone to avoid endometrial hyperplasia

Endo (13 decks)

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