Hypopituitarism Flashcards
What are the anterior pituitary hormones?
What cells create each of these?
Somatotrophs-GH
Gonadotrphs-FSH/LH
Thyrotrophs-TSH
Corticotrophs-ACTH
Lactotrophs-PROLACTIN
What is the term used for total loss of anterior and posterior pituitary function?
Panhypopituitarism
What is radiotherapy induced hypopituitarism?
What pituitary cells are affected most?
Radiotherapy can damage HPA axis
especially GH and gonadotrophs
What is Sheehan’s syndrome?
What are its symptoms?
Does it affect the posterior pituitary?
Post partum hypopituitarism due to hypotension (haemorrhage)
Lethargy, anorexia, weight loss, TSH/ACTH/GH deficiency
Failure to lactate
No resume of post menses
No because posterior pituitary has a neural pathway not circular
What is pituitary apoplexy and how does it present?
Bleeding into pituitary usually due to tumour
Severe onset headache
bitemporal hemianopia
diplopia, ptosis
How is GH, TSH and ACTH deficiency treated?
GH- daily injection- check via IGF-1 plasma levels
TSH-levothyroxine
ACTH-Prednisolone or Hydrocortisone
How is FSH/LH deficiency treated in both men and women?
Comment on the difference in treatment between fertile and non fertile
Men- topical testosterone IF FERTILITY IS OK, if not then inject gonadotrophins
Women-oral oestrogen IF FERTILITY IS OK, if not then IVF
What is the issue with prolactin deficiency?
Prolactin cannot be replaced
What scan is best for a pituitary image?
Pituitary MRI
What are the sick day rules for patients with ACTH deficiency?
Steroid bracelet
Double glucocorticoid dose NOT mineralcorticoid if becomes unwell
If unable to take drug inject intravenously or go to A&E
What are the 8 acquired causes of hypopituitarism?
TTRIIPSS:
Tumour
Trauma
Radiotherapy
Infection
Inflammation (hypophysitis)
Pituitary apoplexy
Surgery
Sheehans
What might you see in a hypopituitarism MRI?
Empty sella turcica
Adenoma
Haemorrhage
