Hypopituitarism

Question 1

What is hypopituitarism?

Answer 1

Refers to decreased secretion of pituitary hormones

Question 2

Hypopituitarism can result from diseases of which organs?

Answer 2

Hypothalamus of the pituitary

Question 3

With hypopituitarism, when will hypofunction of the anterior pituitary occur?

Answer 3

When approximately 75% of the parenchyma is lost or absent

Question 4

What are four common etiologies of pituitary hypofunction?

Answer 4

• Tumors and other mass lesions
• Pituitary surgery or radiation: iatrogenic
• Pituitary apoplexy (lack of blood flow)
• Ischemic necrosis of the pituitary and Sheehan syndrome

Question 5

What is Sheehan syndrome?

Answer 5

Complication of labor and delivery; blood loss with blood pressure drop

Question 6

Name four syndromes of hypopituitarism

Answer 6

1. Panhypopituitarism
2. Dwarfism
3. Hypogonadism
4. Empty sella syndrome

Question 7

What is panhypopituitarism?

Answer 7

Global decrease in all pituitary hormones

Question 8

What is the etiology of dwarfism?

Answer 8

Decreased growth hormone or insensitivity

Question 9

Which hormones are decreased with hypogonadism?

Answer 9

Gonadotropins (FSH/LH)

Question 10

What atrophies with hypogonadism?

Answer 10

Testicular/breast atrophy

Question 11

What are the two types of hypogonadism?

Answer 11

Congenital vs acquired

Question 12

What are two examples of congenital hypogonadism?

Answer 12

• Kallmann syndrome
• Prader-Willi syndrome

Question 13

What are three examples of acquired hypogonadism?

Answer 13

• Pituitary tumor
• Steroid abuse
• Testosterone replacement therapy

Question 14

Testosterone acts as ___ feedback to the hypothalamus and anterior pituitary

Answer 14

negative feedback

Question 15

Kallmann syndrome is a genetic condition resulting in the failure to…

Answer 15

trigger puberty

Question 16

Which sexes can experience Kallmann syndrome?

Answer 16

Both males and females

Question 17

Kallmann syndrome involves hypogonadotropic hypogonadism, which is failure to produce ___

Answer 17

GnRH (less LH/FSH, no secondary sex characteristics)

Question 18

50% of those with Kallmann syndrome display ___

Answer 18

anosmia

Question 19

Are those with Kallmann syndrome fertile?

Answer 19

No

Question 20

Kallmann syndrome involves ___ defects
What is an example?

Answer 20

midline defects
ie. cleft lip/palate

Question 21

Prader-Willi syndrome is hypogonadism with a possible ___ deficit

Answer 21

growth hormone

Question 22

What are some physical characteristics of someone with Prader-Willi syndrome?

Answer 22

• Low muscle tone
• Short stature
• Incomplete sexual development
• Chronic feeling of hunger that can lead to excessive eating and life-threatening obesity
• Cognitive disabilities/low IQ

Question 23

Kallmann syndrome and Prader-Willi syndrome can be confused with ___

Answer 23

Turner’s syndrome

Question 24

Empty sella syndrome is the radiologic term for a…

Answer 24

enlarged sella containing a thin, fattened pituitary at the base

Question 25

What is the etiology of empty sella syndrome?

Answer 25

Congenitally defective or absent diaphragma sella, which permits transmission of cerebrospinal fluid pressure into the sella

Question 26

Empty sella syndrome causes various degrees of…

Answer 26

pituitary dysfunction and endocrine abnormalities

Question 27

Empty sella syndrome causes endocrine disturbances including:

Answer 27

• Hyperprolactinemia
• Oligomenorrhea or amenorrhea
• Frank hypopituitarism
• Acromegaly
• Diabetes insipidus
• Cushing syndrome

Question 28

From what radiologic view is empty sella syndrome visible?

Answer 28

Lateral view of head