hypopituitarism Flashcards
a majority of cases of hypopituitarism are due to?
pituitary disease >hypothalamic disease > idiopathic
post pregnancy w/ post-partum hemorrhage, inability to lactate or return to normal menses, lethargy, anorexia, weight loss
sheehan’s syndrome
when a pituitary adenoma hemorrhages into itselt
pituitary apoplexy
sudden onset of excruciating pain, diplopia due to pressure on oculomotor nerves
pituitary apoplexy
lymphocytic invasion followed by destruction of pit cells occuring late pregnancy or post-partum
lymphocytic hypophysitis
is primary or secondary empty sella syndrome more commonly assc’d with hypopituitarism?
secondary
low cortisol, low ACTH, does not result in aldosterone deficiency
secondary adrenal insufficiency
does primary or secondary Adrenal insufficiency result in hyperpigmentation?
primary
what is a deficient morning cortisol reading?
under 3
what is a normal morning cortisol?
> 18
tx for ACTH deficiency
hydrocortisone 15-30 mg daily
secondary hypothyroidism presents with ___T4 and ____TSH
low T4, low TSH
tx for TSH deficiency
L-thyroxine
what is unneccesary to measure in secondary hypothyroidism
TSH (it will always be low)
what to measure if woman presents with abnormal menstrual cycles
estradiol, LH, FSH
estradiol, LH, FSH are expected to be _____ in gonadotropin deficiency
low
what is the most common measurement of GH deficiency?
IGF-1
likelihood of deficiencies in panhypopituitarism
GH > LH/FSH > TSH> ACTH
how to tx GH deficiency
recombinant human growth hormone
what are the 2 things that stimulate vasopressin release?
- increase in plasma osmolality
2. decr in plasma volume
where are the V1 receptors?
vasculature
where are the V2 receptors?
renal tubules
stimulation of V1 receptors?
vasoconstriction
stimulation of V2 receptors ____permeability of renal tubules
increases
when to admin desmopressin
if central diabetes insipidis & if urine volumers >4 L /day
desmopressin/ddAVP is specific to what type of receptor?
V2
serum prolactin under 200 = prolactinoma of what size?
under 1 cm
serum prolactin 200-1000 = prolactinoma of what size?
1-2 cm
serum prolactin >1000 = prolactinoma of what size?
> 2 cm
prolactin levels under 100 are caused by stalk compression or prolactinoma?
stalk compression
in prolactinomas, prolactin levels are _____
proportional to size of tumor
