Brainscape's Knowledge GenomeTM

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


See full index

Endocrinology > Hypopituitarism > Flashcards

Hypopituitarism Flashcards

1
Q

List the anterior pituitary hormones.

A 
growth hormone (somatotrophin)
prolactin
ACTH (corticotrophin)
FSH/LH
TSH (thyrotrophin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How do hypothalamic releasing/inhibitory factors travel to the anterior pituitary?

A

via portal circulation

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

What is the main difference between primary and secondary hypothyroidism?

A 
primary = failure/loss of function of the thyroid gland 
secondary = failure of hypothalamus/anterior pituitary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name a cause of primary thyroidism.

A

autoimmunity

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

Name a cause of secondary hypothyroidism.

A

pituitary tumour damaging thyrotrophs

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

Describe levels of TSH, T3 and T4 in primary hypothyroidism.

A

TSH high

T3/4 low

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

Describe levels of TSH, T3 and T4 in secondary hypothyroidism.

A

TSH can’t make it/falls

T3/4 low

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

Describe levels of ACTH and cortisol in primary hypoadrenalism.

A

ACTH increase

cortisol falls

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

Describe levels of ACTH and cortisol in secondary hypoadrenalism.

A

ACTH falls

cortisol falls

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

Describe levels of FSH/LH and testosterone/ oestrogen in primary hypogonadism.

A

FSH/LH high

testosterone/oestrogen low

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

Describe levels of FSH/LH and testosterone/ oestrogen in secondary hypogonadism.

A

FSH/LH low

testosterone/oestrogen low

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

What are congenital causes of hypopituitarism?

A

mutations of transcription factor genes needed for normal anterior pituitary development e.g. PROP 1 mutation

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

List acquired causes of hypopituitarism.

A 
Tumours
Radiation
Infection
Traumatic brain injury
Pituitary surgery
Inflammation
Pituitary apoplexy
Peripartum infarction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the term that describes the total loss of anterior and posterior pituitary function?

A

Panhypopituitarism

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

What affect does radiotherapy have on the pituitary?

A

Direct > acromegaly

Indirect > nasopharyngeal carcinoma

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

Which anterior pituitary cells are most sensitive to radiotherapy?

A

Gonadotrophs

17
Q

List some presentations of hypopituitarism.

A

Reduced libido, erectile dysfunction, secondary amenorrhea
Fatigue
Reduced quality of life (short stature in children)
Inability to breastfeed

18
Q

Explain the pathophysiology of Sheehan’s syndrome.

A

Hypotension in pregnancy / post partum haemorrhage > damage to pituitary > deficiency in pituitary hormones

19
Q

Describe presentation of Sheehan’s syndrome.

A

Lethargy, anorexia, weight loss, failure of lactation, failure to resume menses post delivery

20
Q

What is a pituitary apoplexy?

A

Intra pituitary haemorrhage or infarction

21
Q

Pituitary apoplexy can be precipitated by?

A

Anti coagulants

22
Q

Pituitary apoplexy presents as?

A

Severe sudden onset headache, visual field defect (compressed optic chiasm > bitemporal hemianopia), cavernous sinus involvement may lead to diplopia, ptosis

23
Q

When using biochemical means to diagnose hypopituitarism you should take caution because?

A

Cortisol - what of time of day?
T4 - circulating time of 1/2 6 days
FSH/LH cyclical in women
GH/ACTH pulsatile

24
Q

What would you see on a MRI of someone with hypopituitarism?

A

May be haemorrhage, adenoma, empty sella

25
Q

Treatment of GH deficiency?

A

Daily injection of genotropin

Measure response by: improvement in QoL, plasma IGF-1

26
Q

Treatment of TSH deficiency?

A

Replace with levythyroxine, (aim for a fT4 above the middle of the reference range)

27
Q

Treatment of ACTH deficiency?

A

Replace cortisol

Synthetic glucocorticoids to mimic diurnal variation: prednisolone once daily AM, hydrocortisone 3x daily

28
Q

Patients with ACTH deficiency are at risk of ‘………’ triggered by intercurrent illness.

A

Adrenal crisis

29
Q

Features of adrenal crisis?

A 
Dizziness
Hypotension 
Vomiting
Weakness
Can result in collapse and death
30
Q

What are sick day rules for those that take replacement steroid e.g. prednisolone, hydrocortisone?

A

Steroid alert pendant/bracelet
Double steroid dose if fever/intercurrent illness
Unable to take tablets, inject IM or come straight to A&E

31
Q

Describe the treatment of FSH/LH deficiency in men (no fertility required).

A

Replace testosterone
Measure plasma testosterone
(This doesn’t restore sperm production)

32
Q

Describe the treatment of FSH/LH deficiency in men (fertility required).

A

Induction of spermatogenesis by gonadotrophin injections (best response if develops after puberty)
Measure testosterone/semen analysis
Sperm production may take 6-12 months

33
Q

Describe the treatment of FSH/LH deficiency in women (no fertility required).

A

Replace oestrogen

Additional progestogen if intact uterus to prevent endometrial hyperplasia

34
Q

Describe the treatment of FSH/LH deficiency in women (fertility required).

A

Can induce ovulation by carefully timed gonadotrophin injections (IVF)

Endocrinology (15 decks)

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