Hypopituitarism + tumours Flashcards
Causes of hypopituiatrism
Compression of pituiatry gland - macroadenoma
Pituitary apoplexy
Sheehans syndrome
Hypothakamic disorders eg craniopharyngioma
Trauma
Iatrogenic irradtiation
Infiltractive - haemochromatosis, sarcoidosis
What is sheehans sydnrome
Postpartum pituitary necrosis secondary to pp haemorrhage
What does low ACTH cause
Tiredness
Postural hypotension
What does low FSH/LH cause
Amenorrhea
Inferitility
Loss of libido
What does low TSH cause
Feeling cold
Constipation
Low GH symptoms
Low stature if occurs in childhood
Low prolactin causes
Lactation problems
What does bitemporal hemianopia suggest about cause
Pituitary macroadenoma
What feature suggests pituitary apoplexy
Sudden severe headache
Investigations for hypopituitarism
Hormone profile testing
Imaging
Investigations for hypopituiatrism
basal levels of T4, T3, TSH, prolactin, gonadotrophins, testosterone, cortisol,U+Es (dilutional hyponatraemia), FBC(normochromic normocytic anaemia). Note in hypopituitarism thyroxine is reduced and TSH is reduced or normal
assessment of visual fields
skull radiology
CXR may show signs of a primary tumour that has produced metastases, sarcoidosis or tuberculosis
What is pituitray apoplexy
Bleeding into or imparied blood supply of pituitary gland- suddn enlargemet of adenoma caused by this
Precipitating factors of pituiatry apoplexy
hypertension
pregnancy
trauma
anticoagulation
Features of pituitary apoplexy
Sudden onset headache similar to SAH
vomitting
neck stiffness
bitemporal superior quadrantic defect
Extraocular nerve palsies
Pituitary insufficiency eg hypotension/hyponatremia secondary to hypoadrenalism
What is diagnostic for pituiatry apoplexy
MRI is diagnositc
