Hypopituitarism (unfinished)

Question 1

hypopituitarism

Answer 1

decreased secretion of anterior pitutiary hormones

can be selective or multiple

Question 2

is the loss of anterior pituitary function progressive or fixed?

Answer 2

generally progressive

in this order: GH, gonadotrophins: FSH and LH, PRL, TSH, ACTH

Question 3

pan hypopituitarism

• define
• commonly caused by

Answer 3

deficiency of all anterior pituitary hormones

most commonly caused by pituitary tumours, surgery or radiotherapy

Question 4

what can infiltration of sarcoidosis in the pituitary cause

Answer 4

hypopituitarism

Question 5

Sheehan’s syndrome

Answer 5

post-partum pituitary gland necrosis

ischaemic necrosis of the pituitary gland due to blood loss and hypovolaemic shock during/after childbirth

can present as eg postural hypotension due to decreased cortisol (ACTH)

Question 6

what is the most resistant axis of HPA

Answer 6

ACTH - damaged last

Question 7

management

Answer 7

hormone replacement therapy and treatment of underlying cause

Question 8

which hormone must be replaced first

Answer 8

hydrocortisone

Question 9

what may glucocorticoid deficiency mask

Answer 9

urine concentrating ability - diabetes insipidus

Question 10

what are the risks of testosterone replacement

Answer 10

prostate enlargemnent - monitor with a PR exam and PSA test

polycythaemia (too many RBC) - risk of stroke and heart attacks

hepatitis with oral tablets