Pediatric Panhypopituitarism Flashcards
most common pituitary torpic hormone deficit
GH deficiency
- would result in decreased IGFR-1 and decreased GF
(go look for the adenoma please)
how is bone age affected by GH deficiency
Bone age delayed
When is GH most released?
typically released most over night
key test if you suspect growth hormone deficiency
deficiency = excitatory test needed
therefore do an ITT. Make the person hypoglycemic (with insulin), then see if GH increases
Approved indications for GH treatment in children
- GH deficiency
- Prader Willi Syndrome
- Chronic Renal Failure
- Turner Syndrome
- IUGR
TSH deficiency indicates ____ hypothyroidism
central/secondary hypothyroidism.
how does hypER thyroidism cause acute adrenal insufficiency?
thyroxin/t4 excess can increase cortisol. cortisol negatively feedsback to inhibit the ACTH axis– can cause adrenal insufficiency.
gonadotropin deficiency causes a ___ onset of puberty
delayed
if a child has gonadotropin deficiency resulting in dealyed onset of puberty, what do you expect the LH response to be following GnRH stimulation test?
subnormal LH response.
what do you expect the LH response to be following GnRH stimulation test in someone with Kallmanns syndrome?
gonadotropin deficiency
In ACTH deficiency, resulting in low cortisol, how is sugar level, BP level, sodium levels fet affected? what test would you use to look for this?
ACTH deficinecy= adrenal insufficiency (could be primary or secondary)
- low cortisol = catabolic issues
- HYPOglycemia (recall that excess cortisol can cause hyperglycemia/diabetes)
- hyPOtension
- dilutional hyponatremia because ADH is not suppressed because low cortisol.
- BLUNTED repsonse to ACTH stimulation because the adrenal glands start to atrophy due to previous lack of stimulation. Should do an INSULIN TOLERANCE TEST to confrim
treatment for ACTH deficiency
this is like secondary adrenal insufficiency (will see affects of decreased cortisol and decreased aldosterone)
- hydrocortisone
diabetes insipidus would indicate ___natremia due to ___ deficiency
HYPERNATREMIA because of diabetes insipidus.– peeing out all the water.
this is an instance of combined pituitary hormone deficiency
septo-optic dysplasia trio of pediatric hypopituiarism
hypopituitarism
optic nerve hypoplasia
cerebral dysgenesis
praderwilli H4O
hypophagia
hypomentation
hypogonadism
hypotonia
obestiy
key extragonadal symptoms of kallmman syndrome
Kal mutation results in decreased in GnRH prouction but also with anosmia and microphallus
Recall that laurence-moon-mardet-biedl syndrome is a hypogonadotrophic hypogonadism mthat also results in polydactyli
glioma is a mass associated with panhypopituitarsm, as well as the condition ___ type I
neurofibromatosis
