24.) Hypopituitarism Flashcards
(27 cards)
What is hypopituitarism?
Hypopituitarism refers to the inadequate production of one or more anterior pituitary hormones due to damage to the pituitary gland and/or hypothalamus.
What hormones are affected in hypopituitarism?
Affected hormones include growth hormone (GH), prolactin, thyroid stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), follicle stimulating hormone (FSH), and luteinizing hormone (LH).
What is the most common cause of hypopituitarism?
The most common cause is a hypothalamic or pituitary tumor (adenoma).
What are other causes of hypopituitarism?
Other causes include genetic & congenital factors, radiation therapy, Sheehan syndrome, infiltrative processes (e.g., sarcoidosis, hemochromatosis), and head trauma.
What are the clinical features of GH deficiency?
Clinical features include growth failure in kids, high LDL, increased risk of heart disease, and decreased bone density.
What is the clinical feature of prolactin deficiency?
The clinical feature is failure to lactate.
What is the clinical feature of ACTH deficiency?
The clinical feature is adrenal insufficiency (hypocortisolism).
What is the clinical feature of TSH deficiency?
The clinical feature is hypothyroidism, which can cause growth retardation in children.
What are the clinical features of gonadotropin deficiency?
Clinical features include infertility, amenorrhea, loss of secondary sex characteristics, and diminished libido.
What is the clinical feature of ADH deficiency?
The clinical feature is diabetes insipidus.
How is hypopituitarism diagnosed?
Diagnosis involves testing each hormone deficiency individually.
What are the diagnostic tests for GH deficiency?
Tests include decreased IGF-1 levels and decreased GH levels even after administering arginine and exogenous GHRH.
What are the diagnostic tests for TSH deficiency?
Tests include decreased T3, decreased T4, and decreased or normal TSH.
What are the diagnostic tests for gonadotropin deficiency in men?
Tests show low or normal LH that does not increase after GnRH stimulation test and low testosterone.
What are the diagnostic tests for gonadotropin deficiency in females?
Tests show low FSH, low LH, no increase after GnRH stimulation test, and low estradiol.
What rules out gonadotropin deficiency in females?
A regular menstruation cycle rules out gonadotropin deficiency.
What is the diagnostic test for ADH deficiency?
The test shows urine osmolarity below 300, even after water deprivation.
What imaging is used for diagnosing hypopituitarism?
MRI of the brain is used, but it may miss microadenomas.
What is the treatment for hypopituitarism?
Treatment includes addressing the underlying cause and hormone replacement therapy.
What is the treatment for GH deficiency in children?
GH replacement is required in children but not in adults.
What is the treatment for TSH deficiency?
Administration of levothyroxine is the treatment.
What is the treatment for ACTH deficiency?
Glucocorticoid replacement therapy is the treatment.
Hydrocortisone 15-25 mg per day divided into 2–3 doses.
What is the treatment for GnRH deficiency in males if fertility is desired?
Exogenous gonadotropins (e.g., HCG) are used if fertility is desired.
What is the treatment for GnRH deficiency in males if fertility is not desired?
Testosterone replacement therapy is used if fertility is not desired.
