36. Hypopituitarism Flashcards Preview

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Flashcards in 36. Hypopituitarism Deck (15):
1

definition

pituitary gland either fails to produce one or more of its hormones or doesn't produce enough of them

2

treatment

hormone replacement therapy ( corticosteroids, thyroxine, sex, steroids, human GH, sex steroids)

3

hypopituitarism is due to

1. nonsecreting adenoma
2. craniopharyngioma
3. Sheehah syndrome
4. Empty sella syndrome
5. Pituitary apoplexy
6. Brain injury
7. Radiation

4

Sheehah syndrome - definition

ischemic infarct or pituitary following postpartum bleeding

5

Sheehah syndrome - usually present with ( clinically )

1. failure to lactate
2. absent menstruation
3. cold intolerance

6

empty sella syndrome - definition

atrophy or compression gland

7

often cause of empty sella syndrome

idiopathic
common in obese women

8

Empty sella syndrome is common in

obese women

9

Sheehah syndrome - mechanism

pregnancy --> increased in number of prolactin secreting cells --> increased size of pituitary --> not increased in blood flow --> if blood flow compromised ( hypotension associated with obstetrical hemorrhage ---> necrosis of gland

10

Empty sella syndrome - mechanism

incompetent diaphragm sella that allow herniation of arachnoid into the sella turcica --> atrophy of the gland

11

pituitary apoplexy - definition / presentation

sudden hemorrhage of pituitary gland, often in the presence of an existing
pituitary adenoma. Usually presents with sudden onset severe headache, visual impairment (eg,
bitemporal hemianopia, diplopia due to CN III palsy), and features of hypopituitarism.

12

• A woman who had a severe hemorrhage during her recent delivery cannot breastfeed her newborn and feels cold all the time. Pathophysiology?

Sheehan syndrome (an ischemic infarction of the pituitary after postpartum bleeding that causes hypopituitarism)

13

• Name seven causes of hypopituitarism.

Nonsecreting pituitary adenoma, craniopharyngioma, Sheehan syndrome, empty sella syndrome, brain injury or hemorrhage (apoplexy), radiation

14

• After head trauma a woman has sudden-onset cold intolerance, amenorrhea, low blood pressure, and fatigue. How can you treat her?

Hormone replacement therapy: corticosteroids, thyroxine, sex steroids, and human growth hormone (this is hypopituitarism)

15

• A woman with bitemporal hemianopsia is suddenly hypotensive and hypoglycemic. What is the cause of her condition?

Pituitary apoplexy (sudden hemorrhage of the pituitary gland resulting in hypopituitarism, often in the setting of a pituitary adenoma)