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Endocrinology BRS 2 > Hypo pituitarism > Flashcards

Hypo pituitarism Flashcards

1
Q

Explain the difference between primary and secondary hypothyroidism

A

Primary hypothyroidism- a problem with the thyroid gland itself, e.g autoimmune destruction of the thyroid gland. T3/T4 FALL TSH INCREASES.

Secondary hypothyroidism- a problem with the thyrotrophs in the pituitary. e.g tumor. Can’t make TSH. TSH FALLS T3/T4 FALLS.

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2
Q

Explain the difference between primary and secondary hypoadrenalism.

A

Primary hypoadrenalism- Destruction of the adrenal cortex. Cortisol FALLS, ACTH INCREASES.

Secondary hypoadrenalism. Damage to corticotrophs. Cortisol FALLS, ACTH FALLS.

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3
Q

Explain the difference between primary and secondary hypogonadism
With reference to LH & FSH.

A

Primary hypogonadism- Destruction of testes (eg mumps) or ovaries (eg chemotherapy), Testosterone (men) or oestrogen (women) fall, LH & FSH increase (we don’t measure GnRH but that would also be high).

Secondary hypogonadism- pituitary tumour damaging gonadotrophs
Can’t make LH/FSH
LH/FSH FALL, Testosterone/oestrogen FALL.

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4
Q

Which cause of hypopituitarism is more common, congenital or acquired

A

acquired.

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5
Q

What is total loss of anterior and posterior pituitary function called.

A

Panhypopituitarism

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6
Q

Which hormone producing cell type in the pituitary is most sensitive to radiotherapy

A

GH and gonadotrophins

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7
Q

What is Sheehan’s syndrome

A

Post partum hypo pituitarism secondary to hypotension (caused by post partum haemorrhage)

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8
Q

What is an infarction?

A

Infarction is tissue death caused by a lack of blood supply to the affected area.

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9
Q

What causes sheehans syndrom

A

Pituitary infarction secondary to post partum haemorrage.

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10
Q

What is a pituitary apoplexy.

A

Bleeding into or impaired blood supply to the pituitary gland.

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11
Q

What are some symptoms of a pituitary apoplexy

A

-Severe sudden onset headache
-Visual field defect
-Double vision
-Ptsosis (drooping of the eyelid)

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12
Q

Why do we need to be careful when measuring GH/ACTH levels in people

A

Its release is pulsatile

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13
Q

What can ACTH/GH be classified as

A

Stress hormones

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14
Q

What does GnRH produced by the hypothalamus stimulate the release of

A

LH and FSH

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15
Q

How can hypopituitarism be diagnosed

A

By causing an insulin induced hypoglycaemic state.

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16
Q

What does insulin induced hypoglycaemia stimulate the release of in healthy individuals.

A

Stress hormones, ACTH and GH

17
Q

What radiological investigation can you use to help diagnose hypopituitarism

A

Pituitary MRI

18
Q

What do you check for to measure response to Growth Hormone deficiency treatment.

A

-Improvements to Quality of Life
-Plasma IGF1

19
Q

How is TSH deficiency treated.

A

One daily levothyroxine tablet

20
Q

How do we treat ACTH deficiency.

A

Replace cortisol rather than ACTH

21
Q

What are the two main options in treating ACTH deficiency and how are they taken.

A

Prednisolone- Once daily 3mg
Hydrocortisone- Three times per day 10mg/5mg/5mg

22
Q

Addisons is an example of what kind of adrenal failure

A

PRIMARY

23
Q

ACTH deficiency is an example of what kind of

A

SECONDARY

24
Q

Patients who take replacement steroid e.g prednisolone, hydrocortisone must be told what?

A

Sick day rules

25
Q

3 features of an adrenal crisis

A

ANY 3 FROM
-Dizziness
-Weakness
-Hypotension
-Vomiting

26
Q

How do you treat FSH/LH deficiency in MEN if fertility is NOT required.

A

Replace testosterone

27
Q

How do you treat FSH/LH deficiency in MEN if Fertility IS required.

A

Induce spermatogenesis by gonadotropin injections.

28
Q

How long may it take for sperm production to pick back up after beginning gonadotropin injections.

A

6-12 months

29
Q

How do you treat FSH/LH deficiency in WOMEN if Fertility is NOT required.

A

Replace oestrogen

30
Q

What will need to be taken alongside the oestrogen and why.

A

progestogen (progestorone) to prevent endometrial hyperplasia.

31
Q

How do you treat FSH/LH deficiency in WOMEN if Fertility IS required.

A

Can induce ovulation by carefully timed gonadotropin injections.

Endocrinology BRS 2 (12 decks)

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