Hypopituitarism Flashcards
(22 cards)
Anterior pituitary hormone pathway
Hypothalamus–>
stalk–>
hypophyseal portal veins–>
anterior pituitary
GH production pathway
GHRH/somatosatin–>
somatotrophs–>
GH–>
growth (somatostatin/IGF-1)
Prolactin production pathway
Dopamine–>
Lactotrophs–>
Prolactin–>
lactation
TSH production pathway
TRH–>
Thyrotrophs–>
TSH–>
T3/T4
LH/FSH production pathway
GRH–>
Gonadotrophs–>
LH/FSH–>
Oestrogen/progesterone/testosterone
ACTH production pathway
CRH–>
Corticotrophs–>
ACTH–>
Cortisol
T3/T4 during primary hypothyroidism
Low
TSH during primary hypothyroidism
Increases
T3/T4 during secondary hypothyroidism
Decreases
TSH during secondary hypothyroidism
Low
Cortisol during primary hypoadrenalism
Low
ACTH during primary hypoadrenalism
Increases
Cortisol during secondary hypoadrenalism
Decreases
ACTH during secondary hypoadrenalism
Low
Testosterone/oestrogen during primary hypogonadism
Low
LH/FSH during primary hypogonadism
Increases
Testosterone/oestrogen during secondary hypogonadism
Decreases
LH/FSH during secondary hypogonadism
Low
Congenital cause of hypopituitarism (rare)
Mutation of transcription factors (PROP1)
- GH deficiency + at least one more AP hormone
- Short stature
- Hypoplastic AP on MRI
Causes of primary hypogonadism
Mumps (testes), chemo (ovaries)
Acquired causes of hypopituitarism (8)
- Tumours (adenoma, metastases, cysts)
- Radiation (hypothalamic/pituitary)
- Infection (meningitis)
- Traumatic brain injury
- Pituitary surgery
- Hypophysitis
- Pituitary apoplexy
- Peri-partum infarction
Total loss of anterior + posterior pituitary function is called
Panhypopituitarism
hypophysitis/surgery
