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#Phase 2.1: GI > Hypopituitarism > Flashcards

Hypopituitarism Flashcards

1
Q

What is Hypopituitarism?

A

Reduced secretion of Ant pituitary hormones

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2
Q

What is the order Ant pituitary hormones are affected in in Hypopituitarism? (5 things)

A
  1. Growth Hormone (GH)
  2. Gonadotropins (FSH + LH)
  3. TSH
  4. ACTH
  5. Prolactin
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3
Q

What is Panhypopituitarism?

A

Deficiency of ALL Ant pituitary hormones

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4
Q

What is Panhypopituitarism caused by? (3 things)

A
  1. Irradiation
  2. Surgery
  3. Pituitary tumour
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5
Q

The causes of Hypopituitarism are at 3 levels, what are they?

A
  1. Hypothalamus
  2. Pituitary stalk
  3. Pituitary
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6
Q

What are the causes of Hypopituitarism @ the level of Hypothalamus? (5 things)

A
  1. Kallman’s syndrome
  2. Tumour
  3. Inflamm
  4. Infection (Meningitis / TB)
  5. Ischaemia
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7
Q

What are the causes of Hypopituitarism @ the level of Pituitary Stalk? (5 things)

A
  1. Trauma
  2. Surgery
  3. Mass lesion (Craniopharyngioma)
  4. Meningioma
  5. Carotid artery aneurysm
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8
Q

What are the causes of Hypopituitarism @ the level of Pituitary? (6 things)

A
  1. Tumour
  2. Irradiation
  3. Inflamm
  4. AI
  5. Infiltration (Haemochromatosis / Amyloid / Metastases)
  6. Ischaemia
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9
Q

What are the CF of low Growth Hormone in ADULTS? (4 things)

A
  1. Low bone density
  2. Muscle atrophy
  3. Dyslipidaemia
  4. Central obesity
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10
Q

What is Dyslipidaemia? (2 things)

A
  1. High levels of LDL (bad cholesterol)
  2. Low levels of HDL (good cholesterol)
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11
Q

What are the CF of low Growth Hormone in CHILDREN? (2 things)

A
  1. Short stature
  2. Growth retardation
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12
Q

What are the CF of low Gonadotropins (FSH / LH) in WOMEN? (5 things)

A
  1. Reduced libido
  2. Breast atrophy
  3. Osteoporosis
  4. Oligomenorrhoea / amenorrhoea
  5. Infertility
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13
Q

What are the CF of low Gonadotropins (FSH / LH) in MEN? (4 things)

A
  1. Reduced libido
  2. Reduced muscle mass
  3. Erectile dysfunction
  4. Small testes
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14
Q

What are the CF of low TSH? (6 things)

A

Hypothyroidism symptoms

  1. Fatigue
  2. Dry skin
  3. Delayed deep tendon reflexes
  4. Constipation
  5. Cold intolerance
  6. Bradycardia
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15
Q

What are the CF of low ACTH? (5 things)

A

Adrenal insufficiency symptoms

  1. Malaise
  2. N + V
  3. Circulatory collapse
  4. Hypoglycaemia
  5. Weight loss

Note: NO hyperpigmentation like in adrenal insufficiency

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16
Q

What are the CF of low Prolactin? (1 thing)

A

Absent lactation

17
Q

What investigations should you do for sus Hypopituitarism? (3 things)

A
  1. Basal tests
  2. Dynamic tests
  3. MRI
18
Q

What Basal tests should you do for sus Hypopituitarism? (8 things)

A
  1. LH + FSH
  2. Testosterone / Oestradiol
  3. TSH / T4
  4. Prolactin
  5. Insulin-like Growth Factor-1
  6. Cortisol (low)
  7. UnEs (Low Na bc dilution)
  8. Hb (Low = normochromic, normocytic anaemia)
19
Q

What Dynamic tests should you do for sus Hypopituitarism? (4 things)

A
  1. Short Synacthen test (to check adrenal axis)
  2. Insulin tolerance test (ITT) (to check adrenal + GH axes)
  3. Glucagon stimulation test if ITT contraindicated
  4. Arginine + growth hormone-releasing hormone test
20
Q

What is the use of a MRI in sus Hypopituitarism?

A

To investigate cause (hypothalamic / pituitary lesion)

21
Q

How should you manage a Hypopituitarism? (3 things)

A

Refer to Endocrinologist to:

  1. Pituitary function assessment
  2. Oversee hormone replacement
  3. Treat underlying cause
22
Q

What is the hormonal treatment for 2ndary Adrenal failure?

A

Hydrocortisone

23
Q

What is the hormonal treatment for Hypothyroidism?

A

Thyroxine

24
Q

What is the hormonal treatment for Hypogonadism in MEN? (3 things)

A
  1. Testosterone enanthate
  2. Topical gels
  3. Buccal mucoadhesive tablets
25
Q

What is the hormonal treatment for Hypogonadism in WOMEN? (3 things)

A
  1. Oestrogen: Transdermal oestradiol patches / OCP
  2. Testosterone
  3. DeHydropEpiAndrosterone (DHEA) (for hypoandrogenic women)
26
Q

What is the hormonal treatment for infertility caused by Hypogonadism?

A

Gonadotropin therapy

27
Q

What is the hormonal treatment for Low Growth Hormone?

A

Somatotropin (mimics human GH)

28
Q

What problems does Somatotropin (treatment for Low GH) solve? (5 things)

A
  1. Low fat mass
  2. Low bone mass
  3. Low muscle mass
  4. Low exercise capacity
  5. Heat intolerance problems

#Phase 2.1: GI (29 decks)

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