Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endo yr 2 > hypopituitarism > Flashcards

hypopituitarism Flashcards

1
Q

hormones secreted by anterior pituitary

A

growth hormone, prolactin, LH, FSH, TSH, ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hormone stimulated by growth hormone

A

somatotrophin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

hormone stimulated by TSH

A

thyrotrophin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

hormone stimulated by ACTH

A

corticotrophin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what happens to pituitary during pregnancy?

A

anterior pituitary (specifically lactotroph ) gets bigger (hyperplasia) and blood supply doesn’t grow accordingly (increased risk when trauma ect.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how does hypothalamus communicate with anterior pituitary?

A

portal circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the only anterior pit hormone regulated negatively (inhibited) and by what hormone?

A

prolactin by dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is primary vs secondary gland failure?

A

gland fails: primary, pituitary or hypothalamus fails; secondary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

give most common cause of primary and secondary gland failure

A

1: autoimmune (last year) , 2: tumour in pituitary or hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what happens to TSH and t3 / t4 levels in primary hypothyroidism?

A

TSH goes up and t3/t4 goes down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is TRH and where is it released from?

A

thyrotropin releasing hormone from hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what happens to TSH and t3 / t4 levels in secondary hypothyroidism?

A

tsh goes down and t3 t4 also go down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

which hormone(s) stimulates cortisol?

A

ACTH from pituitary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what happens to aldosterone levels in primary and secondary hypoadrenalism?

A

not affected because aldosterone is stimulated by renin-angiotensin NOT from pituitary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is primary hypoadrenalism also known as?

A

adisons disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

most common cause of primary hypoadrenalism

A

autoimmune

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what happens in primary hypoadrenalism

A

destruction of adrenal cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what happens to cortisol and ACTH levels in primary hypoadrenalism?

A

acth up and cortisol down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what happens to cortisol and ACTH levels in secondary hypoadrenalism?

A

both down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

most common cause of secondary hypoadrenalism

A

pituitary tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

common cause of primary hypogonadism in females

A

chemotherapy causing destruction of ovaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

common cause of primary hypogonadism in males

A

mumps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

levels of LH, FSH, testosterone, oestrogen in secondary hypogonadism

A

all down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

causes of hypopituitarism

A

congenital or acquired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

is congenital or acquired hypopituitarism more common?

A

acquired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

problem behind congenital hypopituitarism?

A

mutations of transcription factor genes needed for anterior pituitary development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what hormonal and growth deficiencies are seen in congenital hypopituitarism?

A

GH and at least 1 more anterior pit hormone and short stature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is seen on MRI of hypopituitarism

A

hypoplastic (underdeveloped) anterior pituitary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

does the term hypopituitarism more commonly refer to anterior dysfuncrtion, posterior or both?

A

usually anterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

in what cases does hypopituitarism also affect the posterior pituitary? (and so in these cases the term is used for that posterior dysfunction too)

A

inflammation (hypophysitis) or surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is total loss of anterior and posterior pit function?

A

panhypopituitarism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

WHAT ARE 8 causes of acquired hypopituitarism?

A

Tumours eg adenomas, metastases, cysts
Radiation (hypothalamic/pituitary damage)
Infection eg meningitis
Traumatic brain injury
Pituitary surgery
Inflammatory (hypophysitis)
Pituitary apoplexy - haemorrhage (or less commonly infarction)
Peri-partum infarction (Sheehan’s syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what parts of the HPA axis are sensitive to radiotherapy?

A

hypothalamus and pituitary

34
Q

what pituitary cells and equivalent hormone are most sensitive to radiotherapy?

A

GH and gonadotrophin

35
Q

what do doctors need to do when giving radiotherapy to ensure HPA axis health and why?

A

annual assessment for up to 10 years later bc radiotherapy kills DNA so rapidly growing cells die fast but slow growing cells: brain cells so pituitary cells may take up to 10 yrs

36
Q

FSH LH related presentations of hypopituitarism in both genders

A

reduced pubic hair
reduced libido

37
Q

FSH LH related presentations of hypopituitarism in females

A

secondary amenorrhoea

38
Q

FSH LH related presentations of hypopituitarism in males

A

erectile dysfunction

39
Q

ACTH related presentations of hypopituitarism

A

fatigue
(note) NOT a salt losing crisis (renin- angiotensin)

40
Q

TSH related presentations of hypopituitarism

A

FATIGUE

41
Q

GH related presentations of hypopituitarism

A

Reduced quality of life
NB short stature only in children

42
Q

Prolactin related presentations of hypopituitarism

A

inability to breastfeed

43
Q

some emphasised presentations in specifically Sheehans syndrome (post party hypopit)

A

anorexia, weight loss, lethargy (ACTH, TSH, (GH))
AMMENORHEA after delivery
not lactating

44
Q

is posterior pit common involved in Sheehans?

A

no

45
Q

What is the best radiological way to visualise the pituitary gland and why?

A

MRI: tumor and soft tissue, may reveal specific pit pathology (apoplexy, adenoma ect) (CT not so good at delineating pit gland)

46
Q

what is an empty sella and how serious?

A

After tumour is gone pituitary is squished and theres empty space but they are COMPLETELY FINE ( if they can make the horm- you test for them) you just need to reassure them

47
Q

what is pituitary apoplexy?

A

bleeding into the pituitary

48
Q

who more commonly gets pituitary apoplexy?

A

people with pre existing pituitary adenomas (tumours) (might not be known)

49
Q

what is a pituitary adenoma? (is it common is it serious?)

A

usually benign tumour, 1/5 people have one that doesn’t even matter and hasn’t been diagnosed

50
Q

how can pituitary apoplexy be solved?

A

anti coagulants (blood thinners)

51
Q

symptoms of pituitary apoplexy?

A

severe sudden onset headache

visual field defect (compressed optic chiasm, bitemporal hemianopia

cavernous sinus (vein thing remember?) involvement may lead to diplopia (IV, VI), ptosis (III)

52
Q

what to consider when measuring cortisol in blood to diagnose hypopit?

A

time of day

53
Q

what to consider when measuring T4 in blood to diagnose hypopit?

A

circulating t1/2 6 days

54
Q

what to consider when measuring FSH/LH in blood to diagnose hypopit?

A

cyclical in women

55
Q

what to consider when measuring GH/ ACTH in blood to diagnose hypopit?

A

pulsatle

56
Q

what’s a better way to test for hypopit since pit hormones are pulsatile and dynamic?

A

1)cause a stress effect by inducing hypoglycaemia (<2.2mM).
2)this stimulates GH and ACTH release
3) acth stimulates cortisol which is the thing measured

57
Q

Treatment of GH deficiency 2 non invasive

A

Assess Quality of Life (QoL) using
NICE guidance specific questionnaire

58
Q

Treatment of GH deficiency 2 invasive

A

Confirm GH deficiency on dynamic pituitary function test

Daily injection (no oral option)

59
Q

how to measure response to GH treatment

A

improvement in QoL
plasma IGF-1

60
Q

what replacement is given in Treatment of TSH deficiency

A

levothyroxine

61
Q

what Dif is there in treatment for TSH def as a result of hypopit compared to primary hypothyroidism?

A

1) you can’t measure TSH to adjust the dose of levothyroxine given

62
Q

what t4 level should you aim for in replacement therapy? (since u can’t measure tsh u measure this)

A

above middle of reference range

63
Q

what hormone is replaced in Treatment of ACTH deficiency

A

cortisol

64
Q

what are the 2 replacement option drugs in Treatment of ACTH deficiency

A

Prednisolone once daily AM eg 3mg

Hydrocortisone three times per day eg 10mg/5mg/5mg

65
Q

what is adrenal crisis?

A

patients with primary or secondary adrenal failure can get this when they are ill with smith (any common stuff)

66
Q

adrenal crisis features

A

dizziness, hypotension, vomiting, weakness, collapse, even rarely death

67
Q

what do adrenal failure patients (ppl taking steroid replacements) need to do when ill?

A

wear steroid bracelet

take double dose of their steroid
(go to A &E or inject themselves if they are vommiting and can’t take oral steroid)

68
Q

why do they need this when ill?

A

body is in extra stress, they lack cortisol: stress responce hormone, they need to manage the stress

69
Q

Treatment of FSH/LH deficiency - men

A

Replace testosterone – topical (put on skin and is absorbed) or intramuscular most popular

70
Q

Treatment of FSH/LH deficiency - men check for efficiency

A

Measure plasma testosterone

71
Q

can testosterone replacement help fertility?

A

no, Replacing testosterone does not restore sperm production

72
Q

why Replacing testosterone does not restore sperm production

A

(this is dependent on FSH)

73
Q

alternativeTreatment of FSH/LH deficiency - men for fertility ?

A

induction of spermatogenesis by gonadotropin injections

74
Q

when best responce to gonadotropin injections in men?

A

if secondary hypogonadism has developed after puberty

75
Q

gonadotropin injection check for efficiency

A

Measure testosterone and semen analysis

76
Q

how long dies sperm prod take with gonadotropin injections and what does this mean for when u need to get it?

A

Sperm production may take 6-12 months ( need to do it around a year before kids)

77
Q

Treatment of FSH/LH deficiency - women- no fertility - what is replaced and how?

A

oestrogen oral or topical

78
Q

what extra is required for oestrogen replacement?

A

Will need additional progestogen if intact uterus to prevent endometrial hyperplasia (cancer)

79
Q

Treatment of FSH/LH deficiency - women- fertility yes

A

Can induce ovulation by carefully timed gonadotropin injections (IVF)

80
Q

Which anterior pituitary hormone axis does not need hormone replacement for everyone and why?

A

prolactin bc not everyone needs to breastfeed lol

Endo yr 2 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions