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Risk Factors, TBL 5.3 MECHANISTIC DIAGRAM, Gerry Guo, Kara Harris,…
Risk Factors
Genetics
CRANIOPHARYNGIOMA
Compression of optic chiasm
Bitemporal hemianopia
Poor eyesight even with glasses
Visual acuity right eye 6/5, left eye 6/36
Compression of pituitary
& vessls
Pituitary atrophy
Pan-hypopituitarism
Relatively low LH and FSH
Low testosterone
DELAYED ONSET OF PUBERTY
Small testicular volume (3 mL)
No pubic hair (pre-pubertal)
Left hand X-ray
1 more item...
Psychosocial effect
4 more items...
Testosterone <1 nmol/L
Treat with testosterone
LH 0.1 IU/L and FSH 0.1 iU/L
Relatively low TSH
Low free T4
Free T4 7.0 nmol/L
Treat with thyroxine
Weight gain
TSH 1.2 miU/L
Relatively low GH
Short stature (129cm)
Low IGF-1
IGF-1 15 nmol/L
Treat with GH
Confirm GH deficiency with GH stimulation test
Relatively low ACTH
Low cortisol
Fatigue & lack of concentration
Morning cortisol 80 nmol/L
Treat with hydrocortisone
Education about stress dosing
MRI - 1.5cm mass
Monitor MRI for adequacy of resection
Compression of cranial structures
Increased intracranial pressure
Headache
Compression of blood vessel to optic nerve
Fundoscopy
Pale left optic disc
Decreased visual acuity
Opthalmologist assessment
Increased blockade of dopamine reaching mammotrophs
Decreased inhibition of mammotroph secretion of prolactin
Disconnection syndrome
Normal prolactin
Prolactin 700 m1U/L
Inhibits GnRH
Surgical removal of tumour
+/- radiotherapy
Replace hormones
Monitor if hormone excess/deficient
Nutrient deficiency & excess (Imbalance)
Overweight (BMI 24)
Psychosocial
TBL 5.3 MECHANISTIC DIAGRAM
Gerry Guo, Kara Harris, Mohammed Hassan, Christy Hou & Daniel Kasunic