What are the functions of Endocrine system ?

•  Maintains homeostasis
•  Provides for growth&reproductive

Ectopic (non-endocrine tissue) hormone

• Ectopic source of hormone may result in abnormally elevated hormone level ex. Bronchopulmonary tumors that release adrenocortictopic hormone
• This mechanism operates without  benefit of the normal feedback system for hormone control.
• This ectopic hormone production is called "Autonomous"

Anterior Pituitary Hormone

Think! Too Me, Friend's Love Actually Pretty Good

• T= TSH--> Thyroid stimilaing hormone (stimilate thyroid)
• M= Melanocyte-stimulating hormone (stimulate pigment production in skin)
• F = FSH--> Follicle-stimulating hormone (intiates maturation of ovarian follicles, stimulate spematogenesis)
• L = LH --> Luteinizing hormone (ovulation, stimulate estrogen, progesterone, androgen)
• A = ACTH --> Adrenocorticotropic hormone (stimulate production of glucocorticoids by adrenal cortex)
• P = Prolectin (stimulate brest milk secretion)
• G = GH--> Growth hormone (produce growth)

What is the cause of SIADH?

Anterior & Posterior Pituitary

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What is a SIADH?

• SIADH -- Syndrome of inappropriate antidiuretic hormonr secretion
• Note... ADH ---> Water retention!
• Thus, SIADH causes Hypersecretion of ADH
• Diagnosis -->Normal adrenal & thyroid function must exist***

What are the manifestation of SIADH?

• Related to enhanced renal water retention
• Causing hyponatremia (too much water, thus highly dilute sodium in the blood)
• Also causes Hypoosmolarity (solute concentration)

Which one is caused by insufficiency of ADH?

a. Diabetes insidus

b. SIADH

c. Hyperpituitarism

Answer A

• Diabetes insidus = insufficiency of ADH
• SIADH = too much (hypersecretion) of ADH

Diabetes insipidus (DI)

• Disease of posterior pituitary
• Insufficiency of ADH
• Polyuria (loss the ability to retent water)
• Polydipsia (very thirsty!!)
• Neurogenic -->insufficiency of ADH
• Nephogenic -->inadequate of ADH

Neurogenic DI

Nephrogenic DI

**Any effects to vasopressin receptor has been noted in DI

Hypopituitarism

• Disease of Ant. pituitary
• Can be from absence of selective pituitary trophic hormone to complete failure of hormonal function of ant. posterior

What is a Pituitary infraction?

• Death of pituitary tissue
• Ant. pituitary disease
• Seen in conjuction with Sheehan syndrome (ischemic pituitary necrosis) caused by postpartum hemorrage
• Seen in shock
• Seen in during pregnancy in women with diabetes mellitus

What is Panhypopituitarism?

• All ant. pituitary hormones are absent!!
• The affected hormones are
• FSH deficiency
• TSH deficiency
• LH deficiency
• ACTH deficiency
• GH deficiency
• Note! All ant. hormone except Pretty, Me

Hyperpituitarism:

"Primary adenoma"

• Commonly due to a benign, slow-growing pituitary adenoma

• Complain of headache and fatigue
• Visual change due to the pressure on the optic chiasm include visual field impairment
• Hyposecretion of neighboring ant. pituitary hormones.

What is the cause of Acromegaly?

a. Hypersecretion of GH

b. Hyposecretion of GH

c. Hyposecretion of FSH

d. Hypersecretion of LH

Answer A

***occur during adulthood!

Which one caused by hypersecretion of GH during childhood?

a. Gigantism

b. Acromegaly

c. Panhypoituitarism

d. Ant. pituitary adenoma

Answer A

Note.. Acromegaly --> hypersecretion of GH in adulthood

Caused by "prolactinimas"

Increased level of prolectin causes:

• Amenorrhea -->the absence of a menstrual period in a woman of reproductive age
• Galactorrhea -->spontaneous flow of milk from the breast, unassociated with childbirth or nursing
• Hirsutima--> excessive hairness on women in those parts of body where not normally occur.
• Osteopenia --> weak bone

• Hypogonadism--->decreased functional activity of the gonads, thus resulting in lower amounts of testosterone
• Erectile dysfunction
• Impaired libido---> Lacks of sex drives
• Oligospermia--> oligozoospermia, refers to semen with a low concentration of sperm and is a common finding in male infertility
• Diminished ejaculate volume

Hyperthyriodism

• Thyrotoxoicosis
• Graves disease-->an autoimmune disease where the thyroid is overactive, producing an excessive amount of thyroid hormones (a serious metabolic imbalance known as hyperthyroidism and thyrotoxicosis
• Pretibial myxedema  an infiltrative dermopathy, resulting as a rare complication of Graves' disease, with an incidence rate of about 1-4% in patients.
• Hyperthyriodim resulting from nodular thyroid disease
• Goiter--> enlargement of thyroid gland
• Thyrotoxic crisis--a morbid condition due to overactivity of the thyroid gland; death can occur within 48 hours

Pimary Hypothyroidism

• Subacute hypothyroiditis-> non-bacteria infection, often viral infection
• Antoimmune thyroiditis (Hashimoto disease)->Most common cause of hypothyroidism in US; gradual inflammatory destruction of thyroid tissue by infiltration of lymphocyte & circulating thyroid autoantibodies
• Painless thyroiditis-> Similar to subacute thy., but is pathologically identical to Hashimoto disease
• Postpartum thyroiditis->usually occur 6 months after delivery, up to 7% of all women; has a course similar to painless thyroiditis; cause related to Hashimo disease.
• Myxedema coma--> is a diminished level of conciousness associated with severe hypothyroidism

Congenital hypothyroidism

• Occurs in infant as a result of absent thyroid tissue and hereditary defects in TH synthesis
• Most often in female infants

Hypothalamic-pituitary target cell feedback

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Thyroid Carinoma

• Most common endrocrine malignant
• Normal T3 and T4 level
• Risk factors:
• Exposure to ionizing radiation
• High risk if exposure during childhood.

Hypothyroidism

• Usually caused by parathyroid damage in thyroid surgery
• Abnormally low of PTH levels

Answer Hypoparathyroidism

• Parathyroid gland can be damaged during thyroid surgery

Hyperparathyroidism

• Primary heperparathyroidism
• Excess secretion of PTH from one or more parathyroid glands
• Secondary hyperparathyroidism
• Increased in PTH secondary to a chronic disease

They ar signs of Type 1 DM

• Polyurine
• Polyphagia-->excessive food
• Polydypsia--> excessive thirsty