Alterations in Metabolism: Endocrine/Sexuality/Reproduction

Reading:

Porth, C.M. (2007)  Essentials of Pathophysiology:  Selected portions of chapters 30-32 and 38-40.

Purposes:

Review the normal anatomy and physiology of the endocrine system as a basis for understanding the pathophysiolgocial changes that occur in disease.

Classify hormones with respect to origin, physiological actions, target organs, and results of deficit and overactivity.

Relate the clinical manifestations of underactivity or overactivity of a hormone to the pathophysiologic mechanisms.

Rationalize the treatment of the most prevalent disorders of the endocrine system.

Contrast Type 1 and Type 2 diabetes mellitus with regard to etiology, clinical manifestations, and treatment.

Reading Guide:

By now, you should be quite adept at using the written syllabus for guidance on included topics. 

Also, review the textbook website at http://thePoint.LWW.com/PorthEssentials for links to chapter-related resources with animations and chapter review questions.

Terminology:

Study Questions and Suggestions:

1. Be familiar with the major hormones of the anterior and posterior pituitary (also known as the adenohypophysis and the neurohypophysis).
2. Understand the negative feedback system that acts as a major mechanism for control of hormone levels in the bloodstream.
3. What is endogenous hormone secretion? Exogenous?
4. What is the relationship of the hypothalamus to the anterior pituitary and the posterior pituitary?
5. Know the functions of the various pituitary hormones and which lobe they are released from: oxytocin, ADH, ACTH, GH, prolactin, TSH, LH, and FSH.
6. What are the effects of oversecretion and undersecretion of ADH (and what are the names of the diseases representing each of these conditions)?
7. What are the diseases related to increased and decreased GH?
8. What is acromegaly? What is the corresponding disease in children?
9. If an individual had primary hypothyroidism, would you expect the TSH to be increased or decreased?
10. What are the effects of parathyroid hormone on the kidney, on bone, and (indirectly) on the gastrointestinal tract?
11. What is the major stimulus for PTH release?
12. Secretion of which hormones of the adrenal cortex (glucocorticoids, mineralcorticoids, androgens) does ACTH stimulate? Which hormone of the adrenal cortex is least affected by ACTH in physiological amounts? For that hormone, what is the major mechanism of control of its secretion?
13. What is the major glucocorticoid from the adrenal cortex? The major mineralcorticoid?
14. What is Addison's disease?
15. What is Graves' disease? What are the clinical manifestations?
16. Which gland is hyperfunctioning when pheochromocytoma is seen?
17. Which type of diabetes mellitus (IDDM or NIDDM) is more common? Which is more likely to result in ketoacidosis, if not well-controlled? Which is more likely to result in HHNK?
18. Contrast the two major types of diabetes mellitus as to frequency, etiology, presence of antibody.
19. Why is excess glucose in the bloodstream (as in diabetes) a problem? Why is hypoglycemia a problem?
20. What are examples of problems that result with microvascular disease of diabetes? What are examples of problems that result with macrovascular disease?
21. What is the general treatment for a hormone condition in which a gland is not secreting adequate amounts of a hormone?
22. What are some general treatments for hormone conditions in which a gland is over-secreting its hormone?
23. Which hormone from the pituitary is chronically inhibited by the hypothalamus, except in certain situations?

Exercise:

Answer the true/false questions in the Module 10 Exercise to review and to get another point of extra credit. If the statement is false, think of what changes would be necessary to make the statement a true one. For the extra credit point, only the true-false answer is necessary.

Discussion Group:

The deadline to participate in the discussion group for this module is midnight, Dec. 10th.

You have only one module after this one, so you're almost finished! To stay on schedule, you need to finish this module by Dec. 1, 2006. (You got a little bit of a break from Nov. 22-24 for Thanksgiving -- I hope you enjoyed that!)  This material will be tested on the exam to be held Dec. 12, 3-6 p.m. in 1025 Orr Major.