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The Hypothalamic-Pituitary Axis - Coggle Diagram

- - - - Excessive secretion of antidiuretic hormone (ADH) from the posterior pituitary gland
        
        Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
        
        S/S: Increased water retention, dilutional hyponatremia, and concentrated urine
        
        Diagnostic: low serum sodium levels, concentrated urine with high osmolality, and normal renal, adrenal, and thyroid functions
        
        Treatment: Find the underlying cause, fluid restriction, and medications like demeclocycline or vasopressin receptor antagonists.
    - - Is the receptor binding adequate?
        
        Excessive production of cortisol, leads to impaired receptor binding
        
        Cushing Syndrome
        
        Clinical manifestations: weight gain, truncal obesity, moon face, muscle weakness, and osteoporosis
        
        Diagnostic: elevated cortisol levels, loss of diurnal cortisol rhythm, and abnormal response to dexamethasone suppression test.
        
        Treatment: addressing the underlying cause, reducing glucocorticoid medications, or surgical removal of adrenal tumors.
      - Is the target cell responding to the hormone?
        
        Deficiency of ADH production or release
        
        Diabetes insipidus
        
        Clinical manifestation: inability to concentrate urine, leading to excessive urination and thirst
        
        Treatment: hormone replacement therapy with desmopressin
        
        Diagnostic: water deprivation test and response to ADH administration
      - Is the gland producing active hormone
        
        Adrenal insufficiency
        
        Adison's Disease
        
        The adrenal glands do not produce enough cortisol and aldosterone. Caused by autoimmune destruction of the adrenal glands or other infections.
        
        Diagnostic: low cortisol levels and high adrenocorticotropic hormone (ACTH) levels.
        
        Treatment: hormone replacement therapy with glucocorticoids and mineralocorticoids.
        
        Clinical manifestations include fatigue, weight loss, low blood pressure, electrolyte imbalances, and hyperpigmentation
      - Is there impairment of the endocrine gland
        
        Yes, the endocrine gland is either excessive or not releasing
        
        Hypothyroidism
        
        Decreased production and secretion of thyroid hormones from thyroid gland
        
        Clinical manifestations: fatigue, weight gain, cold intolerance, constipation, and dry skin.
        Diagnostic: elevated thyroid-stimulating hormone (TSH) levels and low T3 and T4 levels.
        
        Treatments: hormone replacement therapy with synthetic thyroid hormones
        
        Hyperthyroidism
        
        Increased production and secretion of thyroid hormones from thyroid gland
        
        Clinical manifestations: weight loss, heat intolerance, palpitations, tremors, and increased appetite. Diagnostic criteria include low TSH levels and high T3 and T4 levels.
        
        Treatment: medications to suppress thyroid hormone production, radioactive iodine therapy, or surgical removal of the thyroid gland.
      - Is hormone being produced ectopically?
        
        Production of hormones outside their normal sites of production
        
        Adrenocorticotropic hormone (ACTH)
        
        Stimulates the adrenal glands to produce excessive cortisol
        
        Clinical findings: weight gain, hypertension, glucose intolerance, and muscle wasting
        
        Treatment: surgical removal or management of the underlying tumor, along with medications to suppress cortisol production.
        
        Diagnostic: elevated cortisol levels, loss of diurnal cortisol rhythm, and imaging studies to identify the ectopic tumor
        
        Tumors like cell lung cancer and carcinoid tumors