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endocrine disorders - Coggle Diagram
endocrine disorders
thyroid
hypothyroidism
signs and symptoms: cold intolerance, weight gain, lethargy, fatigue, memory deficits, poor attention span, muscle cramps, constipation, decreased fertility, puffy face, hair loss, brittle nails
systemic effects: hyperlipidemia, yellow skin, anemia, decreases filtration by kidney, pended's syndrome, myxedema, subclinical hypothyroidism in elderly
diagnosis: high TSH, low free T3, low free T4; ultrasound, thyroid test
treatment: replacement hormone, surgical intervention if necessary, myxedema coma
hyperthyroidism:
elevated free T3 and T4, grave's disease
causes: subacture thyroiditis, thyroid adenoma, excessive TSH, subacture thyroiditis, toxic multi nodular goiter, excessive iodine ingestion
treatment: antiheroic hormone medication propylthiouracil, radioactive iodine treatment, surgery
Grave's disease
thyroid-stimulating antibodies (bind to thyrotopin receptors, gland enlargement, continual synthesis thyroid hormones)
nervousness, insomnia, sensitivity to heat, weight loss, enlarged thyroid gland, atrial fibrillation, increased HR, increased sympathetic nervous system sensitivity, exophthalmos
thyroid nodules
most asymptomatic, hypothyroidism or hyperthyroidism
ultrasound and needle biopsy for diagnosis, technetium scan
malignant thyroid nodule (age younger than 20, older than 70; male; history of neck irradiation; immobile nodule; presence of vertical lymphadenopathy)
hypoparathyroidism
rare, inadvertent damage with thyroid surgery, genetic disorders; presentation due to hypocalcemia
muscle weakness, poor concentration, neuropathies, kidney stones, osteopenia, pathological fractures
endocrine
regulation
negative feedback mechanism: end product hormone negatively feedback to prevent further stimulatory signals
receptor activity: up regulation, down regulation
types of conditions
hormone deficiency
hormone excess
hormone resistance
dysfunction
hypofunction, hyperfunction, (primary, secondary, tertiary)
causes: autoimmune, neoplasia, endocrine-disrupting compounds
assessment
medical history, signs and symptoms, mood and behavior changes
diagnosis: immunoassays, urinary hormone levels, urinary collection, suppression/ stimulation tests, CT scan// MRI, ultrasound
treatments
hormone replacement therapy: glucocorticoids, thyroid hormones, sex steroids, SDH most commonly
suppression of hormone overproduction through medications, surgery, radiation
pituitary
hypopituitarism
panhypopituitarism: complete loss of all pituitary hromones
causes: pituitary tumor, brain surgery, radiation of brain tumor, congenital disorder; trauma, ischemia, and infarction
primary adenoma: most common cause, benign neoplasm, growth can compress pituitary gland in sella turcica
craniopharyngioma: benign neoplasm close to pituitary gland or pituitary stalk
pituitary apoplexy: sudden destruction of the pituitary tissue due to infarction or hemorrhage into gland, traumatic brain injury most common cause
Sheehan's syndrome: ischemia or infarction of the pituitary after childbirth because of severehemorrhage
signs and symptoms: pituitary hormones suppressed, children have different complications, acute/ rapid deterioration of patient
neonate and infants: dwarfism, developmental delay, various visual and neurological symptoms, seizure disorder, congenital malformation
adults: weakness, weight loss or gain, hypotension, sluggishness, depression, excessive urination and dehydration
diagnosis: blood tests, corticotropin stimulation test
diabetes insipidus (DI)
posterior pituitary hypopituitarism; lack of ADH or response to ADH, dilute and large volume urine (central or nephrogenic)
signs and symptoms: frequent urination, thirst, dehydration, disorientation, seizures
hyperpituitarism
pituitary adenoma: most common cause that may produce ACTH, TSH, or RH
large tumors may cause headaches and visual disturbances
children: ACTH-producing adenoma, corticotropinomas, common before puberty, Cushing's like symptoms
GH-secretion adenoma: children get gigantism and adults get acromegaly
diagnosis: serum hormone levels, urine hormone levels may also be assessed, dexamethasone suppression test to assess ACTH response
treatment: depends on elevated hormone, prolactinoma, transsphenoidal surgery, adrenal enzyme inhibitors, GH inhibitors
adrenal
insufficiency: weakness, hypotension, easy fatigue, emotional lability, anorexia, hypoglycemia, electrolyte imbalances
treatment: daily replacement of glucocorticoid and mineralocorticoid
hyperadrenalism/ hypercortisolism
causes: pituitary adenoma, Cushing's syndrome
signs: weight gain, redistribution of body fat to face, trunk, and abdomen, puffy face