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Altered Hormonal and Metabolic Function - Coggle Diagram
Altered Hormonal and Metabolic Function
Type 1 Diabetes Mellitus (T1DM)
Pathophysiology: Autoimmune destruction of pancreatic beta cells, Absolute insulin deficiency
Clinical Manifestations: Hyperglycemia, Polyuria, polydipsia, polyphagia, Weight loss, Fatigue
Diagnostic Criteria: Fasting blood glucose ≥126 mg/dL, Random blood glucose ≥200 mg/dL with symptoms, HbA1c ≥6.5%
Treatment: Insulin therapy, Blood glucose monitoring, Diet and exercise management
Graves' Disease
Pathophysiology: Autoimmune hyperthyroidism
Thyroid-stimulating immunoglobulins (TSIs) stimulate thyroid hormone production
Clinical Manifestations: Weight loss, increased appetite, Heat intolerance, sweating, Tachycardia, palpitations, Goiter, exophthalmos
Diagnostic Criteria: Elevated T3 and T4 levels, Suppressed TSH levels, Positive for TSIs
Treatment: Antithyroid medications (e.g., methimazole), Radioactive iodine therapy, Surgery (thyroidectomy)
Cushing Syndrome
Pathophysiology: Excessive cortisol production, Causes include exogenous corticosteroids, adrenal tumors, pituitary adenomas
Clinical Manifestations: Central obesity, moon face, buffalo hump, Muscle weakness, Hypertension, Hyperglycemia, Osteoporosis
Diagnostic Criteria: Elevated 24-hour urinary free cortisol, Dexamethasone suppression test, Imaging studies (CT/MRI) for tumor detection
Treatment: Gradual reduction of corticosteroid use, Surgery or radiation for tumors, Medications to control cortisol production (e.g., ketoconazole)
Addison Disease
Pathophysiology: Primary adrenal insufficiency, Autoimmune destruction of adrenal cortex, Deficiency of cortisol and aldosterone
Clinical Manifestations: Fatigue, weakness, Weight loss, anorexia, Hyperpigmentation, Hypotension, hyponatremia, hyperkalemia
Diagnostic Criteria: Low cortisol levels, Elevated ACTH levels, ACTH stimulation test
Treatment: Increase salt intake, Mineralocorticoid replacement (e.g., fludrocortisone), Glucocorticoid replacement (e.g., hydrocortisone)
Polycystic Ovary Syndrome (PCOS)
Pathophysiology: Multiple ovarian cysts, Hormonal imbalance: elevated androgens, insulin resistance
Clinical Manifestations: Irregular menstrual cycles, Hirsutism, acne, Obesity, Infertility
Diagnostic Criteria: Rotterdam criteria (2 of 3): hyperandrogenism, ovulatory dysfunction, polycystic ovaries
Treatment:Anti-androgens (e.g., spironolactone), Metformin for insulin resistance, Oral contraceptives, Lifestyle modifications (diet, exercise)
Hypoparathyroidism
Pathophysiology: Insufficient production of parathyroid hormone (PTH), Often due to surgical removal of parathyroid glands
Clinical Manifestations: Hypocalcemia: tetany, muscle cramps, convulsions, Paresthesia, Dry skin, brittle nails
Diagnostic Criteria: Low serum calcium levels, Low PTH levels, Elevated serum phosphate levels
Treatment: Calcium and vitamin D supplementation, Recombinant human PTH (rhPTH) therapy
Autoimmune mechanisms are a common theme in T1DM, Graves' disease, and Addison's disease.
Hormonal imbalances and their systemic effects are central to understanding the clinical manifestations across these conditions.
Diagnostic overlap: Some diagnostic tests like hormone levels and imaging studies are common across these conditions for accurate diagnosis.
Treatment approaches often include hormone replacement or modulation, which is a common therapeutic strategy.
Acromegaly
Clinical Manifestations: Enlarged hands and feet, facial changes, joint pain
Diagnostic Criteria: GH level measurement, MRI of pituitary gland
Treatment Modalities: Surgery, medication (somatostatin analogs), radiation therapy