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Friday, 24 September Ch 11 Endocrine System • The Hypothalamus and Pituitary Glands – Unique anatomy – Long & short loop negative feedback • Stress and Cortisol • Some examples of endocrine disorders 1QQ # 8 for 8:30 class 1. Suppose a biopsy of a patient’s thyroid gland revealed follicles and follicular epithelial cells that were less than half the normal size. If you took a blood sample from that patient, would you predict the TSH level to be normal, high, or low. Explain your choice. 2. Your patient’s body temperature is 97.1 F, blood pressure and heart rate are below normal. You order a blood test to check for hormone levels. Which hormone(s) is/are of greatest interest to you and why? Based on the symptoms, what predictions do you make about the results of the blood test? Explain. 1QQ # 8 for 9:30 class 1. Some tumors of endocrine glands result in unregulated high levels of hormone secretion. Which would you predict to be more severe: a tumor in the anterior pituitary gland or a tumor in the posterior pituitary gland? Explain your reasoning. 2. Your patient’s body temperature is 97.1 F, blood pressure and heart rate are below normal. You order a blood test to check for hormone levels. Which hormone(s) is/are of greatest interest to you and why? Based on the symptoms, what predictions do you make about the results of the blood test? Explain. Tropic hormones control the function S1 Trophic hormones promote survival and growth of targets P P P P A P Hypothalamo-hypophyseal portal system P P S P P P A Releasing Hormone Release-inhibiting Hormone P S Tropic hormones control the function Trophic hormones promote survival and growth of targets Short-loop Neg. Feed. Long-loop negative feedback Releasing Hormone Release Inhibiting Hormone S2 Endocrine disorders • Hypersecretion – Primary – Secondary • Hyposecretion – Primary – Secondary hypothalamus CRH Anterior pituitary ACTH Adrenal Cortex Cortisol S3 Who Cares? S4 • Symptoms of hypothyroidism • Levels of TSH and TH? • Explain enlarged thyroid gland • Cause: Inadequate dietary intake of iodine • Treatment? Endemic Goiter TRH TSH T3 & T4 Goiter Elevates basal metabolic rate, potentiates response to EPI If hypothyroid during pregnancy… cretinism = congenital hypothyroidism Who else Cares? Aunt Dot S5 Grave’s Disease ⇩ ⇩ TRH from Hypothal. TSH from Ant. Pit. T3 and T4 from Thyroid gland ⇧sensitivity to EPI (up-regulation of adrenergic receptors) Blood test: TSH levels low TH levels high The cause: Abnormal Immunoglobulins in patient activate TSH receptors on Thyroid cells ⇧Metabolic rate ⇧Temperature ⇧Heart rate and ⇧Blood Pressure ⇧Lipolysis and fuel mobilization Weight loss S6 Grave’s Disease Treatment: Radioactive Iodine Mechanism:…….. S7 Vasopressin Cytokines from immune cells CRH from Hypothalamus ACTH from Ant. Pit S8 Physical trauma Prolonged exposure to cold Prolonged intense exercise Infection Sleep deprivation Pain Fright Emotional distress Basal levels of Cortisol Required for normal sensitivity to EPI; symptoms of excess cortisol are….. Clinical example: treatment of chronic inflammation (e.g. arthritis) can lead to Cushing’s Syndrome! ⇧Cortisol secretion from Adrenal Cortex Mobilize fuel from muscle & adipose tissue Suppress non-essential functions (reproduction & growth) Suppress inflammatory & immune responses Potentiates response to EPI (vascular smooth muscle) Cushing’s Syndrome Excess Cortisol from 1) adrenal cortex tumor (primary) or 2) hypersecretion of ACTH from anterior pituitary (secondary) S9 Applied Physiology: Menopause Widmaier text p. 694 • • • • Onset ~ age 50 Irregular menstrual cycles Breasts and genital organs gradually atrophy Decrease in bone mass & strength (osteoporosis) (bone resorption greater than bone deposition) • Hot flashes…sweating, etiology unknown • Increased incidence of coronary artery disease Menopause, continued. • Caused by ovarian failure….loss of estrogen • Estrogen has protective function for cardiovascular system and sustains bone • Diagnosis – Test estrogen levels – Test FSH levels….interpretation if high? • Treatment – Hormone replacement therapy – Risk of HRT: increased incidence of breast cancer & uterine endometrial cancer – Advantages: alleviates symptoms, restores cardiovascular protection, sustains bone density S 10