PRE-UNIT STUDY TIPS

1. 内分泌系统的疾病相对来说比较规整，熟悉每个腺体所分泌的激素以及激素的作用，基本每种激素都对应一个分泌过多/过少的疾病
2. 内分泌系统的疾病大部分都有比较明显的外貌特征，例如过胖/过瘦，金鱼眼，水牛背，满月脸等等，做练习的时候注意抓住关键词

0. Anatomy & Physiology

• orderly function of the endocrine system

  • glands secret hormones

  激素们都在这里！

  

• Hormones that stimulate secretion of other hormones are called tropic hormones.

  • The pituitary gland: which is intricately connected to the hypothalamus, plays a central role in regulating most of the endocrine glands

    • anterior lobes
    • posterior lobes

    

• diagnose

  • correctly matching the patient’s symptoms with a specific hormone dysfunction and obtaining laboratory confirmation of overproduction or underproduction of a particular hormone or hormones.
  • blood test
  • radioimmunoassay (RIA) / immunometric assay (IMA)
  • 24-hour urine test
  • locate the lesion: CT, MRI, ultrasound
  • malignant or not: biopsy

1. Pituitary Glands Diseases

1.1 Gigantism 巨人症

• Gigantism describes an abnormal pattern of growth and stature.
• hypersecretion of growth hormone (GH, somatotropin) occurs before puberty
• overgrowth of all body tissue
• signs & symptoms:
  • long bones: ****because epiphyseal 骨骺 closure has not begun
  • Sexual and mental developments are often retarded
• etiology: over secretion of GH
  • Hypogonadism 性腺机能减退 may lead to tall stature, but not gigantism, by delaying puberty and closure of the epiphyses.
• diagnosis:
  • level of GH on lab test
  • age-reference norms for insulin-like growth factor 1 (IGF-1) are the best indicator of endogenous secretion of GH
  • MRI & CT: pituitary lesion
  • bone radio: thickening of the cranrum 颅骨, enlargement of the jaw bone, and elongation of the long bones
• treatment:
  • surgery (transsphenoidal 蝶窦 approach) -/+ medication or radiation to the pituitary gland to reduce its size
  • Appropriate gonadal 性腺的 hormones may be needed in children or adolescents exhibiting hypogonadism

1.2 Acromegaly 肢端肥大症

• chronic metabolic condition of adults caused by hypersecretion of GH by the pituitary gland
• signs & symptoms:
  • after puberty: overgrowth of the bones of the face, hands, and feet
  • 30~40yr
  • jaw grows, causing larger spaces between the teeth
  • joint pain: from osteoarthritis
• etiology: a pituitary tumor or adenoma often is the cause of acromegaly
  • female and male equal frequency
• diagnosis:
  • abnormal thickening of the bones of the face, hands, and feet
  • Levels of GH and IGF-1 are elevated
  • glucose tolerance test: increased glucose levels fail to suppress GH levels
  • CT & MRI
• treatment: reverse or prevent tumor mass effects and reduce the amount of GH secreted
  • surgery (transsphenoidal approach) -/+ medication or radiation

1.3 Hypopituitarism 垂体机能减退

• deficiency or absence of any of the pituitary hormones, produced by the anterior pituitary lobe
• signs & symptoms: metabolic dysfunction, sexual immaturity, or growth retardation
  • if hormone stimulate other endocrine glands: atrophy of those glands.
    • thyrotropin⬇️ 甲状腺刺激激素(thyroid-stimulating hormone [TSH]): thyroid gland_hypothyroidism
    • corticotropin⬇️ ****促肾上腺皮质激素(adrenocorticotropic hormone [ACTH]): salt balance and nutrient metabolism
    • gonadotropin⬇️ 促性腺激素: impaired sexual function_sexual development, menstruation, lidido 性欲
  • growth retardation in children
  • Headache and blindness: tumor infringement on the optic nerve
• etiology:
  • pituitary tumor or a tumor of the hypothalamus
  • congenital deficiencies
  • damage to the pituitary gland caused by radiation or surgical removal or from ischemia of the gland caused by infarct, tumor, or basilar skull fracture
  • panhypopituitarism 全垂体功能减退: Destruction of the entire anterior lobe_a decline in multiple anterior pituitary hormone secretion
  • common in women
• diagnosis:
  • history of head trauma
  • radiation or surgical
  • Plasma levels of all or some of the pituitary hormones are low
  • Radiographic films of the skull, cranial CT, and MRI scans are used to identify tumors
• treatment:
  • neoplasia: removal of tumor
  • replacement theray with sormonal supplements
    • thyroxine 甲状腺素 (T4)
    • cortisone 肾上皮质酮
    • sex hormones
    • somatropin 生长激素 (hGH)

1.4 Dwarfism 侏儒症

• Radiographic films of the skull, cranial CT, and MRI scans are used to identify tumors
• abnormal underdevelopment of the body in children, attaining an adult height of 4 feet 10 inches or less
• signs & symptoms:
• etiology:
• diagnosis: physical
• treatment:

2. Thyroid Gland Disease

• thyroxine (T4) and triiodothyronine 三碘甲状腺氨酸 (T3)—and mass lesions of the thyroid.
• TSH from the pituitary gland control the secretion of T4 and T3