endocrinology(内分泌总论).pptVIP

Dynamic testing Provocative testing assesses the ability of a gland to respond to stimuli as an index of its reserve capacity. Insulin induced hypoglycemia is used to assess the secretory ability of cells that produce growth hormone. Tests that provide indirect information Diagnosis of diabetes mellitus and assessment of therapy depend on measurement of plasma glucose rather than insulin levels. It is helpful to follow the serum calcium levels in hyperparathyroidism and the serum potassium levels in primary aldosteronism. Tests that provide indirect information For instance, serum sodium is almost always greater than 139mEq/liter in patients with an aldosterone producing adenoma, plasma cholesterol tends to be high in hypothyroidism and low in hyperthyroidism. Treatment of endocrine and metabolic disease For endocrine deficiency syndromes, hormones are generally administered to counter the deficiency. Vitamin D is given instead of PTH to treat hypoparathyroidism, since it can increase the extracellular Ca+. In cases in which hormone resistance is present, steps are taken when possible to alleviate this, such as through diet restriction in type 2 diabetes. In hormone-excess syndromes, a variety of approaches are used. Hyperfuctioning tumors are removed or destroyed with radiotherapy when possible, and sometimes hyperplastic glands are removed. In other cases drugs are given to block hormone production and release, such as methimazole/propylthiouracil for thyrotoxicosis and cabergoline/bromocriptine for prolactin-producing adenomas. Antagonists such as spironolactone can some times be useful in primary aldosteronism due to hyperplasia. * Pituitary gland Adrenal Testes Ovaries Parathyroid Hypothalamus * Pituitary gland Adrenal Testes Ovaries Parathyroid Hypothalamus Pineal * Optic chiasm 视交叉 Sella turcica 蝶鞍 The tumour constricts the nerves. The circumscribed mass lesion present here in the sella turcica is a pituitary adenoma. * Anterior pituitary Posterior pi