内科学教学课件：Endocrine System And Metabolic Disease.pptVIP

ACTH CRH Cortisol Hypothalamus Pituitary Adrenal ② Cortisol Secretion Regulation FSH, LH GnRH E2, P Hypothalamus Pituitary Gonads ③Gonadal Hormone Secretion Regulation Classification of endocrine disease Hypofunction Hyperfunction Deficiency of hormone sensitivity Hypofunction Destruction of the gland Autoimmune disease (T1DM, hypothyroidism, Addison, ),neoplasms, infection or hemorrhage. Defects in hormone biosynthesis Hyperfunction Tumor: ACTH-producing tumor Mult tomors H-R disease Ectopic endocrine syndrom Homone metabolic disorder Auto-immune Drugs Defects in Sensitivity to Hormone Type 2 diabetes mellitus Pseudo-hypoparathyroidism Some hypothyroidism Rickets (vitamin D insensitivity) Diagnoses  Function diagnoses ： symptom and physical examination lab examination (level of hormone and test) Location diagnosis Etiological diagnosis Function diagnoses Weight gain Hypothalamic syn. /Cushing syn. /Hypothyroidism. Weight loss Hyperthyroidsm/DM Short stature Idiopathic GH deficiency Tall stature Pituitary gigantism Hyperpigmentation Addison’s syn Acne Androgen excess/ Cushingsyn. Striae Cushing syn. Decreased body hair Hypothyroidism Amenorrhea Adrenal insufficiency /Cushing syn. Proptosis Graves’ disease Hypokalemia Primary aldosteronism Bone pain Osteoporosis/Hyperparathyroidism Polyuria Diabetes mellitus Symptoms Signs Basal levels: FT3, FT4, TT3, TT4 Hormone’s rhythm: ACTH-Cortisol Provocative (functional) tests Stimulation test: on hypofunction disease. eg. TRH, ACTH. Suppression test:on hyperfunction disease. eg. Dexamethasone suppression test on Cushing syndrome. Lab examination Location diag