1. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 19 Endocrinology

2. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Endocrinology –A subspecialty of internal medicine –The study of the function of the endocrine glands _______________: a physician who diagnoses and treats hormone problems

3. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Endocrinology –A subspecialty of internal medicine –The study of the function of the endocrine glands Endocrinologist: a physician who diagnoses and treats hormone problems

4. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Endocrine glands –Located in different parts of the body –Not connected to each other Glands release ___________ Hormones regulate bodily processes Anatomy of the Endocrine System

5. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Endocrine glands –Located in different parts of the body –Not connected to each other Glands release hormones Hormones regulate bodily processes

6. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Pituitary (hypophysis) –Located below ____________ –Called the “master gland” –Release of hormones controlled by the hypothalamus –Divided into __________ and __________ lobes Endocrine Glands

7. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Pituitary (hypophysis) –Located below hypothalamus –Called the “master gland” –Release of hormones controlled by the hypothalamus –Divided into anterior and posterior lobes

8. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Anterior gland –Prolactin (PRL) –_______________ (somatotropin) (GH) –______________ hormone (corticotropin) (ACTH)

9. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Anterior gland –Prolactin (PRL) –Growth hormone (somatotropin) (GH) –Adrenocorticotropic hormone (corticotropin) (ACTH)

10. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Anterior gland (continued) –Thyroid-stimulating hormone (____________) (TSH) –Gonadotropins: Follicle-stimulating hormone (______) ___________ hormone (LH) _______________stimulating hormone (ICSH)

11. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Anterior gland (continued) –Thyroid-stimulating hormone (thyrotropin) (TSH) –Gonadotropins: Follicle-stimulating hormone (FSH) Luteinizing hormone (LH) Interstitial cell-stimulating hormone (ICSH

12. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Posterior gland –___________ (OC) –_____________ hormone (vasopressin) (ADH) Pineal gland –Located in ___________ ventricle of the brain –Produces __________ (regulates body’s clock)

13. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Posterior gland –Oxytocin (OC) –Antidiuretic hormone (vasopressin) (ADH) Pineal gland –Located in third ventricle of the brain –Produces melatonin (regulates body’s clock)

14. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Thyroid gland –A ___________-shaped gland –Two lobes wrap around the ___________ –Regulates the body's ___________ –Produces _3, __4 and calcitonin ____ and _____ regulate metabolism ___________ regulates high balance of calcium

15. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Thyroid gland –A butterfly-shaped gland –Two lobes wrap around the trachea –Regulates the body's metabolism –Produces T3, T4 and calcitonin T3 and T4 regulate metabolism Calcitonin regulates high balance of calcium

16. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Parathyroid glands –________ glands located on the back of each lobe of the thyroid gland –Regulate _________ balance of calcium Thymus gland –Located behind the _________ –Part of both the __________ system and _________system –Releases __________which helps T cells to mature

17. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Parathyroid glands –Four glands located on the back of each lobe of the thyroid gland –Regulate low balance of calcium Thymus gland –Located behind the sternum –Part of both the immune system and endocrine system –Releases thymosin which helps T cells to mature

18. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Adrenals (suprarenal glands) –Lie on top of each __________ –__________ cortex: upper region of the adrenal gland Cortisol Corticosterone Aldosterone

19. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Adrenals (suprarenal glands) –Lie on top of each kidney –Adrenal cortex: upper region of the adrenal gland Cortisol Corticosterone Aldosterone

20. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins –____________: Inner part (core) of the adrenal gland –Releases “________ or _________” hormones –________________ (epinephrine and norepinephrine): Increases heart rate, blood flow to the muscles and brain

21. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers –Adrenal medulla: Inner part (core) of the adrenal gland –Releases “fight or flight” hormones –Catecholamines (epinephrine and norepinephrine): Increases heart rate, blood flow to the muscles and brain

22. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Pancreas –Part of both the __________ system and _________ system –Regulates ___________ –Islets of Langerhans: __________________ ___________: Rising levels of blood sugar (hyperglycemia) ____________: Low levels of blood sugar (hypoglycemia)

23. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Pancreas –Part of both the digestive system and endocrine system –Regulates blood sugar –Islets of Langerhans: Produce insulin and glucagon Insulin: Rising levels of blood sugar (hyperglycemia) Glucagon: Low levels of blood sugar (hypoglycemia)

24. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Gonads –The _____ glands that make sex cells –Ovaries in females and testes (testicles) in males –Ovaries: ___________ and progesterone –Testes (testicles): testosterone and __________

25. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Gonads –The sex glands that make sex cells –Ovaries in females and testes (testicles) in males –Ovaries: estrogen and progesterone –Testes (testicles): testosterone and inhibin

26. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Diseases and Disorders of the Endocrine System _____________ disorders: production of too much or too little of a specific hormone Generally managed by ____________ therapy or therapy to reduce the activity of the gland

27. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Endocrine disorders: production of too much or too little of a specific hormone Generally managed by hormone replacement therapy or therapy to reduce the activity of the gland

28. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins –_________: Low output of growth hormone during childhood –_________: High output of growth hormone during childhood –__________: High output of growth hormone middle-aged adults Treatments –Surgery: ____________ adenectomy –Medical therapy to control production of growth hormone Pituitary Disorders

29. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers –Dwarfism: Low output of growth hormone during childhood –Gigantism: High output of growth hormone during childhood –Acromegaly: High output of growth hormone middle- aged adults Treatments –Surgery: Transsphenoidal adenectomy –Medical therapy to control production of growth hormone

30. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins _____________: loss of hormone secretion of anterior pituitary _______________: all hormones produced by the pituitary are affected –Treatment: restore pituitary to normal function through ______________ or surgical removal of the pituitary Hyperparathyroidism –_____________ (PTH) secreted, resulting in (hypercalcemia) –Treatment: Surgical removal (parathyroidectomy)

31. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Hypopituitarism: loss of hormone secretion of anterior pituitary Panhypopituitarism: all hormones produced by the pituitary are affected –Treatment: restore pituitary to normal function through hormone therapy or surgical removal of the pituitary Hyperparathyroidism –Parathyroid hormone (PTH) secreted, resulting in (hypercalcemia) –Treatment: Surgical removal (parathyroidectomy)

32. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins –_______________ syndrome (hypercortisolism) –_________ disease: when ________ syndrome is caused by pituitary tumor Treatments –Adrenalectomy or removal of pituitary gland tumor –Medications to control the production of excess _________ Adrenal Disorders

33. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers –Cushing syndrome (hypercortisolism) –Cushing disease: when Cushing syndrome is caused by pituitary tumor Treatments –Adrenalectomy or removal of pituitary gland tumor –Medications to control the production of excess cortisol

34. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins __________ disease (adrenal insufficiency): hyposecretion of cortisol –Treatment: oral hormone replacement ______________: benign tumor of the adrenal medulla –Treatment: surgery to remove the _________; medications to control the hypersecretion of catecholamines

35. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Addison disease (adrenal insufficiency): hyposecretion of cortisol –Treatment: oral hormone replacement Pheochromocytoma: benign tumor of the adrenal medulla –Treatment: surgery to remove the pheochromocytoma; medications to control the hypersecretion of catecholamines

36. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Body fails to manufacture or properly use insulin Symptoms: __________, poly_______, poly_____, weight loss, blurred vision Types –Type ___ (IDDM) __________ undergoes autoimmune attack, rendering it useless for making insulin –Type ____ (NIDDM) Pancreas can still produce insulin but not in proper amounts (insulin resistance) Diabetes Mellitus (DM)

37. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Body fails to manufacture or properly use insulin Symptoms: Polyuria, polydipsia, polyphagia, weight loss, blurred vision Types –Type 1 (IDDM) Pancreas undergoes autoimmune attack, rendering it useless for making insulin –Type 2 (NIDDM) Pancreas can still produce insulin but not in proper amounts (insulin resistance)

38. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins –__________ diabetes: occurs during pregnancy only –____________ diabetes: from another body condition or disease Treatment: lifestyle changes and medications

39. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers –Gestational diabetes: occurs during pregnancy only –Secondary diabetes: from another body condition or disease Treatment: lifestyle changes and medications

40. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Medications –Sulfonylureas –Biguanides –Alpha-glucosidase inhibitors –Thiazolidinediones –Drug combinations: Combinations of therapies in one pill

41. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Types of Medications –Sulfonylureas –Biguanides –Alpha-glucosidase inhibitors –Thiazolidinediones –Drug combinations: Combinations of therapies in one pill

42. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of insulin –_______-acting –________-acting –_____________-acting –Long-acting –Very long-acting –_________: two types of insulins mixed together in one bottle

43. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Types of insulin –Rapid-acting –Short-acting –Intermediate-acting –Long-acting –Very long-acting –Premixed: two types of insulins mixed together in one bottle

44. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Pancreas transplantation ______________: caused by deficiency of ADH, body cannot retain water –Called “_____” diabetes to distinguish it from DM or “insulin” diabetes –Treatment: antidiuretic medications

45. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Pancreas transplantation Diabetes insipidus: caused by deficiency of ADH, body cannot retain water –Called “water” diabetes to distinguish it from DM or “insulin” diabetes –Treatment: antidiuretic medications

46. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Laboratory tests –________: level of calcium in the blood –___________: adrenal medulla function –Cortisol: status of adrenal function –____________ (GGT): blood sugar at present moment –__________ hemoglobin (hemoglobin A1c): blood sugar over a 3-month period Diagnostic Studies and Procedures

47. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Laboratory tests –Calcium: level of calcium in the blood –Catecholamines: adrenal medulla function –Cortisol: status of adrenal function –Glucose tolerance test (GGT): blood sugar at present moment –Glycosylated hemoglobin (hemoglobin A1c): blood sugar over a 3-month period

48. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins –FSH and LH: _________ abnormalities –____: secretion of growth hormone –_____: evaluates parathyroid gland function –TSH, T__, and T__: evaluate thyroid function –Rapid ________ stimulation test: integrity of the adrenal glands –Serum _________: levels of aldosterone

49. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers –FSH and LH: gonadal abnormalities –GH: secretion of growth hormone –PTH: evaluates parathyroid gland function –TSH, T3, and T4: evaluate thyroid function –Rapid ACTH stimulation test: integrity of the adrenal glands –Serum aldosterone: levels of aldosterone

50. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Imaging Studies –X-rays –___ and MRI –_________ medicine studies –____________ (RAIU) test: evaluates thyroid function –___________ thyroid imaging: evaluates thyroid gland itself

51. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answers Imaging Studies –X-rays –CT and MRI –Nuclear medicine studies –Radioactive iodine uptake (RAIU) test: evaluates thyroid function –Radionuclide thyroid imaging: evaluates thyroid gland itself

52. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Insight Only the Lonely