1. The Endocrine System Lesson 2: Pathology of the Endocrine System32
The Endocrine System
Lesson 2:
Pathology of the Endocrine System

2. Lesson Objectives
Upon completion of this lesson, students should be able to …
Define and spell the terms to learn for this chapter.
Identify and explain common disorders associated with the endocrine system.

3. Acromegaly
Hormonal disorder that results from the overproduction of growth hormone (GH) by the pituitary gland
Commonly affects middle-aged adults
Most serious health consequences are diabetes mellitus, hypertension, increased risk of cardiovascular disease, and premature death
Can also be caused by a pituitary tumor
Commonly characterized by the abnormal growth of the hands and feet 3

4. Signs and Symptoms of Acromegaly
Soft tissue swelling of the hands and feet
Bony changes altering the facial features
Overgrowth of bone and cartilage often leads to arthritis
Thickened tissue may trap nerves and cause carpal tunnel syndrome
Thick, coarse, oily skin
Skin tags
Enlarged lips, nose, and tongue
Deeper voice
Snoring
Excessive sweating and skin odor
Fatigue and weakness
Headaches 4

5. Signs and Symptoms of Acromegaly
Impaired vision
Abnormal menstrual cycle and sometimes breast discharge in women
Impotence in men
Body organs, such as the liver, spleen, kidneys, and heart, may also enlarge 5

6. Treatment for Acromegaly
Reduce GH production to normal levels
Surgical removal of the tumor
Drug therapy
Radiation therapy of the pituitary 6

7. Addison’s Disease
The cortex of the adrenal gland is damaged, decreasing the production of adrenocortical hormones
Autoimmune disease, in which the body attacks itself
May be caused by infection of the adrenal glands, cancer, or hemorrhage into the glands
Rare condition occurring in 1 in 100,000 Americans

8. Addison’s Disease
Can occur at any age, including infancy, and is equally prevalent in men and women
Diagnosed by blood and urine tests that measure corticosteroid hormone levels

9. Signs and Symptoms of Addison’s Disease
Weight loss
Anorexia
Weakness and lethargy
Increased pigmentation of the skin and mucous membranes
Hypoglycemia
Joint and muscle aches
Persistent fever
Nausea
Vomiting
Diarrhea
Abdominal discomfort

10. Treatment of Addison’s Disease
Replacement of adrenocortical hormones and supplemental sodium
Intramuscular hydrocortisone injections
Patient must always carry medical identification

11. Cushing’s Syndrome or Disease11

12. Critical Thinking Questions
Is it ever appropriate for someone with symptoms of this Cushing’s disease to delay seeking medical advice? Explain.
When should medical advice be sought? 12

13. Cushing’s Disease Results from hypersecretion of cortisol
Rare disorder
Usually a side effect of pharmacological use of steroids in the management of inflammatory illnesses
May be caused by a tumor
May cause death of not treated
Treatments include:
Surgery
Radiation 13

14. Sign and Symptoms of Cushing’s Disease
Muscular weakness
Thinning of the skin
Easy bruising
Rounding of facial features (“moon faces”)
Weight gain
Fatigue

15. Diabetes Mellitus
Condition in which the body is unable to produce enough insulin to properly control blood sugar levels
Silent disease that may not be detected until it is in an advanced stage
Approximately 13 million people have been diagnosed with diabetes, but an estimated 5.9 million are undiagnosed

16. Three Types of Diabetes
Juvenile diabetes (Type 1 diabetes)
Type 2 diabetes
Gestational diabetes

17. Juvenile Diabetes
Known as type 1 diabetes or insulin-dependent diabetes mellitus (IDDM)
Typically diagnosed in children who cannot produce sufficient quantities, if any, of insulin
Dependent on insulin injections for the duration of their lives

18. Type 2 Diabetes
Known as non–insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes
Most common form of the disease
Typically diagnosed later in life
Results from insulin resistance combined with a relative insulin deficiency
There is a very strong correlation between obesity and type 2 diabetes

19. Gestational Diabetes Pregnancy-related
Disappears after the pregnancy is completed, but occasionally it precipitates ongoing type 2 diabetes

20. Signs and Symptoms of Diabetes
Polyuria (frequent urination)
Polydipsia (excessive thirst)
Polyphagia (excessive hunger)
Other symptoms include weakness, weight loss, lethargy, anorexia, irritability, dry skin, recurrent infections, abdominal cramps, and vaginal yeast infections in women

21. Treatment for Diabetes
Type 1 can usually only be treated by a pancreatic transplant
Type 2 is treated with diet, exercise, and oral hypoglycemic medications
Many must administer insulin injections in addition to oral medications
May be preventable with modest lifestyle changes, including healthy diet choices, exercise, and weight management

22. Treatment for Diabetes
During pregnancy, the patient with gestational diabetes may have to monitor her diet and blood sugar and may need to give herself daily insulin injections

23. Achondroplasia
The most common type of dwarfism, occurring in 1 in 25,000 children, with males and females at equal risk
Abnormal skeletal growth is usually diagnosed at birth
Most children born with the disorder have average-size parents 23

24. Achondroplasia
Development of motor skills may be delayed but intellectual development is normal
Men with this condition reach an average full height of 51 inches (130 cm) and women reach 49 inches (125 cm) 24

25. Physical Characteristics of Achondroplasia
Trunk of normal length with disproportionately short arms and legs, and bowed legs
Reduced joint mobility in the elbow, although loose ligaments make other joints seem overly flexible or double-jointed
Shortened hands and feet
Large head

26. Physical Characteristics of Achondroplasia
Flat midface
Crowded teeth (because of a small upper jaw)
Prominent forehead
Flattened bridge of the nose

27. Treatment of Achondroplasia
No cure
In addition to social and family support, treatment focuses on the prevention, management, and treatment of medical complications
Surgery may be performed to relieve pressure on the nervous system, generally at the base of the skull and lower back, or to open obstructed airways by removing the adenoids

28. Treatment of Achondroplasia
Dental and orthodontic work may be necessary to correct malocclusion and preserve dental health

29. Gigantism
Results from excessive secretion of growth hormone (GH) during childhood, before the closure of the bone growth plates 29

30. Causes of Gigantism
Excess growth hormone secretion is most often caused by a pituitary gland tumor
May also be caused by an underlying medical condition such as multiple endocrine neoplasia
Pituitary tumors are rarely ever malignant (cancerous)
If excessive secretion of growth hormone occurs after normal bone growth has stopped, the condition is known as acromegaly

31. Signs, Symptoms and Treatment for Gigantism
Signs and symptoms:
Overgrowth of the long bones and very tall stature, accompanied by growth in the muscles and organs
Children with gigantism are extremely large for their age
Disorder can also delay puberty
Treatments:
Radiation therapy
Surgical removal of the tumor

32. Hyperthyroidisim Characterized as elevated thyroid hormone levels
Graves’ disease is the most common form
Autoimmune disorder; antibodies produced by the immune system stimulate the thyroid to produce too much thyroxine
Other forms of hyperthyroidism may be caused by thyroiditis (inflammation of the thyroid gland), or benign or malignant tumors 32

33. Signs and Symptoms of Hyperthyroidisim
Nervousness
Restlessness
Heart palpitations
Tremors
Sweating
Increased activity in the intestinal tract
Menstrual changes
Weight loss
Changes in the fingernails and hair
Heart may be enlarged
Condition known as exophthalmos 33

34. Treatment for Hyperthyroidism
Antithyroid medications
Radioactive iodine to destroy the thyroid
Surgery (thyroidectomy)
If the thyroid is removed or destroyed, lifelong thyroid replacement therapy must be initiated

35. Hyperthyroidism Exophthalmos Critical Thinking:
Protruding eyeballs from swelling of tissue behind the eyes
Critical Thinking:
Could you recognize this as a symptom of hyperthyroidism compared to someone with genetically indicated protruding eyes?

36. Hypothyroidism
When the thyroid produces inadequate amounts of the thyroid hormones
Since it develops slowly, only about half of the 7 million cases in the United States are diagnosed early
Untreated, it can lead to other conditions because the constant stimulation to release more thyroid hormones can cause the thyroid gland to enlarge (goiter)

37. Hypothyroidism
Untreated hypothyroidism is associated with a higher risk of heart disease, because of the high levels of low-density lipoproteins (LDL)

38. Hypothyroidism
Other complications include depression, decreased sexual desire, and slowed mental functioning
Myxedema is a rare, life-threatening condition that results from long-term, untreated hypothyroidism
Triggered by sedatives, infection, or other stress
Emergency treatment should be administered immediately

39. Signs and Symptoms of Hypothyroidism
Fatigue
Decreased concentration
Intolerance to cold
Constipation
Loss of appetite
Muscle cramping
Stiffness
Weight gain
Other symptoms are hair loss, dry skin, and nail changes
Myxedema symptoms include intense cold intolerance and drowsiness followed by profound lethargy and unconsciousness

40. Treatment of Hypothyroidism
Daily use of a synthetic thyroid hormone called levothyroxine (Synthroid, Levothroid)
This oral hormone reduces symptoms, particularly fatigue, weight loss, and increased LDL
Must be taken on a routine basis
Should be monitored regularly with blood work
Dosage should be adjusted as necessary
Thyroid supplementation is a lifelong therapy

41. Other Disorders Related to the Endocrine System
Acidosis
Excessive acidity of bodily fluids due to the accumulation of acids, as in diabetic acidosis
Adenoma
A neoplasm or tumor of a gland
Cretinism
Congenital condition due to a lack of thyroid, which may result in arrested physical and mental development

42. Other Disorders Related to the Endocrine System
Diabetes insipidus (DI)
Caused by the inadequate secretion of the antidiuretic hormone ADH by the posterior lobe of the pituitary gland
Diabetic retinopathy
Secondary complication of diabetes mellitus (DM) that affects the blood vessels of the retina, resulting in visual changes and even blindness

43. Other Disorders Related to the Endocrine System
Goiter
Enlargement of the thyroid gland
Graves’ disease (also called hyperthyroidism)
Results from an overactivity of the thyroid gland and can result in a crisis situation
Hashimoto’s disease
Chronic form of thyroiditis

44. Other Disorders Related to the Endocrine System
Hirsutism
Condition of having an excessive amount of hair on the body which can be the result of a hormonal imbalance
Hypercalcemia
Condition of having an excessive amount of calcium in the blood
Hyperkalemia
Condition of having an excessive amount of potassium in the blood

45. Other Disorders Related to the Endocrine System
Hypoglycemia
Condition of low amount of glucose (sugar) in the blood
Ketoacidosis
Due to an excess of ketone bodies (waste products) that can result in death for the diabetic patient if not reversed

46. Other Disorders Related to the Endocrine System
Myasthenia gravis
Condition characterized by great muscular weakness and progressive fatigue
May have difficulty in chewing and swallowing, and drooping eyelids
If a thymoma is causing the problem, it can be treated with removal of the thymus gland

47. Myxedema Swelling of tissue
Can be caused by hypofunction of the thyroid gland
Rare and life-threatening if untreated
Symptoms can include: anemia, slow speech, enlarged tongue and facial features, edematous skin, drowsiness, and mental apathy
Treatment is daily use of synthetic thyroid hormones 47

48. Myxedema
Pre-treatment
Post-treatment 48

49. Questions? 49