2. Anatomy and Physiology  Consists of many glands Hypothalamus Pituitary Pineal Thymus Thyroid 2

3. Anatomy and Physiology  Consists of many glands Parathyroids Adrenals Pancreatic islets Ovaries and testes 3

4. Anatomy and Physiology  Each gland is unique and delivers its secretion into the bloodstream  Negative feedback system controls amount of hormones secreted 4

5. Diagnostic Tests  Endocrine glands that can be physically examined are the thyroid and testes  Tests: blood and urine testing for hormones  CT and MRI check for tumors or alteration in organ size 5

6. Pituitary Gland Diseases  Hyperpituitarism Increase in activity of pituitary gland Oversecretion especially affects growth hormone leading to excessive growth of bones and tissues 6

7. Pituitary Gland Diseases  Hyperpituitarism If occurs before puberty, giantism occurs If occurs in adult, acromegaly occurs ○ Affects small bones of hands, feet, and face by enlarging them 7

8. Pituitary Gland Diseases  Hypopituitarism Abnormal decrease in activity of pituitary gland Effects: ○ Dwarfism ○ Abnormality of secondary sex characteristics ○ Amenorrhea and infertility in adult woman 8

9. Pituitary Gland Diseases  Hypopituitarism Adult men may have decreased testosterone levels and libido Decrease in ACTH and TSH may lead to metabolic disorder 9

10. Pituitary Gland Diseases  Diagnosis of pituitary function: blood test  Treatment of hypopituitarism: hormone replacement, monitoring, and adjustment 10

11. Pituitary Gland Diseases  Diabetes Insipidus Caused by decrease in release of vasopressin or antidiuretic hormone Excessive polyuria: urinating 2 to 15 gallons of urine in 24 hours Symptoms may include polydipsia, hypotension, dizziness, and constipation 11

12. Pituitary Gland Disorders  Diabetes Insipidus Diagnosis: urinalysis and water restriction test Urine is colorless with low specific gravity Treatment includes administration of vasopressin 12

13. Thyroid Diseases  Hyperthyroidism Thyroid gland secretes excessive thyroxine Caused by tumor of thyroid gland 13

14. Thyroid Diseases  Hyperthyroidism Symptoms ○ Tachycardia ○ Nervousness ○ Hyperactivity ○ Excessive excitability 14

15. Thyroid Diseases  Hyperthyroidism Symptoms ○ Tremendous appetite with weight loss ○ Diarrhea ○ High heat production ○ Moist skin ○ Extreme thirst 15

16. Thyroid Diseases  Hyperthyroidism Treatment to reduce thyroxine is often effective Surgery may be necessary Autoimmune condition: “Graves’ disease” Exophthalmos is characteristic symptom Treatment: medication, radiation, or surgery 16

17. Thyroid Diseases  Simple Goiter Enlargement of thyroid, generally due to inadequate iodine Asymptomatic until thyroid presses on trachea and esophagus and causes dyspnea and dysphagia 17

18. Thyroid Diseases  Simple Goiter Treatment ○ Potassium iodide followed by iodine in diet ○ Surgery may be necessary to decrease dysphagia and dyspnea 18

19. Thyroid Diseases  Hypothyroidism Decrease in thyroxine Symptoms ○ Fatigue ○ Sensitive to cold temperature ○ Thin nails and brittle hair ○ Excessive weight gain 19

20. Thyroid Diseases  Hypothyroidism Diagnosis is confirmed by blood hormone level Treatment is hormone replacement 20

21. Parathyroid Diseases  Parathyroid glands function in the regulation of blood calcium levels  Hyperparathyroidism Overproduction of parathormones by one or more of the four parathyroid glands 21

22. Parathyroid Diseases  Hyperparathyroidism Causes hypercalcemia leading to kidney stones, bone weakness, hyperactivity of heart 22

23. Parathyroid Diseases  Hyperparathyroidism Diagnosis is based on blood test results Treatment is directed at cause Prognosis is good with proper treatment 23

24. Parathyroid Diseases  Hypoparathyroidism Decrease in parathormone leading to low blood calcium May cause irritability of muscles called tetany Causes uncontrolled contraction of muscles in face and hands 24

25. Parathyroid Diseases  Hypoparathyroidism Diagnosis involves checking for Chvostek’s and Trousseau’s signs Treatment: vitamin D and calcium 25

26. Adrenal Gland Diseases  Also called suprarenals  Two distinct parts  Inner: medulla releases epinephrine and norepinephrine or “fight or flight” hormones  Outer: cortex controlled by adrenocorticotrophic hormone (ACTH) 26

27. Adrenal Gland Diseases  Secretes mineralocorticoids, glucocorticoids, and sex hormones  Cortisone used to treat inflammatory disease  Cortisone should be used short term only 27

28. Adrenal Gland Diseases  Cortisone side effects Hypertension Ulcers “Moon face” Drowsiness may mask symptoms of infection 28

29. Adrenal Gland Diseases  Conn’s syndrome- overproduction of aldosterone, a mineralocorticoid 29

30. Adrenal Gland Diseases  Cushing’s syndrome is overproduction of glucocorticoid, cortisol  Androgenital syndrome is overproduction of sex hormones 30

31. Adrenal Gland Diseases  Hypoadrenalism or Addison’s disease - low secretion of hormones by adrenal cortex 31

32. Pancreatic Islets of Langerhans Disease  Pancreas is exocrine and endocrine gland  Islets of Langerhans secrete insulin and glucagon 32

33. Pancreatic Islets of Langerhans Disease  Insulin lowers blood sugar and glucagon increases blood sugar  Sugar or glucose is primary source of energy for all tissue cells 33

34. Pancreatic Islets of Langerhans Disease  Without glucose, cells produce a waste product called ketones  Diabetes Mellitus - affects carbohydrate and sugar utilization due to lack of insulin 34

35. Pancreatic Islets of Langrerhans Disease  Symptoms Polydipsia Polyuria Polyphagia 35

36. Pancreatic Islets of Langerhans Disease  Two types: Type 1 and Type II  Type 1- Diabetes Mellitus Known as insulin-dependent diabetes mellitus Most serious Affects children and young adults before age 25 36

37. Pancreatic Islets of Langerhans Disease  Two types: Type 1 and Type II  Type 1 - Diabetes Mellitus Requires daily injections of insulin Thought to be an autoimmune disorder Individuals do not usually secrete insulin, making control difficult 37

38. Pancreatic Islets of Langerhans Disease  Type 1 - Diabetes Mellitus Must follow strict diet Monitor blood levels Administer daily insulin Exercise and stress can alter insulin needs 38

39. Pancreatic Islets of Langerhans Disease  Type II: Formerly called non-insulin- dependent Diabetes Mellitus Adult-onset diabetes Gradual onset occurring most often in obese females over forty 39

40. Pancreatic Islets of Langerhans Disease  Type II: Formerly called non-insulin- dependent Diabetes Mellitus Thought to be caused by the wearing out of pancreatic islets of Langerhans Usually controlled with diet, exercise, and oral medication to stimulate insulin secretion 40

41. Pancreatic Islets of Langerhans Disease  Complications Diabetic shock occurs rapidly Result of taking too much insulin and not eating enough food 41

42. Pancreatic Islets of Langerhans Disease  Complications Symptoms ○ Diaphoresis ○ Light-headedness ○ Trembling Treatment is emergent with IV glucose to raise blood sugar 42

43. Pancreatic Islets of Langerhans Disease  Diabetic Coma Not enough insulin or too many carbohydrates in diet Symptoms: ○ Polyuria and Polydipsia ○ Dehydration ○ Ketoacidosis 43

44. Pancreatic Islets of Langerhans Disease  Diabetic Coma Progresses slowly with the individual becoming lethargic and slipping into coma Slow deep breathing pattern and “fruity or sweet” smelling breath 44

45. Pancreatic Islets of Langerhans Disease  Complications of diabetes include Atherosclerosis Diabetic retinopathy Kidney damage Diabetes cannot be cured  Diagnosis: history and blood glucose testing 45

46. Pancreatic Islets of Langerhans Disease  Gestational Diabetes occurs during pregnancy  Usually discovered with routine urine testing during prenatal visits  Treatment: diet, exercise, and medications  Injectable insulin controls sugar levels 46

47. Pancreatic Islets of Langerhans Disease  Gestational Diabetes Usually disappears after delivery Women are often affected later in life by adult-onset diabetes 47

48. Pancreatic Islets of Langerhans Disease  Hypoglycemia Abnormally low blood sugar - less than 60 Symptoms are light-headedness, diaphoresis, and trembling Diagnosis is confirmed with glucose test Treatment is dependent on cause 48

49. Reproductive Gland Disease  Hypergonadism Increased hormone production before puberty Diagnosis: blood testing for elevated hormones Treatment: removal or radiation of tumors to suppress hormones 49

50. Reproductive Gland Disease  Hypogonadism Decreased sex hormone production by puberty Treated with hormones 50