1. Hormones

2. Hormones: compounds which are synthesized and secreted from special secretory or endocrine glands.

3. Hormones Hormones release is regulated by either: 1.Other hormones (feedback mechanism): e.g. TSH stimulates the thyroid gland to secrete thyroid hormones. 2.Chemical agents; e.g.  glucose in blood   insulin secretion.  glucose in blood   insulin secretion.  Na in blood   aldosterone.  Na in blood   aldosterone.  Ca 2+ in serum   parathyroid (PTH)hormone.  Ca 2+ in serum   parathyroid (PTH)hormone. 3. Nervous system: e. g.: Sympathetic activation   Adrenaline secreted from adrenal medulla

4. Hormones Clinical disorders of endocrine system: 1.Overproduction of a certain hormone (hyperfunction). 2.Deficency or absence of a certain hormone (hypofunction).

5. Hormones The case will be divided into: 1.Chief complaint: the symptoms the patient is complaining from and they are the first guide lines for diagnoses of the case. 2.History of patient illness: it includes the pt’s age-physical examination (heart rate, blood pressure)- any apparent features that may lead to the diagnosis of the cause of his complain (skin swelling, tremors, convulsions, fatigue, etc…..)

6. Hormones 3.Family history: illness history of his family, which may help if his illness related to inheritance (genetics). 4.Medications: any drug the pt takes either for treatment of a chronic disease as hypertension of diabetes. Or a drug he recently took before the appearance of the symptoms he complains from.

7. Hormones Laboratory values (lab values): these values may include parameters which are directly related the case, e.g. the level of T 3 and T 4 in case of simple goiter.

8. Hormones Lab values includes: I-Liver function tests: Serum albumin test: measures the amount of albumin in serum  helps in determining liver or kidney diseases or  protein absorption.Serum albumin test: measures the amount of albumin in serum  helps in determining liver or kidney diseases or  protein absorption. Alkaline phosphatase (ALP): Tissue è high amounts of ALP include (liver, bile duct & bone) used to diagnose liver, bone diseases (non- specific).Alkaline phosphatase (ALP): Tissue è high amounts of ALP include (liver, bile duct & bone) used to diagnose liver, bone diseases (non- specific).

9. ALT (alanine transaminase) SGPT: used to determine liver damage.ALT (alanine transaminase) SGPT: used to determine liver damage. AST (asparatate transaminase) SGOT: found in high conc. in heart muscle, liver cells & skeletal muscles  used to determine liver damage (NON specific).AST (asparatate transaminase) SGOT: found in high conc. in heart muscle, liver cells & skeletal muscles  used to determine liver damage (NON specific). Prothrombin time (PT): time taken for blood (plasma ) to clot.Prothrombin time (PT): time taken for blood (plasma ) to clot. Hormones

10. Bilirubin:Bilirubin: it is a product that results from the breakdown of haemoglobin, used to monitor liver or gallbladder problems. Most of bilirubin is chemically attached to another molecule before it is released in bile (Conjugated=direct) while unconjugated bilirubin is called indirect. - Impairment of liver function indirect bilirubin -Impairment of liver secretion to gall bladder due to biliary stone direct bilirubin.. N.B. liver disease should be monitored using combination of ALP, ALT, AST & bilirubin.

11. Hormones

12. Blood urea nitrogen (BUN): urea nitrogen is product as result of breakdown of protein  used to evaluate kidney function.  BUN  liver failure, low protein diet or malnutrition.  BUN  Xss protein, kidney diseases. Heart failure ( blood flow to the kidney) GIT bleeding (ulcers) (blood clots degradation in GIT nitrogenous compounds urea in blood

13. Hormones

14. Mean cell haemoglobin (MCH): the average haemoglobin content of red blood cells.(Hb/RCC). Basophils (Basos): the number of basophils/litre. Platelet count (Plt): the number of platelets/litre. Lymphocytes (Lymphs): the number of lymphocytes/litre. White cell count (WBCs): the number of white cells/litre. Monocytes (Monos): the number of monocytes/litre.. Erythrocyte sedimentation rate (ESR): the velocity of sedimentation of red cells in 1 st hour (mm/hr). It is a non-specific measure of inflammation and infection.

15. Hormones

18. - Endocrine dysfunction Diabetes mellitus Ketoacidosis. Cushing syndrome metabolic alkalosis. Lung function - Hypoventilation accumulation of CO 2 and consequently carbonic acid respiratory acidosis -Hyperventilation flushing CO 2 out of the blood respiratory alkalosis.

19. Hormones