Endocrine System Diseases: Diagnosis and Treatment

1. Chapter 14Endocrine System Diseases and Disorders

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

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

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

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

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

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

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

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

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

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

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

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

14. Thyroid Diseases • Hyperthyroidism • Symptoms • Tachycardia • Nervousness • Hyperactivity • Excessive excitability

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

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

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

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

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

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

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

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

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

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

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

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)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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