Rapid Revision Endocrinology

GH

Low: short stature, delayed puberty [Treatment: TRH]

High: acromegaly, gigantism [T: somatostatin, dopamine analogues]

PROLACTIN

High: galactorrhea [T: bromocriptine, like DOPAMINE]

ADH/AVP/vasopressin

Low: Central DI, from posterior pituitary problem

High: Nephrogenic DI, ADH V2 receptor bad

Symptoms: high urine output, high osmolarity, low blood volume

Hypophysectomy: won't be secreting ADH so won't reabsorb water so

urinate more

THYROID

Hyper: Grave's Disease, Ab activates TSH receptor, high levels of T3 and T4, low TSH from negative feedback of T3, weight loss, hunger, nervousness, sweat, heat intolerance, high BMR, HR, goiter. Can also be caused by high TRH and TSH levels. [T: PTU]

Hypo: AI destruction of thyroid, low T3 and T4, TSH can be high or low. Weight gain, cold intolerance, low BMR, lethargy, goiter. Can cause cretinism (retardation) in developing fetus. [T: TH replacement]

Hashimoto's: main cause of goiter, AI activity towards thyroid gland, high TSH, low T3, T4

ADRENAL CORTEX

High cortisol: hyperglycemia

Low cortisol: hypoglycemia

High aldosterone: High K secretion, hypokalemia, hypervolemia

Low aldosterone: Low K secretion, hyperkalemia, hypovolemia

High androgens: masculinization of females

Low androgens: loss of pubic hair and libido in females

Addison's Disease: primary adrenal cortex deficiency, all 3 hormones low, also get hyperpigmentation form high ACTH levels and relates MSH levels. [T: H replacement]

Secondary adrenalcortical insufficiency: Low CRH and low ACTH. All 3 hormones low. Mostly normal aldosterone. No hyperpigmentation

Cushing's syndrome: High cortisol causes low ACTH. Obesity. DEX test lowers ACTH

Cushing's disease: High cortisol and high ACTH from pituitary tumor. DEX test does nothing. Central obesity, buffalo hump, striae, hyperglycemia [T: metyrapone blocks cortisol synthesis]

Conn's disease: Primary hyperaldosteronism, via tumor

21-B-hydroxylase deficiency: No aldosterone, cortisol. Shunts to androgens, virilization of females. High ACTH levels. [T: H replacement]

17-A-hydroxylase deficiency: No androgens or cortisol, shunts to aldosterone. Lack of pubic hair and low libido in women, high BP

INSULIN

Diabetes Type I: destruction of pancreatic B cells. Hyperglycemia, FFA, ketoacids, polyurea, thirst

Diabetes Type II: obesity causes, insulin resistance

PTH

Primary hyperPTH: From PTH tumors, high PTH, high cAMP, high blood Ca, stones bones and groans

Secondary hyperPTH: Vitamin D deficiency, high PTH, high cAMP, low calcitriol, low 25(OH)D, low Ca, low phosphate. Lack of vitamin D can lead to RICKETS

HypoPTH: Low PTH, low cAMP, low Ca, high phosphate. [T: Calciotriol]

Chronic renal failure: No calcitriol produced, bone abnormalities, 25 (OH)D in liver normal

PTH peptide: low PTH, high cAMP, high Ca

Category: Physiology Notes