Principle of Endocrine & Metabolic Diseases,Contents,Endocrine system and Hormones Diagnosis of Endocrine Diseases Treatment of Endocrine Diseases Progress,Endocrine system & Hormones,(1) Endocrine system & function (2) Hormone & function (3) Regulation of hormone (4) Mechanism of hormone action,Endocrine system,Glands + Cells,Hormones,Hypothalamus Pituitary CRH ACTH TRH TSH GnRH(LRH) FSH, LH GHRH, GHRIH GH PIF, PRIF PRL ADH ADH,Endocrine System & Hormones,Hormones,Organ,Organ Hormone Parathyroid PTH Thyroid TH(T3,T4) , Cacitonine Pancreas Insulin, Glucagon, SS Adrenal gland Glucocorticoid, Aldosterone, Testosterone Catecholamine Ovary Estrogen, Progesterone Testis Testosterone,Endocrine System & Hormones,Cells Hormone APUD cells Peptide or Catecholemine Adipocytes Leptin Endothelium cells Peptides,Endocrine Cells & Hormones,Hormone,Classification Peptides or Proteins: GH Amine: Catecholamines Amino Acid Analogs: TH Steroids: Cortisol, VitD,Hormone,Secretion Endocrine: Paracrine: Autocrine: Intracrine:,Hormone,Secretion Rhythms Pulsatile or cyclic secretion: likes a wave Insulin, PRL, TSH change from min. to hr. FSH, LH, E, and P change in wks T4 change in season Circadian variability ACTH and cortisol : 8am/4pm/midnight Sleep-associated rhythms GH，Prolectin,Hormone,Regulation Endocrine and Nervous system Endocrine and Endocrine Endocrine and Immune system Endocrine and Metabolism,Hypothalamus-pituitary-target glands Feedback Regulation,Nerve impulse & Cytokines,Advanced never center,Hypothalamus,Pituitary,Target Glands,TRH,TH,Hypothalamus,Pituitary,Thyroid,TH Secretion Regulation,TSH,Cortisol Secretion Regulation,FSH, LH,GnRH,E2, P,Hypothalamus,Pituitary,Gonads,Gonadal Hormone Secretion Regulation,One hormone, Multiple actions One function, Multiple hormones,Interaction of Hormones,Self-review Hormone Other regulation system Mechanism of action Hormone receptors,2. Diagnosis of Endocrine Diseases,(1) Symptoms- Fantastico (2) Signs- Inspection (3) Lab Tests- Function (4) Causes or Localization,Symptoms & signs Diseases Weight gain Hypothalamic syn. Cushing syn. Hypothyroidism, Insulinoma Weight loss Adrenal insufficiency, Hyperthyroidsm, DM, Hypopituitarism, Pheochromocytoma Short stature Idiopathic GH deficiency (Dwarfism), Turners syn. Tall stature Pituitary giganism, Sexual precocity,Symptoms & Signs,Symptoms & signs Diseases Polyuria Diabetes insipidus, Diabetes mellitus, Hypercalcemia, Hypokalemia Hyperpigmentation Addisons syn. Nelsons syn. Hypopigmentation Panhypopituitarism Acne Androgen excess, PCOS, Cushing syn. Striae Cushing syn.,Symptoms & Signs,Symptoms & signs Diseases Decreased body hair Hypothyroidism, Hypopituitarism Hirsutism Androgen excess states, Cushing syn. Amenorrhea Adrenal insufficiency, Cushing syn. Hyperprolactinemic states, PCOS, Hypopituitarism, Ovarian failure Galactorrhea Hyperprolactinemic states, Prolactinomas, Hypothyroidism,Symptoms & Signs,Symptoms & signs Diseases Proptosis Graves disease, Obital tumor Hypokalemia Primary aldosteronism, Paralysis Renin-secreting tumors Cushing syn. Acanthosis nigricans Obesity, PCOS, Acromegaly, Severe insulin resistance, Cushing syn. Bone pain Osteoporosis, Hypercalcemia, Hyperparathyroidism,Symptoms & Signs,The level of hormone: TH, GH, Insulin The effect of hormones: BG, Ca Basal condition or to some provocative stimulus Blood or urine samples,Laboratory Tests,Basal levels: FT3, FT4, TT3, TT4 Hormones rhythm: ACTH-Cortisol Provocative (functional) tests Stimulation test: on hypofunction disease eg. TRH, ACTH, OGIRT Suppression test:on hyperfunction disease. eg. dexmethasone suppression test on Cushing syndrome.,Laboratory Tests,Localization & Cause Diagnosis,Localization Imaging studies: MRI , CT, ECT, B ultrasound Cause diagnosis Immunoassay: IAA, ICA, GAD, TPOAb, TgAb Genetic analysis: DNA analysis Biopsy procedures: Fine-needle biopsy,3. Treatment of Endocrine Diseases,(1) To causes (2) To Excess of hormone (3) To Deficiency of hormone (4) To resistance to hormone,Cause of Endocrine Hyperfunction,Tumor: ACTH-producing tumor Hyperplasia: Adrenal hyperplasia Autoimmune stimulation: GD Ectopic endocrine syndrome Drugs,Cause of Endocrine Hypofunction,Destruction of the gland Autoimmune disease Schmidts syn.(hypothyridism, Addison) Neoplasms, infection or hemorrhage. Extraglandular disorders Congenital defects in hormone biosynthesis Receptor Deficiency Drugs,Defects in Sens