Week 11 Module 2 Content

Hypofunction

Underproduction of a hormone

Causes of hypofunction

Congenital defects, injury to glandular cells, decline in function with ageing, atrophy due to drug therapy or unknown causes, receptor defects

Hyperfunction

Excessive hormone production

Causes of hyperfunction

Excessive stimulation and hyperplasia or hypertrophy of endocrine gland, hormone producing tumour of gland, ectopic hormone secretion, medication, decrease negative feedback

Anterior pituitary gland hormones

hGH, TSH, FSH, LH, prolactin, ACTH, MSH

Posterior pituitary gland hormones

Oxytocin, ADH

Causes of multi-hormone pituitary disruptions

Tumours, pituitary surgery or radiation, lesions and head trauma, infection, inflammation, autoimmune disease, genetic disease, hypothalamic disorders, pituitary infarction, hypoxic necrosis

Clinical manifestations of hypopituitarism

Headache, altered mental state, postural hypotension, being chronically unfit, weakness and fatigue, growth failure, loss of appetite, impaired sexual function, cold intolerance, decrease bone density, morbid obesity

Growth hormone hyposecretion in children

Cells responsible for growth hormone secretion do not form properly or are irreversibly damaged, interferes with linear bone growth

Consequences of GH hyposecretion in children

Delayed skeletal maturation, short stature or dwarfism, disrupts normal blood glucose levels

GH hyposecretion in adults

Rare, lean body mass, reduced bone density

GH hypersecretion in children

Results in increased linear bone growth - gigantism, delayed puberty, double vision, weakness

Manifestation of adrenal cortical insufficiency

Anorexia and weight loss, fatigue and weakness, depression, inability to respond to stressful situations, GI symptoms, myalgia, abdominal pain, hyperkalaemia, hyperpigmentation, associated autoimmune conditions

Adrenal cortical hormone excess manifestations

Altered fat metabolic, muscle weakness and wasting, purple striae, osteoporosis, hypokalaemia, gastric acid secretion, poor wound healing, extreme mood swings

Manifestations of hypothyroidism

Mental and physical sluggishness, mental retardation in children, weight gain but decreased appetite, elevated serum cholesterol, decreased co, bradycardia, constipation, hypoventilation, cold intolerance

Manifestations of hyperthyroidism

Restlessness, irritability, anxiety, increased co, tachycardia and palpitations increased appetite, dyspnoea, heat intolerance, thin and silky skin and hair, weigth loss, increased muscle tone

Parathyroid gland

Secretes PTH, regulates calcium balance to increase blood calcium levels, opposes actions of calcitonin

Manifestations of parathyroid deficiency

Muscle twitches and spasms, paraesthesia, fatigue, changes in emotional state, cardiac dysrhythmias, hypercalcaemia

Manifestations of parathyroid excess

Increased risk of pathological fractures, renal stones, GIT disturbances, polyuria, cardiac dysrhythmias

Prediabetes - Impaired fasting plasma glucose

FPG 5.6 to 6.9 mmol/L

Prediabetes - impaired glucose tolerance