Critical illness and endocrinology. ICU Fellowship Training Radboudumc
|
|
- Erick Lester
- 5 years ago
- Views:
Transcription
1 Critical illness and endocrinology ICU Fellowship Training Radboudumc
2 Critical illness Ultimate form of severe physical stress Generates an orchestrated endocrine response to provide the energy for fight and flight response Lipolysis, proteolysis and gluconeogenesis
3 Thyroid metabolism T3 TSH _ T3 Bound to: TBG TB pre-albumin Transthyretin Albumin Protein mrna T3 T3R RxR T3 and T4 T3 (10%) T4 (90%) FT4 0.03% FT3 0.3% T3 T4 D3,D1 T3 T4 D1,D2 T3 rt3 D1,D2 T2 D3,D1
4 Non-thyroidal illness syndrome Low T3, low T4 and normal or slightly decreased TSH Serum T3 decreases within hours after the onset of acute stress (amount varies with severity of stress and predicts outcome)
5 Considerations Acute changes probably adaptive (compare fasting) Potentially maladaptive during prolonged critical illness Four small trials show no benefit from thyroid hormone replacement
6 Pathogenesis Central downregulation of HPT axis (decreased TRH) Changes in liver metabolism of thyroid hormone
7 Acute Chronic Acute low T3-syndrome Euthyroid sick syndrome Non thyroidal illness TRH 7 TSH TSH (miu/l) No nocturnal TSH surge h h h h Acute Chronic T4 Plasma T3 rt3 Liver activity D1 D3 Muscle activity D2
8 NTIS often combined with low food intake
9 Drugs interfering with thyroid hormones
10 Thyroid storm < 10% of patients hospitalized for thyrotoxicosis More common in women (age years) Usually precipitating event Diverse symptoms and signs
11
12 Myxedema coma End stage of untreated hypothyroidism Usually precipitating event Extremely rare (estimated 0.22/ year) Usually hospitalized elderly women
13 Treatment
14 Critical Illness-Related Corticosteroid Insufficiency Inadequate cellular corticosteroid activity for the severity of the patient s critical illness Stress system HPA-axis & Locus ceruleus/ne sympathetic NS Acute phase reaction Systemic inflammation Vital organs tissue defense response
15 HPA axis dysfunction during critical illness 10-20% in critically ill medical patients up to 60% in septic shock
16 Dissociation between ACTH and cortisol
17 Circadian rhythm Daily production of cortisol is μmol
18 Cortisol metabolism during critical illness Cortisol levels are high during acute physical stress Attributed to stress-induced HPA axis activation Reduced cortisol metabolism could be another explanation Bile acids may suppress activity of cortisol metabolising hormones Boonen E. N Engl J Med 2013
19 Cortisol metabolism Kidney Liver
20 Cortisol levels increase during critical illness Boonen E. N Engl J Med 2013
21 ACTH levels are low during critical illness Boonen E. N Engl J Med 2013
22 Boonen E. N Engl J Med 2013
23 Boonen E. N Engl J Med 2013
24 Plasma cortisol 80-90% tightly bound to corticosteroid-binding globulin 10-15% bound with low affinity to albumin or free
25
26 Impairment of adrenal cortisol synthesis Damage to neuroendocrine cells (W-F syndrome) Suppressed ACTH synthesis (feedback by elevated free cortisol and medications) Diminished adrenal steroidogenesis (60%) also by medications (etomidate, opioids) Tissue resistance to glucocorticoids
27
28 Symptoms General Fever, asthenia Neurological Cardiovascular Digestive Respiratory Laboratory Imaging Confusion, delirium, coma Hypotension refractory to fluid loading Decreased sensitivity to catecholamines Huh cardiac index Nausea, vomiting, intolerance to enteral feeding Persistent hypoxia Hypoglycemia, hyponatremia, hyperkalemia, metabolic acidosis, hypereosinophilia Hemorrhage or necrosis in hypothalamus, pituitary gland or adrenal gland
29 Diagnosis Either delta cortisol < 9 μg/dl after 250 μg cosyntropin or random plasma cortisol < 10 μg/dl Use plasma total cortisol and not salivary free cortisol Do not use the hemodynamic response to hydrocortisone for the diagnosis of CIRCI Do not use plasma corticotropin levels for the diagnosis of CIRCI
30 Recommendations for corticosteroids in critical care Do not use corticosteroids in septic patients without shock Only use corticosteroids in patients with septic shock resistant to fluid and moderate- to high vasopressor therapy Use < 400 mg hydrocortison for 3 days In patients with ARDS and P/F < 200 mmhg corticosteroids may be administered within 14 D
31 Recommendations for corticosteroids in critical care Hydrocortison < 400 mg/day for 5-7 days may be considered for severe CAP Do not use corticosteroids in severe influenza Strong recommendation for the use of corticosteroids in meningitis Consider the use of corticosteroids in comatose patients after cardiac arrest
32 Growth hormone secretion Sleep Growth hormone (μg/l) 8 AM 8 PM Midnight 8 AM Pulsatile secretion stimulated by GHRH/ghrelin and inhibited by somatostatin
33 In acute critical illness peripheral GH resistance develops with low IGF-1 levels
34 GH and critical illness Health Acute critical illness Prolonged critical illness In prolonged critical illness during feeding pulsatility is lost and GH resistance decreases
35 GH secretion can be reactivated
Subclinical Problems in the ICU:
Subclinical Problems in the ICU: Corticosteroid Insufficiency C. S. Cutillar, M.D., FPCP, FPSEM Associate Professor Cebu Institute of Medicine H-P-A Axis during Critical Illness CRH ACTH H-P-A Axis during
More informationObjectives. Pathophysiology of Steroids. Question 1. Pathophysiology 3/1/2010. Steroids in Septic Shock: An Update
Objectives : An Update Michael W. Perry PharmD, BCPS PGY2 Critical Care Resident Palmetto Health Richland Hospital Review the history of steroids in sepsis Summarize the current guidelines for steroids
More informationAssessing Adrenal Function in Ill, Hospitalized Patients. Bruce Redmon, MD Division of Endocrinology, Diabetes and Metabolism
Assessing Adrenal Function in Ill, Hospitalized Patients Bruce Redmon, MD Division of Endocrinology, Diabetes and Metabolism Disclosures Very surprised when I received an email two weeks ago disclosing
More informationHormonal regulation of. Physiology Department Medical School, University of Sumatera Utara
Hormonal regulation of nutrient metabolism Physiology Department Medical School, University of Sumatera Utara Homeostasis & Controls Successful compensation Homeostasis reestablished Failure to compensate
More informationBack to the Future: Updated Guidelines for Evaluation and Management of Adrenal Insufficiency in the Critically Ill
Back to the Future: Updated Guidelines for Evaluation and Management of Adrenal Insufficiency in the Critically Ill Joe Palumbo PGY-2 Critical Care Pharmacy Resident Buffalo General Medical Center Disclosures
More informationDIAGNOSING AND TREATING CORTISOL INSUFFICIENCY IN ICU MOHD BASRI MAT NOR, IIUM, KUANTAN, MALAYSIA
DIAGNOSING AND TREATING CORTISOL INSUFFICIENCY IN ICU MOHD BASRI MAT NOR, IIUM, KUANTAN, MALAYSIA Content Glucocorticoid physiology and effects of critical illness on HPA axis Assessment of tissue cortisol
More informationThe endocrine system is made up of a complex group of glands that secrete hormones.
1 10. Endocrinology I MEDCHEM 535 Diagnostic Medicinal Chemistry Endocrinology The endocrine system is made up of a complex group of glands that secrete hormones. These hormones control reproduction, metabolism,
More information1. Changed level of a certain hormone Stimulation of the oxygen consumption 3. Decoupling of oxidative phosphorylation 2.
1. How can endocrine disorders be classified? 1. Hereditary, acquired 2. Active, passive 3. Uncompensated, overcompensated 4. Primary, secondary 5.1, 4 6.1, 2, 3, 4. ENDOCRINE SYSTEM 2. Which is the MAIN
More informationEndocrine System. Regulating Blood Sugar. Thursday, December 14, 17
Endocrine System Regulating Blood Sugar Stress results in nervous and hormonal responses. The adrenal glands are located above each kidney. Involved in stress response. Stress Upsets Homeostasis Stress
More informationTHYROID HORMONES & THYROID FUNCTION TESTS
THYROID HORMONES & THYROID FUNCTION TESTS SCHOOL OF MEDICINE AND HEALTH SCIENCES DIVISION OF BASIC MEDICAL SCIENCES DISCIPLINE OF BIOCHEMISTRY AND MOLECULAR BIOLOGY CLINICAL BIOCHEMISTRY LECTURE BMLS III
More informationTHYROID HORMONES: An Overview
1 SCHOOL OF MEDICINE AND HEALTH SCIENCES DIVISION OF BASIC MEDICAL SCIENCES DISCIPLINE OF BIOCHEMISTRY AND MOLECULAR BIOLOGY PBL SEMINAR MBBS III; BMLS & BDS Year 3 What are the Thyroid Hormones? THYROID
More informationEndocrine part two. Presented by Dr. Mohammad Saadeh The requirements for the Clinical Chemistry Philadelphia University Faculty of pharmacy
Endocrine part two Presented by Dr. Mohammad Saadeh The requirements for the Clinical Chemistry Philadelphia University Faculty of pharmacy Cushing's disease: increased secretion of adrenocorticotropic
More informationThe Endocrine System/Hormones
The Endocrine System/Hormones Controls many body functions exerts control by releasing special chemical substances into the blood called hormones Hormones affect other endocrine glands or body systems
More information13 Common Endocrine INTRODUCTION CHANGES IN GH/IGF-1 AXIS
13 Common Endocrine Abnormalities in ICU Abstract: With sophisticated mechanical devices and monitoring systems, mortality and morbidity in the critically ill patients in the intensive care units (ICU)
More informationHypothalamic Control of Posterior Pituitary
Hypothalamic Control of Posterior Pituitary Hypothalamus neuron cell bodies produce ADH: supraoptic nuclei Oxytocin: paraventricular nuclei Transported along the hypothalamohypophyseal tract Stored in
More information74. Hormone synthesis in the adrenal cortex. The glucocorticoids: biosynthesis, regulation, effects. Adrenal cortex is vital for life!
74. Hormone synthesis in the adrenal cortex. The glucocorticoids: biosynthesis, regulation, effects. Adrenal cortex is vital for life! 5 g each Zona glomerulosa : Mineralocorticoids ALDOSTERON Zona fasciculata:
More informationEndocrine Crises. Fred Pieracci, MD, MPH TACS Fellow
Endocrine Crises Fred Pieracci, MD, MPH TACS Fellow 4.14.14 Endocrine Crises Rare Highly lethal Elusive Easily treatable 1. Thyroid 1. Thyroid storm 2. Myxedema coma Outline 2. Parathyroid: 1. Severe hypercalcemia
More information58 Year-old Male with Alcoholic Cirrhosis Presents with Hyponatremia. Jess Hwang 11/8/12
58 Year-old Male with Alcoholic Cirrhosis Presents with Hyponatremia Jess Hwang 11/8/12 HPI Fluid leaking from umbilical hernia secondary to his ascites Went to OR for drain placement which was complicated
More informationChecking the Right Box at the Right Age: the Art of Pediatric Endocrine Testing
Checking the Right Box at the Right Age: the Art of Pediatric Endocrine Testing Jean-Pierre Chanoine, MD Endocrinology and Diabetes Unit British Columbia s Children s Hospital Objectives 1. Interpret the
More informationFrom Where? Rochester, NY
From Where? Rochester, NY 3 Days of Sunshine Annually Invented SAD Lights Disclosures I have no financial disclosures The feds want their money back The only bad question... Objectives Review endocrine
More informationPITUITARY: JUST THE BASICS PART 2 THE PATIENT
PITUITARY: JUST THE BASICS PART 2 THE PATIENT DISCLOSURE Relevant relationships with commercial entities none Potential for conflicts of interest within this presentation none Steps taken to review and
More informationAdrenal Insufficiency in Critical Illness
Adrenal Insufficiency in Critical Illness Mark Stuart Cooper, BM BCh, MRCP, PhD Paul Michael Stewart, MD, FRCP, FmedSci One of the more controversial areas in critical care in recent decades relates to
More informationStress and Disease. Chapter 8. Elsevier items and derived items 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
Stress and Disease Chapter 8 Stress A person experiences stress when a demand exceeds a person s coping abilities, resulting in reactions such as disturbances of cognition, emotion, and behavior that can
More informationPrinciples of Endocrinology
Principles of Endocrinology 凌雁 Yan Ling Department of Endocrinology and Metabolism Zhongshan Hospital Fudan University Scope of endocrinology Endocrinology is a branch of biology and medicine dealing with
More informationBIOH111. o Cell Module o Tissue Module o Integumentary system o Skeletal system o Muscle system o Nervous system o Endocrine system
BIOH111 o Cell Module o Tissue Module o Integumentary system o Skeletal system o Muscle system o Nervous system o Endocrine system Endeavour College of Natural Health endeavour.edu.au 1 Textbook and required
More informationLABORATORY TESTS FOR EVALUATION OF THYROID DISORDERS
LABORATORY TESTS FOR EVALUATION OF THYROID DISORDERS Maryam Tohidi Anatomical & clinical pathologist Research Institute for Endocrine Sciences THYROID GLAND (15-25 gr), (12-20 gr), 2 lobes connected by
More informationPituitary Gland Disorders
Pituitary Gland Disorders 1 2 (GH-RH) (CRH) (TRH) (TRH) (GTRH) (GTRH) 3 Classification of pituitary disorders: 1. Hypersecretory diseases: a. Acromegaly and gigantism: Usually caused by (GH)-secreting
More informationLou Haenel, IV,D.O., FACOI, FACE Roper Endocrinology Charleston, SC
Lou Haenel, IV,D.O., FACOI, FACE Roper Endocrinology Charleston, SC Myxedema Coma Life-threatening hypothyroidism resulting from untreated or inadequately treated hypothyroidism Precipitated by severe
More informationShould Roids Be the Rage in Septic Shock? Lauren Powell, MSN, RN, CCRN, AGACNP-BC CHI Baylor St. Luke s Medical Center, Houston, TX
Should Roids Be the Rage in Septic Shock? Lauren Powell, MSN, RN, CCRN, AGACNP-BC CHI Baylor St. Luke s Medical Center, Houston, TX Learning Objectives 1. Review the mechanism of action for the use of
More informationCortisol (serum, plasma)
Cortisol (serum, plasma) 1 Name and description of analyte 1.1 Name of analyte Cortisol 1.2 Alternative names Hydrocortisone, 11β; 17, 21 trihydroxypregn 4 ene 3,20 dione 1.3 NMLC code 1.4 Description
More informationLawrence S. Kirschner, MD, PhD Professor of Medicine
Adrenal Insufficiency: Current Practice 2012 Lawrence S. Kirschner, MD, PhD Professor of Medicine Division of Endocrinology, Diabetes, and Metabolism The Ohio State University s Wexner Medical Center Overview
More informationBIOLOGY - CLUTCH CH.45 - ENDOCRINE SYSTEM.
!! www.clutchprep.com Chemical signals allow cells to communicate with each other Pheromones chemical signals released to the environment to communicate with other organisms Autocrine signaling self-signaling,
More informationCh 8: Endocrine Physiology
Ch 8: Endocrine Physiology Objectives 1. Review endocrine glands of body. 2. Understand how hypothalamus controls endocrine system & sympathetic epinephrine response. 3. Learn anterior pituitary hormones
More informationShould we use steroids in sepsis? J.G. van der Hoeven
Should we use steroids in sepsis? J.G. van der Hoeven Why I don t like it It is boring.. It usually results in emotional outcries in the audience If any, the effects on outcome are very small You are not
More informationDISORDERS OF THE THYROID GLAND SIGNS, SYMPTOMS, & TREATMENT ENDOCRINE SYSTEM AT A GLANCE OBJECTIVES ANATOMY OF THE THYROID
OBJECTIVES DISORDERS OF THE THYROID GLAND SIGNS, SYMPTOMS, & TREATMENT Stephanie Blackburn, MHS, MLS(ASCP) CM LSU Health Shreveport Clinical Laboratory Science Program Discuss the synthesis and action
More informationEmergency Medical Training Services Emergency Medical Technician Paramedic Program Outlines Outline Topic: Endocrine Revised: 11/2013
Emergency Medical Training Services Emergency Medical Technician Paramedic Program Outlines Outline Topic: Endocrine Revised: 11/2013 Endocrine system includes 8 major glands. 1. Pituitary (master gland)
More informationW. Heath Giles, M.D. University of Tennessee College of Medicine Chattanooga Assistant Professor of Surgery Associate Residency Program Director
W. Heath Giles, M.D. University of Tennessee College of Medicine Chattanooga Assistant Professor of Surgery Associate Residency Program Director It is our duty to each learner to honor your right to expect
More informationENDOCRINOLOGY COORDINATION OF PHYSIOLOGICAL PROCESSES:
ENDOCRINOLOGY COORDINATION OF PHYSIOLOGICAL PROCESSES: -In a living organism there must be coordination of number of physiological activities taking place simultaneously such as: movement, respiration,
More informationAdrenal Glands. Huiping Wang ( 王会平 ), PhD. Rm C541, Block C, Research Building, School of Medicine Tel:
Adrenal Glands Huiping Wang ( 王会平 ), PhD Department of Physiology Rm C541, Block C, Research Building, School of Medicine Tel: 88208292 Outline The Adrenal Glands The adrenal cortex The Adrenal Medulla
More informationSajeev Menon MD ADRENAL INSUFFICIENCY? FATIGUE? OUTLINE OBJECTIVES PATIENT 1 PATIENT 1 : CLINICAL COURSE
ADRENAL INSUFFICIENCY? FATIGUE? Sajeev Menon MD Endocrinologist KCIM OBJECTIVES OUTLINE Review primary and adrenal insufficiency including clinical and laboratory findings To appropriately interpret the
More informationEndocrine secretion cells secrete substances into the extracellular fluid
Animal Hormones Concept 30.1 Hormones Are Chemical Messengers Endocrine secretion cells secrete substances into the extracellular fluid Exocrine secretion cells secrete substances into a duct or a body
More informationThyroid Gland 甲状腺. Huiping Wang ( 王会平 ), PhD Department of Physiology Rm C541, Block C, Research Building, School of Medicine Tel:
Thyroid Gland 甲状腺 Huiping Wang ( 王会平 ), PhD Department of Physiology Rm C541, Block C, Research Building, School of Medicine Tel: 88208292 Outline Thyroid Hormones Types Biosynthesis Storage and Release
More informationManagement Of Medical Emergencies
Management Of Medical Emergencies U.S. Aging Population 35 million people (12%) 65 years or older Number will increase by nearly 75% by year 2030 The number of people more than 85 years old will approach
More informationEndocrine System. Chapter 20. Endocrine Glands and Hormones. The Endocrine System. Endocrine glands
Chapter 20 Endocrine System Endocrine Glands and Hormones The endocrine system consists of glands and tissues that secrete hormones Hormones are chemicals that affect other glands or tissues, many times
More informationChemical Regulation. Chapter 26. Testosterone and Male Aggression: Is There a Link? THE NATURE OF CHEMICAL REGULATION
Chapter 6 Chemical Regulation PowerPoint Lectures for Biology: Concepts and Connections, Fifth Edition Campbell, Reece, Taylor, and Simon Testosterone and Male Aggression: Is There a Link? Among male animals,
More informationThe Hypothalamo-Pituitary- Adrenal Axis
The Hypothalamo-Pituitary- Adrenal Axis Table 10.1 Factors Influencing Evaluation of Endocrine Function in Aging Physiologic Metabolism Body Composition Nutrition Exercise Stress Inter-endocrine Relations
More informationAdrenal insufficiency 25/09/57
Adrenal insufficiency นายแพทย อ ดมศ กด เล ศส ทธ พร โรงพยาบาลมหาราชนครราชส มา 25/09/57 Adrenal insufficiency Cause Primary VS secondary Acute VS Chronic Diagnosis Critically ill VS non-critically ill Treatment
More informationAdrenal gland consist of: Outer Cortex and Inner Medulla Hormones secreted by Adrenal Cortex are: Glucocorticoid, Mineralocorticoid and Sex Steroids
1 UNIVERSITY OF PAPUA NEW GUINEA SCHOOL OF MEDICINE AND HEALTH SCIENCES DIVISION OF BASIC MEDICAL SCIENCES DISCIPLINE OF BIOCHEMISTRY AND MOLECULAR BIOLOGY PBL MBBS Year III; BMLS & BDS Year 3 ADRENAL
More informationThe Endocrine System Part II
The Endocrine System Part II Thyroid gland Parathyroid glands Regulation of blood Calcium level Adrenal gland Exocrine part of pancreas (Islets of Langerhans) Thyroid Gland Located in the anterior neck
More informationCORTICOSTEROID USE IN SEPTIC SHOCK THE ONGOING DEBATE DIEM HO, PHARMD PGY1 PHARMACY RESIDENT VALLEY BAPTIST MEDICAL CENTER BROWNSVILLE
CORTICOSTEROID USE IN SEPTIC SHOCK THE ONGOING DEBATE DIEM HO, PHARMD PGY1 PHARMACY RESIDENT VALLEY BAPTIST MEDICAL CENTER BROWNSVILLE 1 ABBREVIATIONS ACCP = American College of Chest Physicians ARF =
More informationArt labeling Activity: Figure 16.1
ANP 1105D Winter 2013 Assignment 6 part I: The Endocrine Sy... Assignment 6 part I: The Endocrine System, Chapter 16 Due: 11:59pm on Monday, March 4, 2013 Note: To understand how points are awarded, read
More informationSCHOOL OF MEDICINE AND HEALTH SCIENCES DIVISION OF BASIC MEDICAL SCIENCES DISCIPLINE OF BIOCHEMISTRY & MOLECULAR BIOLOGY
1 SCHOOL OF MEDICINE AND HEALTH SCIENCES DIVISION OF BASIC MEDICAL SCIENCES DISCIPLINE OF BIOCHEMISTRY & MOLECULAR BIOLOGY PBL SEMINAR: SEX HORMONES PART 1 An Overview What are steroid hormones? Steroid
More informationTestosterone and other male hormones seem to be related to aggressive behavior in some species
Testosterone and Male Aggression Testosterone and other male hormones seem to be related to aggressive behavior in some species In the fish species Oreochromis mossambicus, elevated levels have been found
More informationEndocrine Notes Mrs. Laux AP Biology I. Endocrine System consists of endocrine glands (ductless), cells, tissues secrete hormones
I. Endocrine System consists of endocrine glands (ductless), cells, tissues secrete hormones regulates metabolism, fluid balance, growth, reproduction A. Hormones 1. chemical signals-cell to cell communication
More informationTHE ADRENAL (SUPRARENAL) GLANDS
THE ADRENAL (SUPRARENAL) GLANDS They are two glands, present above the kidneys. One adrenal gland is sufficient for human beings/mammals (example: we also have two kidneys but one is sufficient). The Adrenal
More informationAdrenal Insufficiency
Adrenal Insufficiency Normal adrenal physiology Clinical features, Laboratory findings Common causes of primary adrenal insufficiency Evaluation of suspected adrenal insufficiency Acute and chronic management
More informationInflammation. Sepsis Ladder
Maureen Maloney-Poldek MSN, RN Chamberlain College of Nursing Pathophysiology of sepsis and septic shock How sepsis affects the endocrine system Pathophysiology of adrenal insufficiency Clinical manifestations
More information4/23/2018. Endocrine System: Overview. Endocrine System: Overview
Endocrine System: Overview With nervous system, coordinates and integrates activity of body cells Influences metabolic activities via hormones transported in blood Response slower but longer lasting than
More informationSanjay B. Dixit, M.D. BHS Endocrinology Associates November 11, 2017
Sanjay B. Dixit, M.D. BHS Endocrinology Associates November 11, 2017 I will not be discussing this Outline of discussion Laboratory tests for thyroid function Diagnosis of hypothyroidism Treatment of
More informationChapter 12 Endocrine System (export).notebook. February 27, Mar 17 2:59 PM. Mar 17 3:09 PM. Mar 17 3:05 PM. Mar 17 3:03 PM.
Endocrine System Hormones Chemical messengers released directly into the bloodstream Regulate: *May have wide spread effect or only affect certain tissues ** : cells with receptors that respond to specific
More informationEndocrine changes in children with dengue virus infection
Asian Biomedicine Vol. 3 No. 5 October 2009; 557-561 Brief communication (Original) Endocrine changes in children with dengue virus infection Suttipong Wacharasindhu, Yupayong Bunjobpudsa, Somlak Tongmeesee,
More informationAdrenal function in critically ill patients: How to test? When to treat?
MEDICAL GRAND ROUNDS CME CREDIT AMIR HAMRAHIAN, MD Department of Endocrinology, Diabetes, and Metabolism, The Cleveland Clinic Foundation TAKE-HOME POINTS FROM LECTURES BY CLEVELAND CLINIC AND VISITING
More informationThyroid and Antithyroid Drugs
Thyroid and Antithyroid Drugs Dr. Yunita Sari Pane, MSi Department of Pharmacology HYPOTHALAMIC PITUITARY THYROID AXIS T3 and T4 are synthesized in the thyroid gland. Inorganic iodine is trapped with great
More informationThe Investigations of the Pituitary Gland
The Investigations of the Pituitary Gland Essential for understanding this presentation: 1) Anatomy: The Pituitary Gland and it s surroundings 2) Biochemistry: Hormones produced by the Pituitary Gland
More informationPancreas. Endocrine pancreas - Islets of Langerhans A or alpha cells glucagon B or beta cells insulin Delta cells somatostatin
Endocrine System Pancreas Endocrine pancreas - Islets of Langerhans A or alpha cells glucagon B or beta cells insulin Delta cells somatostatin Glucagon & Metabolism Produced by beta cells of Islets Primary
More informationEndocrine System. Human Physiology Unit 3
Endocrine System Human Physiology Unit 3 Endocrine System Various glands located throughout the body Some organs may also have endocrine functions Endocrine glands/organs synthesize and release hormones
More informationName. Endocrinology. d.) What gland in the brain is a major organizing center of hormone release?
Endocrinology Background Information: The endocrine system functions to maintain homeostasis within many of the longterm, ongoing processes that occur in the body. Some examples of these processes include
More informationThe Endocrine System. Lipid-Soluble Hormones. Bio217 Sp14 Unit 5. Bio217: Pathophysiology Class Notes Professor Linda Falkow
Bio217: Pathophysiology Class Notes Professor Linda Falkow Mechanisms of Hormonal Regulation Unit V: Endocrine System Disorders Chapter 17 Chap. 17: Mechanisms of Hormonal Regulation Chap. 18: Alterations
More informationThe Investigations of the Thyroid gland
The Investigations of the Thyroid gland Essential for understanding this presentation: 1) Anatomy: The Thyroid Gland and it s surroundings 2) Biochemistry: Hormones produced by the Thyroid Gland 3) Physiology:
More informationEndocrine System. A system that consists of glands that transmit chemical messengers throughout the body.
Endocrine System A system that consists of glands that transmit chemical messengers throughout the body. HORMONES: chemical that circulates throughout the blood stream and influence the activity of distant
More informationChapter 11 - Endocrine System
Chapter 11 - Endocrine System 11.1 Introduction A. The endocrine system is made up of the cells, tissues, and organs that secrete hormones into body fluids. B. The body has two kinds of glands, exocrine
More informationChapter 20. Endocrine System Chemical signals coordinate body functions Chemical signals coordinate body functions. !
26.1 Chemical signals coordinate body functions Chapter 20 Endocrine System! Hormones Chemical signals Secreted by endocrine glands Usually carried in the blood Cause specific changes in target cells Secretory
More informationThyroid disorders. Dr Enas Abusalim
Thyroid disorders Dr Enas Abusalim Thyroid physiology The hypothalamic pituitary thyroid axis And peripheral conversion of T4 to T3, WHERE, AND BY WHAT ENZYME?? Only relatively small concentrations of
More informationGUNA -ACTH GUNA -BETA-ENDORFIN GUNA -BETA-ESTRADIOL ADRENOCORTICOTROPIC HORMONE
GUNA -ACTH Stimulation of the adrenal cortex hormones as follows: Glucocorticoids: hydrocortisone, corticosterone, cortisol Mineralcorticoids: aldosterone, 11-Deoxycorticosterone Sex hormones Asthenia
More informationAdrenal Insufficiency During Pregnancy
Disclosures Adrenal Insufficiency During Pregnancy Research funding from Diurnal Limited via NIH CRADA mechanism Deborah P. Merke, M.D., M.S. Bethesda, MD Outline Primary Adrenal Insufficiency Physiological
More informationMedical and Rehabilitation Innovations Neuroendocrine Screening and Hormone Replacement Therapy in Trauma Related Acquired Brain Injury
Medical and Rehabilitation Innovations Neuroendocrine Screening and Hormone Replacement Therapy in Trauma Related Acquired Brain Injury BACKGROUND Trauma related acquired brain injury (ABI) is known to
More informationThe Pathological l Basis of Disease
Endocrine Diseases The Pathological l Basis of Disease - Graduate Course CMM5001 Qiao Li, MD, PhD Faculty of Medicine University of Ottawa Qiao.Li@uottawa.ca Outline Endocrine System Adrenal Gland Anatomy
More informationMOLECULAR BASIS OF THE NON-THYROIDAL ILLNESS SYNDROME IN CRITICAL ILLNESS
MOLECULAR BASIS OF THE NON-THYROIDAL ILLNESS SYNDROME IN CRITICAL ILLNESS BTC AWARD LECTURE LIESE MEBIS 21th May 2011 Laboratory of Intensive Care Medicine Katholieke Universiteit Leuven, Belgium Critical
More informationHormones by location
Endocrine System Hormones by location Pineal Gland: Melatonin Feeling of sleepiness Hypothalamus: Hormones that stimulate or inhibit pituitary Temp., hunger, parenting attachment, thirst Pituitary Gland:
More informationHormones. Introduction to Endocrine Disorders. Hormone actions. Modulation of hormone levels. Modulation of hormone levels
Introduction to Endocrine Disorders Hormones Self-regulating system (homeostasis) Affect: Growth Metabolism Reproduction Fluid and electrolyte balance Hormone actions Endocrine gland Hormone synthesis
More informationHormones and the Endocrine System Chapter 45. Intercellular communication. Paracrine and Autocrine Signaling. Signaling by local regulators 11/26/2017
Hormones and the Endocrine System Chapter 45 Intercellular communication Endocrine signaling Local regulators Paracrine and autocrine signaling Neuron signaling Synaptic and neuroendocrine signaling Paracrine
More informationEndocrine system overview
Endocrine system overview Nature of the hormonal system -Major integrator of body function Classification of hormones Endocrine vs paracrine Nature of hormone-receptor systems Role of the hypothalamuspituitary
More informationADDISON S DISEASE THE FACTS YOU NEED TO KNOW
ADDISON S DISEASE THE FACTS YOU NEED TO KNOW WHAT IS Addison's disease is a severe or total deficiency of the hormones made in the adrenal cortex, caused by its destruction. There are normally two adrenal
More informationBIO 116 Practice Assignment 1 The Endocrine System and Blood This is not a required assignment but it is recommended.
BIO 116 Practice Assignment 1 The Endocrine System and Blood This is not a required assignment but it is recommended. 1. Match the following glands of the endocrine system with the appropriate label 1.
More informationCATEGORY Endocrine System Review. Provide labels for the following diagram CHAPTER 13 BLM
CHAPTER 13 BLM 13.1.1 CATEGORY Endocrine System Review Provide labels for the following diagram. 1. 6. 2. 7. 3. 8. 4. 9. 5. 10. CHAPTER 13 BLM 13.1.2 OVERHEAD Glands and Their Secretions Endocrine gland
More informationCHAPTER 50 Endocrine Systems. Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
CHAPTER 50 Endocrine Systems Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Endocrine system All the endocrine glands and other organs with hormonesecreting
More informationThe Pathological l Basis of Disease
Endocrine Diseases The Pathological l Basis of Disease - Graduate Course CMM5001 Qiao Li, MD, PhD Faculty of Medicine University of Ottawa qiaoli@uottawa.ca Outline Endocrine System Adrenal Gland Anatomy
More informationThe Endocrine System
The Endocrine System Endocrine Glands Glands that secrete their products (HORMONES) into extracellular spaces around cells. The hormones then enter into the bloodstream by diffusing into the capillaries
More informationEndocrine System. Chapter 9
Endocrine System Chapter 9 Endocrine Organs Hormones Chemical messengers that are released from one tissue and transported through blood to a target tissue. Chemical classification: amino acids, steroids,
More informationEndocrine part one. Presented by Dr. Mohammad Saadeh The requirements for the Clinical Chemistry Philadelphia University Faculty of pharmacy
Endocrine part one Presented by Dr. Mohammad Saadeh The requirements for the Clinical Chemistry Philadelphia University Faculty of pharmacy HORMONES Hormones are chemicals released by a cell or a gland
More informationAdrenal Steroid Hormones (Chapter 15) I. glucocorticoids cortisol corticosterone
Adrenal Steroid Hormones (Chapter 15) I. glucocorticoids cortisol corticosterone II. mineralocorticoids i id aldosterone III. androgenic steroids dehydroepiandrosterone testosterone IV. estrogenic steroids
More informationAdrenal Disorders for the USMLE, Step One: Abnormalities of the Fasciculata: Hypocortisolism
Adrenal Disorders for the USMLE, Step One: Abnormalities of the Fasciculata: Hypocortisolism Howard Sachs, MD Patients Course, 2017 Associate Professor of Clinical Medicine UMass Medical School Manifestations
More informationChapter 26. Hormones and the Endocrine System. Lecture by Edward J. Zalisko
Chapter 26 Hormones and the Endocrine System PowerPoint Lectures for Biology: Concepts & Connections, Sixth Edition Campbell, Reece, Taylor, Simon, and Dickey Copyright 2009 Pearson Education, Inc. Lecture
More informationThe Adrenals Are a key factor in all hormonal issues Because the adrenals can convert one hormone to another they play a role like no other in the bod
The Players Part II The Adrenals Are a key factor in all hormonal issues Because the adrenals can convert one hormone to another they play a role like no other in the body Can affect all hormone systems
More informationThyroid Hormones (T 4 & T 3 )
1 Thyroid Hormones (T 4 & T 3 ) Normalize growth and development, body temperature, and energy levels. Used as thyroid replacement therapy in hypothyroidism. Thyroxine (T 4 ) is peripherally metabolized
More informationCommon Endocrinopathies in the Intensive Care Unit
Common Endocrinopathies in the Intensive Care Unit Tejal S. Brahmbhatt, MD* Fellow of Trauma Surgery, Surgical Critical Care & Emergency Surgery Hospital of the University of Pennsylvania Philadelphia,
More informationASTHMA TREATMENT AND THE HPA AXIS
ASTHMA TREATMENT AND THE HPA AXIS Paul A. Greenberger, M.D. 7/12/2010 10:30-10:50 10:50 Objectives To review HPA axis suppression and its clinical significance in adults and children To describe methods
More informationAssistant Professor of Endocrinology
Pathophysiology Of Adrenal Disorder Dr.Rezvan Salehidoost Assistant Professor of Endocrinology Pathophysiology Of Adrenal Disorder The adrenal glands lie at the superior pole of each kidney and are composed
More informationEndocrine System. Chemical Control
Endocrine System Chemical Control Endocrine System - the system that secretes hormones in the body - hormones can last for minutes or for hours - a major gland, once called the master gland, is the pituitary
More informationSTRESS AND THE HEALTH OF THE BODY
Slide 1 STRESS AND THE HEALTH OF THE BODY Slide 2 What is Stress It is a physical response that occurs in our body when we are stressed Physiologically, it is a series of actions in the body that are regulated
More information