Targeted Issues in Endocrinology Joshua S. Coren, DO, MBA, FACOFP

Size: px
Start display at page:

Download "Targeted Issues in Endocrinology Joshua S. Coren, DO, MBA, FACOFP"

Transcription

1 Targeted Issues in Endocrinology Joshua S. Coren, DO, MBA, FACOFP

2

3 Endocrine in 25 Minutes Joshua S. Coren, D.O., MBA, FACOFP Vice Chair and Associate Professor, Family Medicine Rowan University School of Osteopathic Medicine Outline Goals Pituitary Thyroid Parathyroid Other Endocrine 1

4 ANTERIOR PITUITARY Follicle-stimulating hormone Luteinizing Hormone Adrenocoricotropic Hormone Thyroid-Stimulating Hormone Prolactin Beta-Endorphins Growth Hormone POSTERIOR PITUITARY Oxytocin Vasopressin Case 1 32 y.o. female evaluated for Amenorrhea - LMP = 4 Months Ago - Home Pregnancy Tests Negative x 2 - Menarche at Age 11 - Regular Cycle until 4 Months Ago - Weekly Headaches - Occasional Galactorrhea on breast palpation - Physical Examination = Normal - Neuro / Musculoskeletal/ Reflexes = Normal - Serum Prolactin = 1665 ng /ml - (Normal Range = 2 29 ng/ml) Case 1 Which of the following is the most likely cause of this patient s elevated prolactin level? 1. Hypothyroidism 2. Primary Hyperparathyroidism 3. Pregnancy 4. Pituitary Adenoma 2

5 Pituitary Adenoma Symptoms Headache Vision loss, particularly loss of peripheral vision Nausea and vomiting Fatigue Weakness Amenorrhea Galactorrhea Cold intolerance Constipation Low blood pressure Body hair loss Sexual dysfunction Unintended weight loss or gain Case 2 26 y.o. Female with Fatigue & Weight Gain - Irregular Menstrual Cycle - Galactorrhea x 6 Months - No Change in Vision - Taking no Medications - Small Goiter - Dry Skin - Bilateral Expressive Galactorrhea - Normal Visual Fields - Pregnancy Test = Negative 2 Questions - Prolactin Level = 55 ng/ ml // Normal ( 2 = 20 ng/ml) - Slight Enlargement of Pituitary Gland on MRI Case 2 Which of the following is the most appropriate next step in management of this patient? Which of the following is the next best treatment option? 1) Dopamine Agonist Therapy 2) Re-measure serum prolactin 3) Estrogen/Progesterone therapy 4) Serum TSH and Free T4 1) Administer bromocriptine 2) Use of Oral Contraceptives 3) Administration of L-thyroxine 4) Resection of Pituitary Gland 3

6 Case 3 16 year old female presents with concerns of overactive thyroid Mother and Sister with similar condition Which of the following are symptoms of hyperthyroidism? 1) Weight Gain 2) Palpitations 3) Dry Skin 4) Constipation Hyperthyroid Symptoms Palpitations Heat intolerance Nervousness Insomnia Breathlessness Increased bowel movements Light or absent menstrual periods Fatigue Fast heart rate Trembling hands Weight loss Muscle weakness Warm moist skin Hair loss Staring gaze 4

7 Hypothyroid Symptoms Fatigue Weakness Weight gain or increased difficulty losing weight Coarse, dry hair Dry, rough pale skin Hair loss Cold intolerance (you can't tolerate cold temperatures like those around you) Muscle cramps and frequent muscle aches Constipation Depression Irritability Memory loss Abnormal menstrual cycles Decreased libido Case 4 51 y.o. female presents with 2 month history of palpitations, diaphoresis, & tremor. 10 Pound Weight Loss Appears Nervous on Examination Taking no Current Medications Tachycardia at 108 bpm Enlarged / Non-Tender Thyroid Gland Case 4 Which is the best initial test to evaluate the patients hyperthyroidism? 1) Serum TSH 2) Serum Total T4 3) Serum Total T3 4) Thyroid Stimulating immunoglobulin 5

8 TSH Group Recommendations TSH Group Recommendations USPSTF ATA ACP AAFP AACE Insufficient Evidence for Recommendation ALL Men / Women 35 < & Every 5 Years ALL Women 50 < with 1 or more symptom <60 Recommends Against Routine Screen Asympt Pts Childbearing Age before Pregnancy or 1 st trimester Case 5 45 year old female presents with palpitations, tachycardia, & exophthalmous. - Concerns of Graves disease Which of the Following Statements is true? 1) Serum TSH and Free T4 are Elevated 2) Thyroid Scan Shows a hot nodule 3) Test for Thyroid Antibodies are negative 4) Serum TSH Decreased & Free T4 Elevated 6

9 Case 6 18 year old female with complaints of fatigue Cold intolerance Dry Skin Constipation Physical Examination Normal Serum TSH = 8.9 (Normal ) Case 6 What is the next more appropriate step in the evaluation of this patient s thyroid function? 1) Thyroid Scan 2) Start Thyroxine & Check Serum TSH in 8 Weeks 3) Thyroid Ultrasound 4) Serum T4 Level 7

10 Case 7 45 year old male patient presents to the office for a well check - No complaints or concerns during this visit - History of primary hyperparathyroidism Case 7 Which of the following if the most common patient presentation of primary hyperparathyroidism? 1) Spinal Fracture 2) Osteopenia 3) Kidney Stones 4) Asymptomatic hypercalcemia 5) Acute Renal Failure 8

11 Hyperparathyroid Symptoms Moans Constipation Nausea Abdominal Pain Peptic Ulcer Disease Stones Kidney Stones Flank Pain Frequent Urination Groans Dementia Depression Confusion Memory Loss Bones Bone Aches / Pains Fractures Spine Curvature Loss of Height Case 8 38 year old male presents with diaphoresis and hypertension. Palpitations for past 2 months History of Medullary Thyroid Cancer BP = 162 / 112 Heart Rate = 112 Pallor in Face and Palms after position change Case 8 What is the most appropriate next step evaluation for this patient? 1) Serum TSH 2) Blood Cultures 3) Thyroid Ultrasound 4) 24 hour Urine for Metanephrine 5) Serum Prolactin 9

12 5P s for Pheochromocytoma Pressure (hypertension) Pain (headache, chest pain, abdominal pain) Perspiration (diaphoresis) Palpitations Pallor Case 9 From prior case, what other test would you want to consider if you were considering the patient had multiple endocrine neoplasia IIA? 1) BUN/Creatinine 2) PTH 3) Prolactin 4) Testosterone Level MEN I Pancreas Adenomas Pituitary Adenomas Hyperparathyroid MEN IIA Medullary Carcinoma Thyroid Pheochromocytoma Hyperparathyroid MEN IIB Medullary Carcinoma Thyroid Pheochromocytoma Neurofibromas 10

13 Covered Topics Pituitary Thyroid Parathyroid Other Endocrine Any? s References Picture 1 (Major Endocrine Glands) Picture 2 (Thyroid Gland) Picture 3 (Calcium Regulation) Picture 4 (Persian Goitered Gazelle) Picture (Pituitary) Ladenson PW, Singer PA, Ain KB, et al. American Thyroid Association guidelines for detection of thyroid dysfunction. [erratum appears in Arch Intern Med2001 Jan 22;161(2):284]. Arch Intern Med 2000;160(11): American College of Physicians. Clinical guideline, part 1. Screening for thyroid disease. Ann Intern Med 1998;129(2): AACE Thyroid Task Force. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocrine Prac 2002;8: American Academy of Family Physicians. Summary of Policy Recommendations for Periodic Health Examinations. Leawood, KS: American Academy of Family Physicians;

THYROID DISEASE IN CHILDREN

THYROID DISEASE IN CHILDREN THYROID DISEASE IN CHILDREN Michelle Schweiger, D.O. Center for Pediatric and Adolescent Endocrinology Cleveland Clinic Foundation Neither I nor any immediate family members have any financial interests

More information

THYROID AWARENESS. By: Karen Carbone. January is thyroid awareness month. At least 30 million Americans

THYROID AWARENESS. By: Karen Carbone. January is thyroid awareness month. At least 30 million Americans THYROID AWARENESS By: Karen Carbone January is thyroid awareness month. At least 30 million Americans have a thyroid disorder and half-15 million-are silent sufferers who are undiagnosed, according to

More information

Common Issues in Management of Hypothyroidism

Common Issues in Management of Hypothyroidism Common Issues in Management of Hypothyroidism Family Medicine Refresher Course April 5, 2018 Janet A. Schlechte, M.D. Disclosure of Financial Relationships Janet A. Schlechte, M.D. has no relationships

More information

Regula'ng Body Func'on

Regula'ng Body Func'on Chapter 10 Regula'ng Body Func'on Working closely with your nervous system is the endocrine system, a chemical communication system that regulate many body functions. Exocrine vs Endocrine Exocrine Glands

More information

J. Van Lier Ribbink, M.D., F.A.C.S. Center for Endocrine and Pancreas Surgery at Honor Health

J. Van Lier Ribbink, M.D., F.A.C.S. Center for Endocrine and Pancreas Surgery at Honor Health J. Van Lier Ribbink, M.D., F.A.C.S. Center for Endocrine and Pancreas Surgery at Honor Health Patient Clinical Information Questionnaire 1.0 Date of Questionnaire Completion; / / 2.0 Patient Data 2.1 Name:

More information

Thyroid Disorders Towards a Healthy Endocrine System

Thyroid Disorders Towards a Healthy Endocrine System Thyroid Disorders Towards a Healthy Endocrine System What are Thyroid Disorders? The thyroid is a butterfly-shaped gland in the middle of the lower neck. Through the release of hormones, the thyroid regulates

More information

Endocrine system pathology

Endocrine system pathology Endocrine system pathology Central endocrine system peripheral endocrine system: thyroid gland parathyroid gland pancreas adrenal glands Thyroid gland. the weight of normal thyroid gland is about 15 grams.

More information

Thyroid Disorders. January 2019

Thyroid Disorders. January 2019 Thyroid Disorders January 2019 What is the Thyroid? The thyroid is a small butterfly-shaped gland inside the neck, located in front of the trachea (windpipe) and below the larynx (voicebox). It produces

More information

4.04 Understand the Functions and Disorders of the ENDOCRINE SYSTEM Understand the functions and disorders of the endocrine system

4.04 Understand the Functions and Disorders of the ENDOCRINE SYSTEM Understand the functions and disorders of the endocrine system 4.04 Understand the Functions and Disorders of the 4.04 Understand the Functions and Disorders of the What are the functions of the endocrine system? What are some disorders of the endocrine system? How

More information

Initials:.. Number of patient in the registry:... Date of visit:.. Gender (genetic): female / male

Initials:.. Number of patient in the registry:... Date of visit:.. Gender (genetic): female / male 1. Patient personal details Institute code: Physician code: Initials:.. Number of patient in the registry:... Date of visit:.. Gender (genetic): female / male 2. Changes in acromegaly-specific medical

More information

BODY CONTROL SYSTEMS

BODY CONTROL SYSTEMS BODY CONTROL SYSTEMS THE ENDOCRINE SYSTEM - 1 of the 2 chemical control systems of the human body - function of the endocrine system: regulate body functions = maintain homeostasis ie. physical and mental

More information

OUTLINE. Regulation of Thyroid Hormone Production Common Tests to Evaluate the Thyroid Hyperthyroidism - Graves disease, toxic nodules, thyroiditis

OUTLINE. Regulation of Thyroid Hormone Production Common Tests to Evaluate the Thyroid Hyperthyroidism - Graves disease, toxic nodules, thyroiditis THYROID DISEASE OUTLINE Regulation of Thyroid Hormone Production Common Tests to Evaluate the Thyroid Hyperthyroidism - Graves disease, toxic nodules, thyroiditis OUTLINE Hypothyroidism - Hashimoto s thyroiditis,

More information

Reproductive Health and Pituitary Disease

Reproductive Health and Pituitary Disease Reproductive Health and Pituitary Disease Janet F. McLaren, MD Assistant Professor Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology jmclaren@uabmc.edu Objectives

More information

PITUITARY: JUST THE BASICS PART 2 THE PATIENT

PITUITARY: 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 information

Hyperthyroidism Diagnosis and Treatment. April Janet A. Schlechte, M.D.

Hyperthyroidism Diagnosis and Treatment. April Janet A. Schlechte, M.D. Hyperthyroidism Diagnosis and Treatment Family Practice Refresher Course April 2015 Janet A. Schlechte, M.D. Disclosure of Financial Relationships Janet A. Schlechte, M.D. has no relationships with any

More information

Thyroid Gland. Patient Information

Thyroid Gland. Patient Information Thyroid Gland Patient Information Contact details for Endocrine and Thyroid Clinics Hawke s Bay Fallen Soldiers Memorial Hospital Villa 16 Phone: 06 8788109 ext 5891 Text: 0274 102 559 Email: endoclinic@hbdhb.govt.nz

More information

Common Causes of Hypothyroidism

Common Causes of Hypothyroidism Common Causes of Hypothyroidism Autoimmune thyroidi4s Surgical removal of thyroid gland Medica4on Therapy Iodine and iodine containing medica4ons Neck radia4on Post Partum thyroidi4s Prevalence of Hypothyroidism

More information

p171 - thyroid hyperplasia https://med-vmicro.med.illinois.edu/v/475/ p34 - prostate hyperplasia https://med-vmicro.med.illinois.

p171 - thyroid hyperplasia https://med-vmicro.med.illinois.edu/v/475/ p34 - prostate hyperplasia https://med-vmicro.med.illinois. THE ENDOCRINE AND REPRODUCTIVE SYSTEMS The focus of this week s lab will be pathology of the endocrine and reproductive systems. There are a bunch of tissues and topics that can be covered in these systems,

More information

9.2 Hormonal Regulation of Growth

9.2 Hormonal Regulation of Growth 9.2 Hormonal Regulation of Growth Hormonal Regulation of Growth Pituitary gland regulates growth and development Thyroid gland regulates metabolic rate (exception: some hormones for growth and development)

More information

Pathophysiology of the th E d n ocr i ne S S t ys em B. Marinov, MD, PhD Endocrine system Central: Hypothalamus

Pathophysiology of the th E d n ocr i ne S S t ys em B. Marinov, MD, PhD Endocrine system Central: Hypothalamus Pathophysiology of the Endocrine System B. Marinov, MD, PhD Pathophysiology Department Medical University of Plovdiv Endocrine system Central: Hypothalamus Pituitary Pineal Peripheral Thymus Thyroid Parathyroid

More information

Graves Disease in Pediatrics

Graves Disease in Pediatrics Graves Disease in Pediatrics Graves disease is a common cause of an overactive thyroid. It occurs in about 1 in 5000 children and teens. It occurs more often in females than males. This booklet is designed

More information

Kimberley A. Schroeder, D.O. 115 Baker Drive Tomball, TX

Kimberley A. Schroeder, D.O. 115 Baker Drive Tomball, TX Kimberley A. Schroeder, D.O. 115 Baker Drive Tomball, TX 77375 281.290.0531 www.feelwellagain.com FEMALE MEDICAL QUESTIONNAIRE (POSTMENOPAUSAL) NAME: DATE OF BIRTH: CHIEF COMPLAINT What is your primary

More information

Scrub In. TSH is secreted by the pituitary and acts on the: Parathormone tends to increase the concentration of:

Scrub In. TSH is secreted by the pituitary and acts on the: Parathormone tends to increase the concentration of: Scrub In TSH is secreted by the pituitary and acts on the: a. Pancreas b. Testes c. Thymus gland d. Thyroid gland Parathormone tends to increase the concentration of: a. Calcium in the blood b. Endorphins

More information

The Metabolic System. Physiologic Integrity and Therapeutic Nursing Interventions for Patients With Endocrine Needs. The Endocrine System

The Metabolic System. Physiologic Integrity and Therapeutic Nursing Interventions for Patients With Endocrine Needs. The Endocrine System Physiologic Integrity and Therapeutic Nursing Interventions for Patients With Endocrine Needs Black, J.M. & Hawks, J.H. (2005) Chapters 44, (pp 1154-1189) Baptist Health School of Nursing NSG 4037: Adult

More information

Patient History Form

Patient History Form Patient History Form Advanced Directive Care Plan? Yes No Name: Birth date: / / Address: Age: Sex: F M STREET DAY YEAR Telephone: Home ( ) CITY STATE DAY YEAR MARITAL STATUS: Divorced Separated Alive/Age

More information

university sciences of Isfahan university Com

university sciences of Isfahan university   Com Introduce R. Gholamnezhad Lecturer of school of nursing & midwifery of Iran university Ph.D student tof Immunology, Sh School of medical sciences of Isfahan university E-Mail: Gholami278@gmail. Com Interpreting

More information

When the level of calcium in the blood falls too low, the parathyroid glands secrete just enough PTH to restore the blood calcium level.

When the level of calcium in the blood falls too low, the parathyroid glands secrete just enough PTH to restore the blood calcium level. Hyperparathyroidism Primary hyperparathyroidism is a disorder of the parathyroid glands, also called parathyroids. Primary means this disorder originates in the parathyroids: One or more enlarged, overactive

More information

Disorders of the Thyroid Gland

Disorders of the Thyroid Gland Disorders of the Thyroid Gland István Takács MD., PhD, 1st Department of Medicine, Semmelweis University Connection to the dentistry: close to each other higher operation risk radiating pain macroglossia

More information

Women s Health in General Practice Symposium 2015 Thyroid & Parathyroid Cases

Women s Health in General Practice Symposium 2015 Thyroid & Parathyroid Cases Women s Health in General Practice Symposium 2015 Thyroid & Parathyroid Cases Bill Fleming Epworth Freemasons Hospital 1 Common Endocrine Presentations anatomical problems thyroid nodule / goitre embryological

More information

THE ENDOCRINE AND REPRODUCTIVE SYSTEMS

THE ENDOCRINE AND REPRODUCTIVE SYSTEMS THE ENDOCRINE AND REPRODUCTIVE SYSTEMS The focus of this week s lab will be pathology of the endocrine and reproductive systems. There are a bunch of tissues and topics that can be covered in these systems,

More information

03-Dec-17. Thyroid Disorders GOITRE. Grossly enlarged thyroid - in hypothyroidism in hyperthyroidism - production of anatomical symptoms

03-Dec-17. Thyroid Disorders GOITRE. Grossly enlarged thyroid - in hypothyroidism in hyperthyroidism - production of anatomical symptoms Thyroid Disorders GOITRE Grossly enlarged thyroid - in hypothyroidism in hyperthyroidism - production of anatomical symptoms 1 Physiological Goiter load on thyroid supply of I - limited stress due to:

More information

Name: Date of Birth: Street Address: Apt.# City: State: ZIPCODE: Home Phone: Work Phone: Cell Phone: Pharmacy name & address: Phone#:

Name: Date of Birth: Street Address: Apt.# City: State: ZIPCODE: Home Phone: Work Phone: Cell Phone: Pharmacy name & address: Phone#: Stephen L. Aronoff, M.D., F.A.C.E. Diplomate of the American Board of Internal Medicine and the Subspecialty Board of Endocrinology and Metabolism 2400 Lakeside Blvd., Suite 130, Richardson, TX 75082 Phone:

More information

PT Final Exam. July 2018 Core Content Review 6 Presented by Mark. Copyright 2018 PT Final Exam

PT Final Exam. July 2018 Core Content Review 6 Presented by Mark. Copyright 2018 PT Final Exam PT Final Exam July 2018 Core Content Review 6 Presented by Mark A 34 year old male comes to your clinic with reoccurring hamstring tears. Upon examination, the therapist is able to achieve 130 degrees

More information

Hormones by location

Hormones 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 information

Please answer all questions in blue or black ink by filling in the blank or circling. SOCIAL HISTORY

Please answer all questions in blue or black ink by filling in the blank or circling. SOCIAL HISTORY PATIENT QUESTIONNAIRE / ASSESSMENT Endocrinology Form Please answer all questions in blue or black ink by filling in the blank or circling. SOCIAL HISTORY Date Phone (H) (W) (C) Age Male Female Marital

More information

The most current assessment of this problem can be found in the Apex note dated

The most current assessment of this problem can be found in the Apex note dated Him andpcos Smartphrase:.REFENDOPCOS NOTE: patients with suspected PCOS are welcomed to endocrine clinic. There is also a PCOS clinic is available in the Ob/Gyn Department. I am referring @name@, a @age@

More information

DISORDERS OF THE THYROID GLAND SIGNS, SYMPTOMS, & TREATMENT ENDOCRINE SYSTEM AT A GLANCE OBJECTIVES ANATOMY OF THE THYROID

DISORDERS 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 information

HYPERTHYROIDISM. Hypothalamus. Thyrotropin-releasing hormone (TRH) Anterior pituitary gland. Thyroid-stimulating hormone (TSH) Thyroid gland T4, T3

HYPERTHYROIDISM. Hypothalamus. Thyrotropin-releasing hormone (TRH) Anterior pituitary gland. Thyroid-stimulating hormone (TSH) Thyroid gland T4, T3 HYPERTHYROIDISM Hypothalamus Thyrotropin-releasing hormone (TRH) Anterior pituitary gland Thyroid-stimulating hormone (TSH) Thyroid gland T4, T3 In hyperthyroidism, there is an increased production of

More information

ENDOCRINE SYSTEM-PART 2

ENDOCRINE SYSTEM-PART 2 ENDOCRINE SYSTEM-PART 2 Hello and welcome back to InterpreterPrep.com Welcome to our second presentation on the ENDOCRINE SYSTEM. In the first part we covered the pancreas, the pituitary gland and the

More information

Biology 30. Morinville Community High School. Unit 2: Endocrine System. Name:

Biology 30. Morinville Community High School. Unit 2: Endocrine System. Name: Biology 30 Morinville Community High School Unit 2: Endocrine System Name: 2 Endocrine System Unit Outline Chapter 13 text p. 434-471 Key Concept A: The endocrine system and nervous system both mediate

More information

THE THYROID. Your thyroid evaluation may include the following:

THE THYROID. Your thyroid evaluation may include the following: An endocrinologist is a doctor specially trained to diagnose and treat diseases affecting your glands. Glands are small organs that produce hormones, which are substances that help control various activities

More information

TANJA KEMP INTERNAL MEDICINE: ENDOCRINOLOGY

TANJA KEMP INTERNAL MEDICINE: ENDOCRINOLOGY ENDOCRINE DISORDERS IN THE ELDERLY (part 2) TANJA KEMP INTERNAL MEDICINE: ENDOCRINOLOGY Pituitary axis Target organs of the pituitary gland Negative feedback Hypothalamus-Pituitary-Thyroid axis Thyroid

More information

Some Issues in the Management of Hypothyroidism

Some Issues in the Management of Hypothyroidism Some Issues in the Management of Hypothyroidism Family Medicine Refresher Course April 6, 2016 Janet A. Schlechte, M.D. Disclosure of Financial Relationships Janet A. Schlechte, M.D. has no relationships

More information

Lesson 1. Nervous & Endocrine Comparison Endocrine Glands diagram Feedback Mechanisms

Lesson 1. Nervous & Endocrine Comparison Endocrine Glands diagram Feedback Mechanisms Lesson 1 Nervous & Endocrine Comparison Endocrine Glands diagram Feedback Mechanisms Nervous System Endocrine System 1. Uses neurons to transmit electrochemical messages (neurotransmitters) Regulation

More information

Parathyroid Disease Scenarios for the Practicing Clinician. Vijaya Chockalingam MD Faculty Endocrinologist Banner University Medical Center- Phoenix

Parathyroid Disease Scenarios for the Practicing Clinician. Vijaya Chockalingam MD Faculty Endocrinologist Banner University Medical Center- Phoenix Parathyroid Disease Scenarios for the Practicing Clinician Vijaya Chockalingam MD Faculty Endocrinologist Banner University Medical Center- Phoenix Clinical Scenario-1 73 year man (BK) with hypercalcemia

More information

Chapter 20. Endocrine System Chemical signals coordinate body functions Chemical signals coordinate body functions. !

Chapter 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 information

Thyroid and parathyroid glands

Thyroid and parathyroid glands Thyroid and parathyroid glands Dr. Isabel Hwang Department of Physiology Faculty of Medicine University of Hong Kong May 2007 The thyroid gland straddles the esophagus, just below the larynx, in the neck.

More information

New Patient Specialty Intake Form Department of Surgery

New Patient Specialty Intake Form Department of Surgery This form contains questions specific to the Department of Surgery. If you are new to Baylor College of Medicine and have not been seen in any of our offices, please be sure to complete our New Patient

More information

The Presence of Thyroid Autoantibodies in Pregnancy

The Presence of Thyroid Autoantibodies in Pregnancy The Presence of Thyroid Autoantibodies in Pregnancy Dr. O Sullivan does not have any financial relationships with any commercial interests. KATIE O SULLIVAN, MD FELLOW, ADULT/PEDIATRIC ENDOCRINOLOGY ENDORAMA

More information

CASE-BASED SMALL GROUP DISCUSSION MHD II SESSION VI

CASE-BASED SMALL GROUP DISCUSSION MHD II SESSION VI MHD II, Session VI, Student Copy Page 1 CASE-BASED SMALL GROUP DISCUSSION MHD II SESSION VI Wednesday, MARCH 26, 2014 STUDENT COPY MHD II, Session VI, Student Copy Page 2 CASE 1 History: A 57-year-old

More information

HUMAN ENDOCRINE SYSTEM

HUMAN ENDOCRINE SYSTEM HUMAN ENDOCRINE SYSTEM The human endocrine system consists of ductless glands which releases hormones directly to the bloodstream. Glands are any tissue or organ which secretes chemical compounds useful

More information

HYPERPARATHYROIDIS M FAISAL GHANI SIDDIQUI MBBS; FCPS; PGDIP-BIOMEDICAL ETHICS; MCPS-HPE

HYPERPARATHYROIDIS M FAISAL GHANI SIDDIQUI MBBS; FCPS; PGDIP-BIOMEDICAL ETHICS; MCPS-HPE HYPERPARATHYROIDIS M FAISAL GHANI SIDDIQUI MBBS; FCPS; PGDIP-BIOMEDICAL ETHICS; MCPS-HPE PROFESSOR OF SURGERY J I N N A H S I N D H M E D I C A L U N I V E R S I T Y PREAMBLE Anatomy & physiology of the

More information

Ch 8: Endocrine Physiology

Ch 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 information

CATEGORY Endocrine System Review. Provide labels for the following diagram CHAPTER 13 BLM

CATEGORY 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 information

NEOPLASMS OF THE THYROID PATHOLOGY OF PARATHYROID GLANDS. BY: Shifaa Qa qa

NEOPLASMS OF THE THYROID PATHOLOGY OF PARATHYROID GLANDS. BY: Shifaa Qa qa NEOPLASMS OF THE THYROID PATHOLOGY OF PARATHYROID GLANDS BY: Shifaa Qa qa Neoplasmas of the thyroid thyroid nodules Neoplastic ---- benign, malignant Non neoplastic Solitary nodules ----- neoplastic Nodules

More information

Endocrine System. Chemical Control

Endocrine 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 information

Pituitary, Parathyroid Pheochromocytomas & Paragangliomas: The 4 Ps of NETs

Pituitary, Parathyroid Pheochromocytomas & Paragangliomas: The 4 Ps of NETs Pituitary, Parathyroid Pheochromocytomas & Paragangliomas: The 4 Ps of NETs Shereen Ezzat, MD, FRCP(C), FACP Professor Of Medicine & Oncology Head, Endocrine Oncology Princess Margaret Hospital/University

More information

Chapter 45-Hormones and the Endocrine System. Simple Hormone Pathways

Chapter 45-Hormones and the Endocrine System. Simple Hormone Pathways Chapter 45-Hormones and the Endocrine System Simple Hormone s Low ph in duodenum Hormones are released from an endocrine, travel through the bloodstream, and interact with the receptor or a target to cause

More information

Definition Elevated Adjusted Calcium > 2.6 mmol/l (adjusted for albumin), taken without using a cuff.

Definition Elevated Adjusted Calcium > 2.6 mmol/l (adjusted for albumin), taken without using a cuff. Hypercalcaemia Definition Elevated Adjusted Calcium > 2.6 mmol/l (adjusted for albumin), taken without using a cuff. Mild (usually no symptoms) 2.6 3.0 mmol/l Moderate (start to develop symptoms) 3.0 3.4

More information

Pituitary Pathology Too much Too little Especially space occupying lesions The Basics Pituitary Vascular Anterior Comes from GI Controlled by hypothal

Pituitary Pathology Too much Too little Especially space occupying lesions The Basics Pituitary Vascular Anterior Comes from GI Controlled by hypothal Endocrine Pathology Endocrine Pathology Cell signaling system Surface receptors camp and tyrosine kinase system Cytoplasmic receptors Penetrate cell membrane Gene activation -> transcription -> translation

More information

Overview of Reproductive Endocrinology

Overview of Reproductive Endocrinology Overview of Reproductive Endocrinology I have no conflicts of interest to report. Maria Yialamas, MD Female Hypothalamic--Gonadal Axis 15 4 Hormone Secretion in the Normal Menstrual Cycle LH FSH E2, Progesterone,

More information

Functional Pituitary Adenomas. Fawn M. Wolf, MD 2/2/2018

Functional Pituitary Adenomas. Fawn M. Wolf, MD 2/2/2018 Functional Pituitary Adenomas Fawn M. Wolf, MD 2/2/2018 Outline Prolactinoma Acromegaly Cushing s disease Thyrotroph adenomas Gonadotroph adenomas Hyperprolactinemia Clinically apparent prolactinomas:

More information

The Endocrine System

The Endocrine System C H A P T E R 1 2 The Endocrine System OBJECTIVES After studying this chapter, you should be able to: 1. List the functions of hormones. 2. Classify hormones into their major chemical categories. 3. Describe

More information

Chapter 13 worksheet

Chapter 13 worksheet Name: Chapter 13 worksheet The Endocrine System Please label the: hypothalamus pineal gland pituitary gland thyroid gland parathyroid gland thymus heart stomach liver adrenal glands kidneys pancreas small

More information

THE FACTS YOU NEED TO KNOW

THE FACTS YOU NEED TO KNOW PHEOCHROMOCYTOMA THE FACTS YOU NEED TO KNOW Pheochromocytoma is a part of the pheochromocytoma and paraganglioma group of syndromes. A pheochromocytoma is a tumor arising in the adrenal gland medulla.

More information

Pituitary for the General Practitioner. Marilyn Lee Consultant physician and endocrinologist

Pituitary for the General Practitioner. Marilyn Lee Consultant physician and endocrinologist Pituitary for the General Practitioner Marilyn Lee Consultant physician and endocrinologist Pituitary tumours Anterior/posterior pituitary Extension of adenoma upwards/downwards/sideways Producing too

More information

4) Thyroid Gland Defects - Dr. Tara

4) Thyroid Gland Defects - Dr. Tara 4) Thyroid Gland Defects - Dr. Tara Thyroid Pituitary Axis TRH secreted in the hypothalamus stimulates production and Secretion of TSH TSH stimulates secretion of T3, T4 T4 has negative feedback on secretion

More information

New Patient History. Name: DOB: Sex: Date: If yes, give the name of the physician who did your evaluation or ordered your tests:

New Patient History. Name: DOB: Sex: Date: If yes, give the name of the physician who did your evaluation or ordered your tests: New Patient History Name: DOB: Sex: Date: Chief Complaint: 1. Give a brief description of the problem you are seeking treatment for today: 2. Have you been evaluated for this problem or had any tests for

More information

Endocrine System Notes

Endocrine System Notes Endocrine System Notes is the tendency to maintain a stable internal environment. - parts of the body that secrete hormones directly into the body. - parts of the body that make secretions which travel

More information

Definition Elevated Adjusted Calcium > 2.6 mmol/l (adjusted for albumin), taken without using a cuff.

Definition Elevated Adjusted Calcium > 2.6 mmol/l (adjusted for albumin), taken without using a cuff. Authoriser: Fiona Davidson Page 1 of 5 Hypercalcaemia Definition Elevated Adjusted Calcium > 2.6 mmol/l (adjusted for albumin), taken without using a cuff. Mild (usually no symptoms) 2.6 3.0 mmol/l Moderate

More information

Lab Guide Endocrine Section Lab Guide

Lab Guide Endocrine Section Lab Guide Lab Guide - 2019 Endocrine Section Lab Guide Estradiol Estradiol, Cerner Name: Estradiol Competitive test principle using a polyclonal antibody specifically directed against 17βestradiol in Roche Cobas

More information

Graves Disease. What is Graves disease?

Graves Disease. What is Graves disease? Graves Disease What is Graves disease? The thyroid gland s production of thyroid hormones (T 3 and T 4 ) is triggered by thyroidstimulating hormone (TSH), which is made by the pituitary gland. Graves disease,

More information

Chapter 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.

Chapter 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 information

Summary and Conclusion

Summary and Conclusion SUMMARY AND CONCLUSION Thyroid disorder is an increasing disorder amongst endocrine diseases in India. The seriousness of thyroid disorders should not be under estimated as thyroid storm and myxedema coma

More information

Take Home Messages in Endocrinology

Take Home Messages in Endocrinology Conflict of Interest/Disclosures Take Home Messages in Endocrinology None Carolyn Becker, MD 2 Diabetes Thyroid Pituitary Adrenal Hypoglycemia Overview Diagnostic Criteria for T2DM Diabetes should be diagnosed

More information

Antidiuretic Hormone

Antidiuretic Hormone 1 Antidiuretic Hormone 2 Physiology of the Posterior Pituitary The posterior pituitary gland secretes two hormones which are: oxytocin, increase uterine contractions during parturition Contraction of mammary

More information

BELIEVE MIDWIFERY SERVICES

BELIEVE MIDWIFERY SERVICES TITLE: THYROID DISEASE IN PREGNANCY EFFECTIVE DATE: July, 2013 POLICY STATEMENT: Pregnancy changes significantly the values influenced by the serum thyroid binding hormone level (i.e., total thyroxine,

More information

Endocrine System. Modified by M. Myers

Endocrine System. Modified by M. Myers Endocrine System Modified by M. Myers 1 The Endocrine System 2 Endocrine Glands The endocrine system is made of glands & tissues that secrete hormones. Hormones are chemicals messengers influencing a.

More information

Endocrinology for Finals. Maralyn Druce Professor of Endocrine Medicine Barts and the London School of Medicine

Endocrinology for Finals. Maralyn Druce Professor of Endocrine Medicine Barts and the London School of Medicine Endocrinology for Finals Maralyn Druce Professor of Endocrine Medicine Barts and the London School of Medicine Fair Game - Endocrine Topics Endocrine Emergencies Thyroid Disease Adrenal Disease Endocrine

More information

Chapter 50 4/9/2015. Care of the Patient with an Endocrine Disorder. Endocrine Glands and Hormones. Endocrine Glands and Hormones cont d

Chapter 50 4/9/2015. Care of the Patient with an Endocrine Disorder. Endocrine Glands and Hormones. Endocrine Glands and Hormones cont d Chapter 50 Care of the Patient with an Endocrine Disorder All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Endocrine Glands and Hormones Pituitary

More information

Medical-Surgical Nursing: An Integrated Approach - Chapter 27

Medical-Surgical Nursing: An Integrated Approach - Chapter 27 Medical-Surgical Nursing: An Integrated Approach - Chapter 27 NURSING CARE OF THE CLIENT: ENDOCRINE SYSTEM NVOC 22C Eliza Rivera-Mitu Mitu,, RN, MSN A Unique System The endocrine system is unique in that

More information

Pituitary Stalk Interruption Syndrome. Leena Shahla, MD, PGY5 Endocrinology, Diabetes and Metabolism Fellowship University of Massachusetts

Pituitary Stalk Interruption Syndrome. Leena Shahla, MD, PGY5 Endocrinology, Diabetes and Metabolism Fellowship University of Massachusetts Pituitary Stalk Interruption Syndrome Leena Shahla, MD, PGY5 Endocrinology, Diabetes and Metabolism Fellowship University of Massachusetts 11/12/2016 Case: NP, 42 year old female, from Dominican Republic.

More information

B. Environmental Factors. a. The major risk factor to papillary thyroid cancer is exposure to ionizing radiation, during the first 2 decades of life.

B. Environmental Factors. a. The major risk factor to papillary thyroid cancer is exposure to ionizing radiation, during the first 2 decades of life. B. Environmental Factors. a. The major risk factor to papillary thyroid cancer is exposure to ionizing radiation, during the first 2 decades of life. b. Deficiency of dietary iodine: - Is linked with a

More information

Florida Hospital Spine Center Patient Intake Form

Florida Hospital Spine Center Patient Intake Form Florida Hospital Spine Center Patient Intake Form Today s Date Last Name First Name Middle Street Address DOB (Address, City, State, Zip Code) First Contact # Please Circle: Home Cell Other Second Contact

More information

Mechanism of hyperprolactinemia

Mechanism of hyperprolactinemia Hyperprolactinemia Mechanism of hyperprolactinemia Causes of hyperprolactinemia Hormone-producing pituitary tumors Prolactinoma Acromegaly Hypothalamic/pituitary stalk lesion Tumors, cysts (craniopharyngeoma,

More information

Endocrine System. Overview Hormones Endocrine Organs

Endocrine System. Overview Hormones Endocrine Organs Endocrine System Overview Hormones Endocrine Organs Endocrine vs. Exocrine Gland Secretes hormones sweat & saliva Ductless gland has ducts Injects tissue duct is filled Chemistry of Hormones & Physiology

More information

SECTION OF NEUROSURGERY PATIENT INFORMATION SHEET

SECTION OF NEUROSURGERY PATIENT INFORMATION SHEET SECTION OF NEUROSURGERY PATIENT INFORMATION SHEET EC#: (for office use only) Patient s Name: Today s Date: Age: Date of Birth: Height: Weight: Physician you are seeing today: Marital Status: Married Work

More information

Angelica archangelica

Angelica archangelica Angelica archangelica Bladder Facts Average adult passes about 1 ½ quarts of urine each day Bladder holds up to 2 cups of urine The bladder is a muscle When full, the bladder is about the size of a large

More information

Endocrine System. A gland is any organ that produces a secretion 2 types: endocrine and exocrine. Endocrine: Exocrine:

Endocrine System. A gland is any organ that produces a secretion 2 types: endocrine and exocrine. Endocrine: Exocrine: Endocrine System Endocrine System A gland is any organ that produces a secretion 2 types: endocrine and exocrine Endocrine: Organized groups of tissue that use materials from the blood to make hormones

More information

Thyroid Plus. Central Thyroid Regulation & Activity. Peripheral Thyroid Function. Thyroid Auto Immunity. Key Guide. Patient: DOB: Sex: F MRN:

Thyroid Plus. Central Thyroid Regulation & Activity. Peripheral Thyroid Function. Thyroid Auto Immunity. Key Guide. Patient: DOB: Sex: F MRN: Thyroid Plus Patient: DOB: Sex: F MRN: Order Number: Completed: Received: Collected: Sample Type - Serum Result Reference Range Units Central Thyroid Regulation & Activity Total Thyroxine (T4) 127 127

More information

Name: [Type text] Date of Birth: ENDOCRINOLOGY HEALTH HISTORY. What is the reason for your visit?

Name: [Type text] Date of Birth: ENDOCRINOLOGY HEALTH HISTORY. What is the reason for your visit? ENDOCRINOLOGY HEALTH HISTORY What is the reason for your visit? MEDICATIONS List current prescription and over-the-counter medications. Also list current vitamin, herbal, and nutritional supplements: MEDICATION/SUPPLEMENT

More information

THE THYROID BOOK. Medical and Surgical Treatment of Thyroid Problems

THE THYROID BOOK. Medical and Surgical Treatment of Thyroid Problems THE THYROID BOOK Medical and Surgical Treatment of Thyroid Problems Trouble with Your Thyroid Gland The thyroid is a small gland in your neck that plays a big role in how your body functions. It impacts

More information

Flashpoint: Regulating Your Body s Temperature. Presented by: Shari M. Lawson, MD MBA Date Presented: November 1,

Flashpoint: Regulating Your Body s Temperature. Presented by: Shari M. Lawson, MD MBA Date Presented: November 1, Flashpoint: Regulating Your Body s Temperature Presented by: Shari M. Lawson, MD MBA Date Presented: November 1, 2014 1 Disclosures None 2 Objectives Today s discussion will cover How body temperature

More information

Virginia ACP Clinical Update Thyroid Clinical Pearls. University of Virginia. Richard J. Santen MD

Virginia ACP Clinical Update Thyroid Clinical Pearls. University of Virginia. Richard J. Santen MD Virginia ACP Clinical Update Thyroid Clinical Pearls University of Virginia Richard J. Santen MD Goal Provide a guide to frequently encountered problems in thyroid disease Follow my approach to recently

More information

Updates in Thyroid Disease. Thyroid Outline. Thyroid 10/5/2015. Leila Wing, MD. Endocrinology, Diabetes, and Metabolism

Updates in Thyroid Disease. Thyroid Outline. Thyroid 10/5/2015. Leila Wing, MD. Endocrinology, Diabetes, and Metabolism Updates in Thyroid Disease Leila Wing, MD Endocrinology, Diabetes, and Metabolism Background Hypothyroidism Hyperthyroidism Thyroid nodules Thyroid Cancer Conclusions Resources/References Thyroid Outline

More information

Thyroid gland defects. Dr. Tara Husain

Thyroid gland defects. Dr. Tara Husain Thyroid gland defects Dr. Tara Husain Thyroid Pituitary Axis TRH secreted in the hypothalamus stimulates production and Secretion of TSH TSH stimulates secretion of T3,T4 T4 has negative feed back on secretion

More information

Hyperparathyroidism. When to Suspect, How to Diagnose, When and How to Intervene. Johanna A. Pallotta, MD, FACP, FACE

Hyperparathyroidism. When to Suspect, How to Diagnose, When and How to Intervene. Johanna A. Pallotta, MD, FACP, FACE Hyperparathyroidism When to Suspect, How to Diagnose, When and How to Intervene Johanna A. Pallotta, MD, FACP, FACE Potential conflicts of interest: None Johanna A. Pallotta, MD Outline Definition of hyperparathyroidism

More information

Kingdom of Bahrain Arabian Gulf University College of Medicine and Medical Sciences. Endocrinology. (Review) Year 5 Internal Medicine

Kingdom of Bahrain Arabian Gulf University College of Medicine and Medical Sciences. Endocrinology. (Review) Year 5 Internal Medicine Kingdom of Bahrain Arabian Gulf University College of Medicine and Medical Sciences Endocrinology (Review) Year 5 Internal Medicine Presented by: Dr. Mona Arekat Prepared by: Ali Jassim Alhashli Case (1):

More information

Screening for hypothyroidism

Screening for hypothyroidism Screening for hypothyroidism Current health supervision guidelines for TEENren with DS suggest reviewing results of the newborn thyroid function screen, then repeating thyroid function tests. Screening

More information

Parathyroid Imaging What is best

Parathyroid Imaging What is best Parathyroid Imaging What is best Mike Avison Bradford Why me? I m honoured to be asked to present this. There is no killer paper or text which clearly proves the best methodology. Bradford has performed

More information