ENDOCRINE DISORDERS:
Primary Disorder = Defect within the gland
o Ex: Primary hypothyroidism
Secondary Disorder = Over/under stimulation
o Ex: Pituitary – Secondary hyperaldosteronism or hypothyroidism
Hypersecretion = Hormone excess
ETIOLOGY:
o Over-stimulation
o Secreting tumors
o Ectopic hormone production
o Exogenous hormones (corticosteroids)
o Antibodies
o Gland destruction
TREATMENT:
o Surgery
o Chemical ablation
o Stop hormone replacement
Hyposecretion = Too little hormone
ETIOLOGY:
o Under-stimulation
o Autoimmunity
o Non-secreting tumor
o Ischemia
o Infarction
o Surgical removal (tx for hyperthyroid – remove thyroid – leads to hypothyroidism)
o Receptor defects
TREATMENT:
o Hormone replacement therapy
SIADH = Syndrome of Inappropriate ADH secretion
Hypersecretion of ADH causing excessive reabsorption of water by the kidney
CAUSES:
o Tumors
o Head trauma
o IV fluids
o PNA, Infxns, drugs
SIGNS/SYMPTOMS:
o Hyponatremia
o Hemodilution
o CNS changes (r/t how low Na+ level is)
TREATMENT = RAISE NA+ LEVEL
o Water restriction
o Administer sodium (hypertonic saline, 3%)
o Furosemide to block circulatory overload (pee out water)
o Chronic SIADH – Give drugs to block the renal response to ADH
demeclocycline hydrochloride (tertracycline abx)
lithium
o Surgical removal of ADH-secreting tumors
, Patho Wk 7: Endocrine Part 2 - 2
DIABETES INSIPIDUS
Hyposecretion of ADH or insensitivity to ADH
o Central (neurogenic) – deficiency of ADH from posterior pituitary
o Nephrogenic – renal insensitivity to ADH
Distal and collecting ducts of the nephrons fail to reabsorb water
o Psychogenic – drinking too much water
CAUSES:
o Central – brain injury, stroke, *pituitary tumors, infection
o Nephrogenic – renal disease, medications (lithium, methicillin)
o Psychogenic – polydipsia
SIGNS/SYMPTOMS:
o Hypernatremia
o Polyuria
o Dehydration
o Thirst
o Findings indicative of cause
TREATMENT:
o IM or intranasal administration of ADH
o Oral hypoglycemic agents (increase the response of the renal tubule to ADH)
o Thiazide diuretics (induce a state of salt depletion)
GROWTH HORMONE
1) GIGANTISM (Child) / ACROMEGALY (Adult) Hypersecretion of growth hormone
CAUSE:
o *Benign pituitary tumor
SIGNS/SYMPTOMS: (pic)
o Increased ring, hat, shoe, and glove size
o Impotence in men
o Amenorrhea in women
o Deepening of the voice
o Thick, fleshy face
o Enlarged lips, nose, and ears
o Proganthism
o Enlarged internal organs
o Osteoporosis and arthritis develop
TREATMENT = SURGERY
o Transphenoidal hypophysectomy (remove pituitary)
Sequelae:
Transient devel of diabetes insipidus
Lifelong hormone replacement
o Radiation possibly considered
o Medications that block effects of growth hormone
2) DWARFISM Hyposecretion of growth hormone
CAUSE:
o Pituitary not producing adequate amounts
SIGNS/SYMPTOMS:
o Small stature
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