• Endocrine Pathophysiology

• Adrenal gland:
• Cushing’s syndrome;
• an abnormal condition caused by excess levels of
corticosteroids and especially cortisol in the body
due either to
• 1. hyperfunction of the adrenal gland (as from
adrenal adenoma)
• 2. hypersecretion of ACTH by the pituitary gland
• 3. prolonged use of corticosteroid medications (as
prednisone)
• Hypothyroidism:
• Lab results
• Decreased T3 & T4
• Increased TSH (Thyroid stimulating hormone).
• Increased serum cholesterol.
• Clinical syndromes
• 1. Myxedema (in adult):
• More in women than men.
• Causes:
• Thyroidectomy (surgery removing thyroid)
• Irradiation. Drugs.
• Hashimoto’s thyroiditis (autoimmune).
• Iodine deficiency
• 2. Cretinism (in children)
• Causes
• Iodine deficiency
• Deficiency of enzyme necessary for the synthesis of
thyroid hormones.
• Maldevelopment of the thyroid gland.
• Clinical features
• 1. severe mental retardation.
• 2. impairment of physical growth, and retarded
bone development
• 3. large tongue
• 4. protuberant abdomen.
• Hyperthyroidism
• Hyperthyroidism is the condition that occurs due to
excessive production of thyroid hormones by the
thyroid gland.
• Thyrotoxicosis is the condition that occurs due to
excessive thyroid hormone of any cause and
therefore includes hyperthyroidism.
• Causes:
• Graves' disease,
• multinodular goiter,
 •Lab results
•Markedly increased T3,
T4
•Decreased TSH
• Diabetes mellitus
• Is a disorder of insulin action and secretion that
results in high blood glucose, (hyperglycemia).
• Diabetes is defined as a fasting blood glucose level
126mg/dl or more, or a blood glucose level
200mg/dl on any occasion.
• There are two types of diabetes
• Type I the pancreas does not secrete enough insulin
• Type II the insulin is produced but is not effective.
criteria Type I (10%) of cases Type II (90%) of cases
Age at onset Teenage (Juvenile diabetes) Mature adult
Rapidity Sudden severe Slow
Body weight Normal to underweight Over weight to obese
Genetics Less than 20% More than 60%
Autoimmunity yes No
Islet pathology Minimal inflammation or fibrosis Amyloid deposits
Beta cells Marked decrease Near normal
Blood insulin level Marked decrease Normal or increased
ketoacidosis yes Rare
Clinical approach Insulin and diet Diet, oral drugs and insulin.
• Type I diabetes (juvenile)
• Caused by an absolute deficiency of insulin that
results from autoimmune destruction of the islets
by anti-islet cell antibodies.
• Type I accounts for 10% of cases, it appears most
frequently in people under age 20 years, however
few cases occur in adults.
• The remaining 90% of people with diabetes have
type II, adult-onset diabetes, usually appears in
obese, mature adults.
• Type 2 is initially caused by resistance to the action
of insulin by peripheral tissues.
• Dx of type I
• The initial diagnosis of type I is usually made
because the patient
develops
• DIABETIC ACIDOSIS;
• Characterized by;
• Rapid breathing
• Mental disorientation
• Sudden coma
• Frequent urination
• Thirstiness
• Increase appetite
• Patients with type II however are often diagnosed
following routine laboratory test that demonstrate
high fasting blood glucose, Or glucose in the urine