The Endocrine System

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by C. Sommers

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The Endocrine System

  1. 1. GLYCOSURIA HYPERCALCEMIA
  2. 2. Glycosuria  The presence of sugar or glucose in the urine – Two basic causes:  Blood glucose levels are so elevated that the renal tubules are unable to reabsorb all that is present  Failure of tubules to reabsorb when glucose levels are normal – Renal glycosuria
  3. 3. Blood Glucose Levels  Under normal circumstances about 10 mmol/L  It can occur in the non-diabetic if a substantial amount of food high in sugar is consumed and transiently overwhelms the insulin response causing hyperglycemia  Some hyperglycemia causes – Thyrotoxicosis – Acromegaly – Severe anxiety – Diabetes mellitus – Cushing’s disease – Pancreas dysfunction  Glycosuria occurs when a normal renal threshold has been exceeded due to hyperglycemia
  4. 4. Renal Glycosuria  In pregnancy – Results from increased renal blood flow – Tubules are presented with a greater volume each minute – May be the first sign of gestational diabetes
  5. 5. Renal Glycosuria  Other causes – Fanconi’s Syndrome  Inadequate proximal renal tubular reabsorption of glucose  Inherited or acquired  Other symptoms include – growth failure, rickets, polyuria, polydipsia, or dehydration
  6. 6. Renal Glysuria  Some secondary causes: – Oculocerebrorenal dystrophy (Lowe's syndrome) – Cystinosis – Wilson's disease – Interstitial nephritis – Hereditary tyrosinemia – Heavy metal poisoning such as lead, mercury or after use of out-of-date tetracycline – Intestinal glucose-galactose malabsorption (where the defective sodium-dependent glucose co- transporter protein is also present in the renal tubules)
  7. 7. Benign Glycosuria  Occurs without significant pathology  Divided into 3 categories – Type A  Classical glycosuria, with reduction in both glucose threshold and maximal glucose reabsorption rate – In type B  Reduction in the glucose threshold and a normal rate of reabsorption – Type O  Failure of glucose reabsorption  Plasma glucose, glucose tolerance test (GTT), insulin levels and HbA1C are all normal
  8. 8. Hypercalcemia  Condition of excessive calcium levels in the blood – Normal range: 9-10.5 mg/dL or 2.2-2.6 mmol/L – Symptoms are more common at high calcium blood values  12.0 mg/dL or 3 mmol/l). – Severe hypercalcemia  above 15-16 mg/dL or 3.75-4 mmol/l  considered a medical emergency – coma and cardiac arrest can result
  9. 9. Signs and Symptoms  Some signs of  Chronic hypercalcemia hypercalcemia – fatigue – Urinary calculi (renal – depression stones or bladder – stones) confusion – Abnormal heart – anorexia rhythms ECG findings – nausea of a short QT interval – vomiting and a widened T wave – constipation – pancreatitis  Peptic ulcers may also – polyuria occur
  10. 10. Remember: "groans (constipation), moans (psychotic noise), bones (bone pain, especially if PTH is elevated), and stones (kidney stones)”
  11. 11. – Excessive skeletal – Hyperparathyroidism calcium release and malignancy – Increased intestinal account for about 90% calcium absorption of hypercalcemia – Decreased renal – Other causes calcium excretion  Cancer  Disorders related to – Indicative of another bone loss disease  Medications  Excessive use of calcium and vitamin D supplements
  12. 12. Follow the link… …for more information on hypercalcemia!
  13. 13. resources cited  aafp.org  Fremgen, Bonnie F. & Frucht, Suzanne S. Medical Terminology: A Living Language: 3e. New Jersey: Pearson Education. 2005  patient.co.uk  wikipedia.org

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