Aldosterone Research Paper

Aldosterone Research Paper
Also produced by the adrenal glands is aldosterone. Aldosterone belongs to a class off
hormones called mineralocorticoids and it helps maintain blood pressure as well as water and
salt balance, by helping the kidney excrete potassium and retain sodium. When the production
of aldosterone falls too low, the kidneys cannot regulate salt and water balance, resulting in the
drop of blood volume and blood pressure.
Failure to produce enough cortisol can happen for different reasons. The adrenal glands
may be the problem (primary adrenal insufficiency), or the pituitary gland is not secreting
enough ACTH (secondary adrenal insufficiency).
In primary adrenal insufficiency the majority of cases are caused by the destruction of
the outer layer of the adrenal glands by the body's immune system. ... Show more content on
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The lack of ACTH
can cause the adrenal glands to produce less cortisol, but not aldosterone. This can happen
when someone is taking glucocorticoid hormones and suddenly stop. Glucocorticoid hormones
stop the release of corticotropin releasing hormone (CRH) and ACTH. CRH tells the pituitary
gland to release ACTH. If the CRH gets low it prevents the pituitary from releasing ACTH,
causing the adrenals in failure to secrete enough levels of cortisol.
The surgical removal of a benign ACTH producing tumor of the pituitary gland is another
cause of secondary adrenal insufficiency.

Symptoms to Addison's disease usually develop gradually and may include:
 Irritability
 Nausea, diarrhea or vomiting
 Extreme fatigue
 Weight loss and decreased
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What Is Secondary Adrenal Insufficiency?
Adrenal insufficiency is a condition that develops when a large part of the adrenal gland function is
lost. Primary adrenal insufficiency arises due to the damage of the adrenal glands or by using drugs
that halt cortisol synthesis. In contrast, secondary adrenal insufficiency stems from processes that
reduce the secretion of the adrenocorticotropic hormone (ACTH) by the hypophysis as a result of a
pituitary or hypothalamic pathology (the latter is sometimes also referred to as tertiary adrenal
insufficiency).
Adrenal insufficiency is still a significant challenge for both patients and their physicians, but also
scientists and researchers. In the past decade long–term studies with adequate follow–up have
shown surge in mortality and morbidity, ... Show more content on Helpwriting.net ...
In a large number of cases, the disease has a gradual onset, thus the diagnosis can be made only
when the affected individual presents with an acute crisis due to an inadequate rise in cortisol
secretion during a physiologic stress. Such acute adrenal insufficiency (also known as the
Addisonian crisis) is a medical emergency.
On the other hand, the course of chronic adrenal insufficiency is more subtle and insidious, with the
predomination of symptoms such as fatigue, weakness, weight loss, diarrhea or constipation, muscle
cramps, pain in joints and postural hypotension (low blood pressure). Salt craving and low–grade
fever may also be present.
The classic physical finding that can help in differentiating primary from secondary adrenal failure
is hyperpigmentation of the skin or the "suntan that does not fade". Furthermore, patients with
secondary adrenal insufficiency may present with additional symptoms related to pituitary disease
(e.g. menstrual disturbances, loss of libido, galactorrhea, or

Addison's Disease Analysis
What's going on in my liver? What is Addison's disease? Will I live? Are there any treatments? Let
me explain what is Addison's disease, it also known as Hypoadrenocorticism or Adrenal
insufficiency. It's one of the most common diseases that occur in the dogs. This disease can make the
diagnosis very difficult; when it's treated then dogs can live a normal life. Addison's Disease is
associated with the adrenal glands releasing organs which mean it only has one on each side of the
small gland of kidney that will create amount of layers which is cortex and the medulla. What is
cortex? Cortex is the outer area that will secrete corticosteroid hormones like cortisol or aldosterone.
Medulla is part of the inside area where it controls the sympathetic ... Show more content on
Helpwriting.net ...
When Veterinarians are treating your dog for this type of disease, you would want to give
mineralocorticoid that replace aldosterone where hormones regulate the electrolyte levels. There are
in pills form or injection forms. With replacing aldosterone, cortisol will secrete by adrenals which
is also need to be replaced. Adrenals to replace, you will need prednisone or hydrocortisone which is
done by orally medicine. Dogs having this disease will be on lifetime medicine to treat and monitor.
It's very important to watch their behavior changes to avoid their trigger. There are therapy options
as well, to reduce their medication, which will substitute to herb, which has a lot of beneficial for
the dog's life. This herbs medicine purpose are calls Western Herbs, its humankind and softer natural
medicine. With Addison's disease will experience stress, stomachache, increase liver enzymes,
laziness, joint stiff and vomit. This herb will help individual symptoms or any of the side

Adrenocorticotropic Hormone Test Research Paper
Why am I having this test? The adrenocorticotropic hormone test, also called an ACTH test, is a test
that evaluates the functioning of the pituitary gland in your brain. Your health care provider may
order this test if you have symptoms of either too much or too little ACTH. For example, too much
ACTH can be seen in Addison disease, where symptoms include being tired (fatigue). Too little
ACTH can be seen in Cushing syndrome, where symptoms include being overweight, having acne,
and having more hair on your body. What is being tested? The ACTH test measures the level of
ACTH produced by your pituitary gland in the brain. The test examines a part of the pituitary gland
in your brain called the anterior pituitary gland, and it measures how much adrenocorticotropic
hormone (ACTH) that gland is producing. ... Show more content on Helpwriting.net ...
These changes during the day are called diurnal variation. What kind of sample is taken? How do I
prepare for this test? Do not eat or drink anything after midnight on the night before the test or as
directed by your health care provider. You may have this test both in the morning and in the evening.
This checks for diurnal variation. How are the results reported? Your test results will be reported as
a range of values. Your health care provider will compare your results to normal ranges that were
established after testing a large group of healthy people. Reference ranges may vary among different
people, labs, and hospitals. For this test, reference ranges are: Children, male or female: 1 week to 9
years: 5–46 pg/mL. 10–18 years: 6–55 pg/mL. Adults, age 19 and older: Female: 6–58

course ouline
1. What should the nurse suspect when hourly assessment of urine output on a postcraniotomy
patient exhibits a urine output from a catheter of 1,500 mL for 2 consecutive hours? A) Cushing 's
syndrome B) Syndrome of inappropriate antidiuretic hormone (SIADH) C) Adrenal crisis D)
Diabetes insipidus 2. The PACU staff have brought a patient to the unit following a thyroidectomy.
To promote comfort for this patient, how should the nurse position this patient? A) Side–lying
(lateral) with one pillow under the head B) Head of the bed elevated 30 degrees and no pillows
placed under the head C) Semi–Fowler 's with the head supported on two pillows D) Flat, with a
small roll supporting the neck 3. The nurse is caring ... Show more content on Helpwriting.net ...
The pathophysiological effects of the patient 's tumor include excessive secretion of
adrenocorticotropic hormone (ACTH). As a result, this patient is likely to exhibit signs and
symptoms that are characteristic of what endocrine disorder? A) Addison 's disease B) Cushing 's
disease C) Hyperthyroidism D) Diabetes insipidus 12. A patient has been admitted to an acute
medical unit with a diagnosis of diabetes insipidus with a neurogenic etiology. When planning this
patient 's care, what diagnosis should be the nurse 's most likely priority? A) Fluid volume deficit
related to increased urine output B) Acute confusion related to alterations in electrolytes C) Altered
nutrition: less than body requirements related to decreased intake D) Risk for injury related to
decreased level of consciousness 13. A 24–year–old male patient is being cared for in the intensive
care unit following a motorcycle accident. In addition to musculoskeletal injuries, he has developed
syndrome of inappropriate antidiuretic hormone (SIADH) from the traumatic head injury. Which of
the following imbalances is consistent with this diagnosis? A) Hyponatremia B) Hyperkalemia C)
Hyperbilirubinemia D) Hypoglycemia 14. A nurse practitioner is aware of the high incidence and
prevalence of hypothyroidism and regularly encourages many patients to undergo screening of their
thyroid secreting hormone (TSH) levels. Which of the following individuals likely

Sample Resume : ' Daily Soap ' Essay
Eva Anguiano
Equine 2
Weekly SOAP 1
April 25, 2015
Complete signalment: "Dusty" 17 year old, 500lbs (estimated), Shetland Pony gelding
Presenting complaint: Require EWT and F/R vaccination
History: Dusty has been living in a stall in a barn with more than 15 horses. He is primarily a pet.
He has been eating, drinking, urinating, and defecating normally with no changes in behavior noted
by his owner. No history of laminitis.
Examination: BAR, stressed reaction when restrained for vaccines, T: 100.1, P: 48, R: 20, BCS 4/9,
pink moist mucous membranes, CRT<2 seconds, no auscultable cardiac or respiratory abnormalities,
good gut sound in all four quadrants (1–2 borborygmi sounds per minute), no palpable digital pulse
on any limbs, Hirsutism evident over abdomen, slightly pendulous abdomen
Diagnostic testing:
ACTH baseline: 75.2 pg/mL
Insulin: 11.60 µUI/mL
Problem List:
1. Mild tachycardia (48 bpm)
2. Mild tachypnea (20 breaths/minute)
3. Hirsutism
4. Pendulous abdomen with appropriate BCS (4/9)
5. Elevated ACTH (75.2 pg/mL; reference 9–35)
Main Problem: Hirsutism
Subjective: Stressed, no changes in eating or drinking habits, no changes in urination
Objective: 17 year old pony, BCS 4/9, hirsutism, pendulous abdomen, ACTH 75.2 pg/mL, Insulin
11.60 µUI/mL

Assessment: The problem of hirutism is localized to congenital or metabolic abnormalities; since
this pony does not have a history of abnormal hair growth this is most likely a metabolic issue.
Pituitary

Mode Of Delivery Affect On Stress Response At Birth And...
Mode of Delivery Affects on Stress Response at Birth and Possible Shift of HPAAxis Nicole Miller
Eastern Michigan University Abstract Several journal articles were reviewed regarding the effects
that mode of delivery had on cortisol (CORT) and adrenocorticotropic hormone (ACTH) at birth and
its possible long term effects on the hypothalamic–pituitary–adrenal axis (HPA). Umbilical cord
blood was collected immediately following delivery with a time frame of up to 20 minutes and
analyzed for hormone concentrations. Studies indicate that significant differences in hormone
concentrations can be seen between vaginal and caesarean delivery. Follow up studies indicate that
that stress related biochemical change ... Show more content on Helpwriting.net ...
Schuller et al. (2012) showed that pain and stress responses in newborns can be measured by
physiological parameters such as heart rate, blood pressure, and cortisol concentrations within
bodily fluids. The body's reaction to stress is governed by the hypothalamic–pituitary–adrenal axis
(HPA). A major part of the neuoendorine system which consists of the interactions between the
hypothalamus, pituitary gland, and adrenal glands. Rothenberg et al. (1996) found that exposure to
stress either prenatally or during birth alters the hypothalamic–pituitary–adrenal axis (HPA) and
influences the newborns further development. Similarly Kapoor et al. (2006) and Dean et al. (2001)
found in animal and in human studies that prenatal stress causes increased cortisol concentrations at
birth which may alter the circuitry of the HPA axis. Furthermore, Gitau et al. (2004) found that fetal
cortisol levels decreased in newborns delivered by cesarean section when compared to those
delivered vaginally. In contrast Mears et al. (2004) reported elevated cortisol concentrations in
assisted vaginal deliveries. Research has documented that there is some evidence supporting that
birth mode determines stress response. (Taylor et al. 2000) As stated previously stress is
psychosomatic, and causes or exacerbates a range of serious health issues. Knowledge of how our
initial stress response at birth can modulate our reactions to stress could improve,

Primary And Secondary Adrenal Insufficiency
Adrenal Insufficiency This paper describes the differences between primary and secondary adrenal
insufficiency. As health care providers it is important to be able to distinguish between the two and
to know how to treat the patient. It is also imperative that an acute adrenal crisis can be recognized.
This paper will discuss how to recognize and treat adrenal insufficiency.
Primary adrenal insufficiency Primary adrenal insufficiency occurs when the adrenal glands fail to
release glucocorticoids and mineralocorticoids, despite the release of adrenocorticotrophic hormone
(ACTH) from the pituitary, and may be fatal if untreated (Griffing, 2015). Margulies (2015)
describes primary adrenal insufficiency, also known as Addison's disease, as ... Show more content
on Helpwriting.net ...
& Hamrahian, A.H., 2010). Other clinical and laboratory manifestations of primary adrenal
insufficiency are presented in Table 1.
Evaluation
A medical history is very important if the patient has any symptoms mentioned above, especially
hyperpigmentation of the skin or gums, it is often enough to raise a strong suspicion, prompting the
appropriate tests. The following tests are appropriate to order to diagnose adrenal insufficiency:
Serum chemistry, abnormalities are present in as many as 56% of patients. Hyponatremia is
common although not diagnostic; hyperkalemia, metabolic acidosis, and hypoglycemia also may be
present. However, the absence of laboratory abnormalities does not exclude the diagnosis of adrenal
crisis. Serum cortisol, less than 20 mcg/dL in severe stress or after ACTH stimulation is indicative
of adrenal insufficiency. ACTH test which is diagnostic, determine baseline serum cortisol, then
administer ACTH 250 mcg intravenous push (IVP), and then draw serum cortisol 30 and 60 minutes
after ACTH administration. An increase of less than nine mcg/dL is considered diagnostic of adrenal
insufficiency. CBC, anemia mild and nonspecific, lymphocytosis, and eosinophilia highly
suggestive may be present. Serum thyroid levels, assess for

Extreme Pulmonary Fibrosis: A Case Study
Death Certificate #3
Name of deceased: Louvenia Alexander Forrester
Age: 30
Date of Birth: November 8, 1981
Date of Death: January 13, 2012
Cause of death: Extreme Pulmonary Fibrosis; Pulmonary Hypertension
1. Etiology – Pulmonary fibrosis is a condition in which the lungs are scarred throughout their
surfaces. It is often caused by chronic inflammatory diseases, infections or environmental agents,
exposure to radiation, or chronic conditions such as lupus or rheumatoid arthritis(Pulmonary
Fibrosis, 2014). Additionally, in this very young patient the cause may be idiopathic in that there
really is no known reason why it occurs.
Pulmonary hypertension in this case likely resulted as a product of the initial pulmonary fibrosis. As
the ... Show more content on Helpwriting.net ...
Treatment – Medications that may be used in the treatment of emphysema include bronchodilators,
inhaled steroids, and antibiotics. Therapy options may include pulmonary rehabilitation, nutrition
therapy, and supplemental oxygen. Surgery that may be used includes lung volume reduction
surgery which removes chunks of damage tissue to allow the remaining tissue to move more freely
and lung transplant.
5. Prognosis – Survival depends upon the staging of the disease. Currently there are two staging
systems used. These are the GOLD and the BODE. BODE stands for Body mass index, or the
weight of the person, O is obstruction, which is determined by pulmonary function tests, D is for
dyspnea, and E is for the ability to exercise. The GOLD standard is as follows:
Stage I, Mild emphysema: FEV1 greater than or equal to 80% of normal
Stage II, Moderate emphysema: FEV1 less than 80%, but greater than or equal to 50% of normal
Stage III, Severe emphysema: FEV1 less than 50%, but greater than or equal to 30% of normal
Stage IV, Very severe emphysema: FEV1 less than 30% of normal, OR less than 50% of normal
with low blood oxygen levels (Emphysema, 2013).
Combining both systems results in the following survival

Pathophysiology Of Addison 's Disease
Pathophysiology
Addison's disease is also known as Adrenocortical Insufficiency, which means the adrenal cortex
does not produce enough hormones (Understanding Medical Surgical Nursing, 2015). Addison's
disease occurs when the adrenal glands, above the kidneys, don't make enough hormones that are
essential to normal body functions (Understanding Addison's Disease, n.d.). The most common
cause of Addison's disease is due to the adrenal cortex being abnormally small or atrophied. This
causes the adrenal cortex to not produce as many hormones (Understanding Medical Surgical
Nursing, 2015). If the disease is primary, the pituitary gland may be sending out elevated levels of
ACTH (adrenocorticotropic hormone) to try to get the adrenal cortex to produce more hormones.
When the disease is secondary, the ACTH does not stimulate the adrenal cortex to produce more
hormones (Understanding Medical Surgical Nursing, 2015). Only 1 out of 100,000 people actually
have Addison's disease; making it very rare. Addison's disease occurs in men and women of any age
(Understanding Addison's Disease).
Etiology, Causes, and Risk Factors
Some people believe that Addison's disease is autoimmune disease. They think the gland sort of
"terminates" itself. Diseases such as tuberculosis, AIDS, cancer, and fungal infections are thought to
cause the self–destruction of the adrenal cortex. Hashimoto's thyroid and bilateral adrenalectomy
may also cause Addison's disease. Secondary Addison's disease

Taking a Look at Addison's Disease
Autoimmune diseases are very common. There are over 23.5 million Americans who suffer from
such diseases. Women of child bearing age and people with a family history of autoimmune diseases
are more likely to be affected by these diseases. Addison's can also occur in dogs. This type of
disease is one that is caused by the attack of healthy cells and tissue. The immune system can't tell
the difference between the healthy tissue and the bad one and it attacks the normal one creating an
autoimmune disorder. Autoimmune disorders can destroy body tissue, change the function of an
organ, or cause abnormal growth in an organ. Parts of the body that are usually affected by these
disorders are joints, muscles, blood vessels, endocrine glands, or other organs. There is a wide
variety of autoimmune diseases. More than 80 kinds of diseases have been discovered.
One common autoimmune disease is Addison's disease. Addison's occurs when your body creates
antibodies which attach onto your adrenal cortex and destroys the cells which create cortisol, and
aldosterone. This may not seem to be a big deal but, it is life threatening. Cortisol is a hormone
which responds to stress, increases blood sugar, and suppresses the immune system. . It also helps
regulate the metabolism. When there is a lack of cortisol you can have symptoms such as diarrhea,
inability to handle stress, vomiting, loss of appetite, and much more. Aldosterone works with blood
pressure, and helps regulate the salt and water

Addison's Disease
Anatomy & Physiology
Gerald McGraw
January 27, 2012
Addison's Disease
A disorder that takes place when your body produces an insufficient amount of certain hormones
that are produced by the adrenal glands is called Addison's disease. With Addison's disease, the
adrenal glands do not produce enough cortisol and often times an insufficient amount of aldosterone
as well. Doctors sometimes refer to Addison's disease as the illness of chronic adrenal insufficiency,
or also called hypocortisolism. "In 1855, Thomas Addison first described adrenal insufficiency,
which was subsequently named after him. The basis of Addison disease has dramatically changed
since its initial description. Originally, the disease usually resulted from ... Show more content on
Helpwriting.net ...
A person should visit their doctor for the diagnosis of this disease if they have severe fatigue, muscle
or joint pains, salt cravings, unintentional weight loss, and gastrointestinal problems, such as
vomiting and abdominal pain and nausea. The cause of Addison's disease is the result of the adrenal
glands being damaged and producing insufficient amounts of cortisol and aldosterone as well. The
adrenal glands are located just above the kidneys. Being part of the endocrine system, the adrenal
glands produce hormones that give instructions to almost every organ and tissue in the body. The
adrenal glands are made up of two different sections. The interior (medulla) which produces
hormones similar to adrenaline. The (cortex) outer layer has the role of producing a group of
hormones that are called corticosteroids; these include mineralocorticoids, glucocorticoids and the
male sex hormones known as (androgens). Addison's disease takes place when the cortex is
damaged and does not produce hormones in adequate quantities. Doctors often refer to this
condition that involves damage to the adrenal glands as a primary adrenal insufficiency. When the
adrenal glands fail to produce adrenocortical hormones it is commonly a result of an autoimmune
disease where the body is attacking itself. For an unknown reason the immune system sometimes
views the

Music Through The Measurement Of Skin Conductance Level (...
A highly regarded art form, music aids in defining cultural phenomenon that individuals use to
experience, communicate and express emotional states. Music is also known to evoke an emotional
response that is associated with physiological arousal (Olsen & Stevens, 2013). Past and present
research has defined arousal as an early emotional response. The present study seeks to examine
physiological response (anxiety) in response to classical music through the measurement of skin
conductance level (SCL). The purpose of this study is to determine if music affects, specifically
lowers, the amount of physiological arousal (anxiety) experienced by a participant while listening to
classical music. SCL works by passing an electrical current across ... Show more content on
Helpwriting.net ...
Those with GAD also experience fatigue, muscle tension, difficulty sleeping, irritability, restlessness
and edginess (ADAA, 2015). Worry and anxiety are a natural part of everyday life, but for those
with GAD, the worry becomes so severe that it impairs their normal functioning. The lifetime
prevalence of GAD is 28%, with a mean age of onset at 11 years (Duval et al., 2015). This section
will focus on the neurological information of GAD, current research and the effect music has on
GAD. Neuroscience. When an anxiety response occurs, objectively unthreatening stimuli becomes
threatening (Davidson, 2013). To help cope with stress, the brain releases the hormone cortisol
(Bear, Connors & Paradiso, 2007). During the fear and anxiety response, the central nucleus of the
amygdala is active; once active, an excitatory response in the hypothalamus occurs (Davidson,
2013). This excitation causes corticotrophin–releasing–hormone (CRH) to be released; CRH then
triggers the anterior pituitary gland to secrete ACTH (Davidson, 2013). The ACTH levels in the
blood stream cause cortisol to be released from the adrenal cortex and once the levels of cortisol
become high, the hippocampus activates, suppressing the release of CRH (Davidson, 2013). The
bloodstream carries cortisol to the brain, where it bind to receptors in the cytoplasm of man

The Effect Of Cortisol On The Levels Of Cortisol
Cortisol is a cholesterol derivative steroid hormone. It is produced in the cortex of the adrenal gland.
Cortisol is secreted because of stress related events and its part of our adaptive stress response.
The total plasma cortisol taken in the morning, in a healthy individual is 200 – 700nmol. Secretion
of cortisol follows the diurnal rhythm so naturally levels of cortisol are at their highest 20 – 30
minutes after awakening; with an average of 50% increase. This is referred to as the cortisol
awakening response (CAR)
Cortisol levels start to decline in a steady manner throughout the day; reaching its lowest point late
in the evening. High levels of cortisol in the morning are linked to sleep cycle, therefore jet lag,
night shifts are some of the factors that can disrupt ACTH secretion and consequently cortisol too.
The patient presented with weight gain, flushed skin, tiredness, inability to concentrate, hirsutism,
depression and facial swelling; which all indicate that the patient might be suffering from Cushings
Syndrome.
Cushings sydrome is characterised by a group of symptoms that occur as a result of elevated levels
of cortisol.
The source can be endogenous, the first would be Cushings disease which is a cortcotropinoma
(tumour in the anterior pituitary gland) which can be a microadenoma or a macroadenoma. The
second is the adrenal adenoma and adrenal carcinoma, which are tumours in the adrenal cortex
On the other hand the source of hypercortisolism, can be

Case Study in Nursing
INTRODUCTION
Congenital Adrenal Hyperplasia (CAH) refers to a complex series of rare but well–studied
enzymatic errors of metabolism with deficient levels of different enzymes involved in the synthesis
of cortisol (hydrocortisone).
CAH comprises a group of disorders resulting from defective synthesis of adrenal corticosteroids.
Lack of glucocorticoids, especially cortisol, causes various kinds of metabolic problems. The
response to low levels of cortisol is increased production of corticotropin (ACTH). Lack of
mineralocorticoids, primarily aldosterone (steroid hormone), causes sodium and water imbalance
which, in some cases, can be fatal. The various forms of CAH represent defects in the different
stages of corticosteroid synthesis, ... Show more content on Helpwriting.net ...
There were two folds of skin coming from the top of the penis and encircling it on either side. These
were somewhat loose and resembled labia majora."
De Crecchio then described the internal organs, which included a normal vagina, uterus, tubes, and
ovaries.
It was of the greatest importance to determine the habits, tendencies, passions, and general character
of this individual... I was determined to get as complete a story as possible, determined to get at the
base of the facts and to avoid undue exaggeration which was rampant in the conversation of many of
the people present at the time of the dissection.
He interviewed many people and satisfied himself that Joseph Marzo "conducted himself within the
sexual area exclusively as a male, "even to the point of contracting the "French disease" on two
occasions. The cause of death was another in a series of episodes of vomiting and diarrhea.[5]
This account was translated by Alfred Bongiovanni from De Crecchio (Soprauncaso di
apparenzivirili in una donna. Morgagni 7:154–188, 1865) in 1963 for an article in the New England
Journal of Medicine.
Currently due to the impressive advocacy of CARES Foundation, all 50 states in the United States
and over 40 countries EVERY child born is screened for CAH at birth. This life saving screen will
detect elevated levels of 17–hydroxy–progesterone (17–OHP). Detecting high levels of 17–OHP
enables early detection of CAH. Newborns detected early enough can be placed on

Treatment During Childhood Case Study
3. Treatment during childhood
In children, hydrocortisone (8 mg/m2/d) is recommended as starting dose in 3–4 divided doses and
synthetic, long acting glucocorticoids are avoided.
Monitoring by clinical assessment like growth velocity, weight, BP etc.
In PAI with hypoaldosteronism, fludrocortisone should be started with 100mcg/day. In infants and
newborns sodium chloride supplementation is recommended.
C. Treatment of acute adrenal crisis5
Initial resuscitation and fluid correction by normal saline is mandatory. Sodium correction to be
done gradually.
100mg hydrocortisone IV to be started followed by 200mg/24 hours by 6 hourly
injection/continuous IV (rate of infusion is 10mg/hour) till oral feed started
The stress dose of ... Show more content on Helpwriting.net ...
Replacement of thyroid hormone without cortisol can precipitate acute adrenal insufficiency.
Patients with hypopituitarism with partial/total ACTH deficiency and on suboptimal cortisol therapy
may develop symptoms of cortisol deficiency upon initiation of growth hormone therapy due to
inhibition of 11–beta–hydroxysteroid dehydrogenase– type–1.6–9
Once Daily Long Acting Hydrocortisone Therapy
Current replacement strategies require modification due to evidence of impaired health and
increased mortality as result of inappropriate glucocorticoid therapy. Mah et al (2004)10 concluded
that a thrice daily regimen is preferable, but immediate release hydrocortisone with short half–life
(t½) cannot properly replicate physiological cortisol release, so delayed–release hydrocortisone are
being explored. Prednisolone and dexamethasone have longer t½ but cause high night–time
glucocorticoid activity resulting in detrimental effects on insulin sensitivity and bone mineral
density.11 Therefore, there was an immense need for more physiological long acting preparations:
a) Modified release hydrocortisone (Dual release DR–HC) are being investigated in few trials.12
b) Plenadren is a modified release preparation of hydrocortisone licensed recently. It has extended
release core covered by immediate release coating, administered once daily and replicated normal
cortisol rhythm. It showed

A & P Case Study on Addisons Disease Essay
Unit 1 Case Study
Addison's disease is from a result from damage to the adrenal cortex. These two
adrenal glands are located on top of the kidneys, where they are enclosed in a
fibrous capsule and a cushion of fat. . The have an outer portion, called the
cortex, which is a glandular tissue derived from embryonic mesoderm. The inner
portion called the medulla, which is more like a knot of nervous tissue than a gland
and it is part of the sympathetic nervous system. The adrenal cortex synthesizes
over two dozen steroid hormones called corticosteroids. The Adrenal medulla is part
of the autonomic nervous system. They are often referred to as the suprarenal
glands. That damage causes the cortex to produce ... Show more content on Helpwriting.net ...
Treatment with
replacement corticosteroids will control the symptoms of this disease, and this
usually will require the patient to take these drugs for life. It is receive a
combination of glucocorticoids and mineralocorticoids. The provider may increase
the dose in times of infection, injury and stress. With adrenal crisis patients will
need an immediate injection of hydrocortisone, either IM, or IV. If the blood
pressure is extreme low IV fluids will be helpful. Complications can occur if you
take too much or not enough of the adrenal hormone supplement. This

complications can arise due to related illnesses such as diabetes, chronic thyroiditis,
hypoparathyroidsim, ovarian hypofunction or testicular failure, thyrotoxicosis and
pernicious anemia. Low sodium with Addison's should be carefully corrected, if
done to quickly it can lead to brain damage, this is noted in a 2004 article in
"American family Physician" they require immediate but slow administration of
saline, which is basically salt water, composed of sodium chloride in water. They list
a second step which then be finding the underlying cause. Primary adrenocortical
insufficiency is not a common disorder. It's incidence in western populations are
near 50 cases per 1,000, 000. However with the widespread corticosteroid use
secondary adrenocortical insufficiency due to steroid withdrawal

Symptoms And Symptoms Of Addison 's Disease
Addison's disease is a disorder that occurs only when your body doesn't produce enough of the
certain hormones that you need from the adrenal glands. In this type of disease, the adrenal glands
don't produce much of cortisol and the levels of aldosterone also have the lack of producing in our
bodies. This disease can also be called adrenal insufficiency. This disease can happen in all the age
groups and affect both of sexes. The Addison's disease can be a life threatening thing to our bodies.
You start seeing symptoms slowly during the months passing by like having muscle weakness and
feeling fatigue, you're going to see weight loss and your appetite is going to be decreased, your skin
can darken (hyperpigmentation) which is a harmless ... Show more content on Helpwriting.net ...
When the darkening begins it starts when an excess of melanin, the brown pigment that makes our
normal skin color, it forms deposits in the skin. You can also have low blood pressure, you can even
faint, you can have salt cravings, you can have hypoglycemia, this is a deficiency of the glucose in
the blood stream in our body. You can also have nausea, diarrhea, vomiting, you can also experience
muscle or joint pains, it can also put you in a depressed mood, and you can also have loss of hair in
your body or sexual dysfunction in women. If you have an acute adrenal failure these would be
some of the symptoms. You would have pain in your lower back, abdomen or even in the legs; you
would also experience a lot of vomiting and diarrhea leading to dehydration in your body, also
having low blood pressure. Those would be some of the symptoms, there are couple more but these
are the major ones. The cause of this disease is when your adrenal glands are damaged, and not
producing enough of the hormones cortisol and aldosterone. These glands in our body are located
just above our kidneys. The endocrine system in our body what that does for us that they produce
the hormones that gives instructions to virtually every organ and tissue in our body. Our adrenal
glands are composed into two sections. The interior is the medulla, what that does is that it produces
adrenaline like in the hormones. The outer layer is called the cortex and what that does is that it

Adrenal Gland Essay
Adrenal gland
In mammals, the adrenal glands (also known as suprarenal glands) are the triangular–shaped
endocrine glands that sit on top of the kidneys. They are chiefly responsible for releasing hormones
in conjunction with stress through the synthesis of corticosteroids and catecholamines, including
cortisol and adrenaline (epinephrine), respectively.
Anatomy and function
Anatomically, the adrenal glands are located in the retroperitoneum situated atop the kidneys, one on
each side. They are surrounded by an adipose capsule and renal fascia. In humans, the adrenal
glands are found at the level of the 12th thoracic vertebra. Each adrenal gland is separated into two
distinct structures, the adrenal cortex and medulla, both of which ... Show more content on
Helpwriting.net ...
The suprarenal veins may form anastomoses with the inferior phrenic veins.
The adrenal glands and the thyroid gland are the organs that have the greatest blood supply per gram
of tissue. Up to 60 arterioles may enter each adrenal gland.[4]
Terminology
The adrenal glands are named for their location relative to the kidneys. The term "adrenal" comes
from ad– (Latin, "near") and renes (Latin, "kidney"). Similarly, "suprarenal" is derived from supra–
(Latin, "above") and renes. Colloquially, they are referred to as "kidney hats".
Adrenal cortex
Situated along the perimeter of the adrenal gland, the adrenal cortex mediates the stress response
through the production of mineralocorticoids and glucocorticoids, including aldosterone and cortisol
respectively. It is also a secondary site of androgen synthesis. Contents * 1 Layers * 2 Hormone
synthesis * 3 Production * 3.1 Mineralocorticoids * 3.2 Glucocorticoids * 3.3 Androgens * 4
Pathology * 5 See

Analysis Of Cushing 's Syndrome And Its Effects On The Body
Cushing's syndrome is a rare endocrine disorder that occurs when your body is exposed to an
overabundance of the hormone cortisol.3 Cortisol is known as the stress hormone. The interruption
of cortisol secretion can cause weight gain and can ultimately determine where you put the weight
on.8 There are many underlying causes such as Pituitary Adenomas, Ectopic ACTH Syndrome,
Adrenal Tumors, and Familial Cushing's Syndrome.2 The majority of these people affected by this
hormonal disorder experience weak muscles, increase fat, high blood pressure, etc.1 Although
thousands are affected in various ways, there are currently several channels of treatment
administered by medical professionals. Through the use of improving technology, medical
professionals are better understanding the disorder, allowing them to develop better treatment
practices.
Cortisol plays a major role in the development of this disorder. It is secreted by the adrenal gland,
located above the kidneys, in a precise sequence of events. The hypothalamus directs corticotropin–
releasing hormone(CRH) to the pituitary gland.1 CRH causes the pituitary to release
adrenocorticotropin hormone(ACTH) activate the adrenal glands.1 The adrenal glands pick up the
ACTH, they reciprocate by releasing cortisol in the bloodstream.1 Cortisol helps with quite a few of
your body functions. Some of these functions are stress response, balancing the effects of insulin,
reducing the immune system's inflammatory response, regulating

Addison 's Disease : An Autoimmune Disorder Of The...
Addison's disease is an autoimmune disorder of the endocrine system. It is a hormonal insufficiency
of adrenocortical due to the dysfunction of the adrenal glands. It effects men and women of all ages
and races. Delay in diagnosis or treatment can be life–threatening. Treatment requires life–long
hormone replacement therapy. Addison's is predominantly found in Western countries then
developing ones though it is unknown if individuals are more resilient or are dying undiagnosed.
Higher education worldwide about this disorder could improve diagnosis and ultimately save lives.
Addison's Disease
Addison's disease was first detected by Thomas Addison in 1855, it is a disorder caused by
insufficient levels of hormones produced by the adrenal glands such as adrenocortical. It is caused
by damage or dysfunction of the whole adrenal cortex and can be referred to as adrenal
insufficiency. This failure to produce adequate hormone levels results in the body attacking itself
known as an autoimmune disorder. It occurs in both men and women at any age and has no racial
preference. Addison's is predominantly seen more in Western countries than developing ones.
Although it is not known if it is less common in these areas or if people are dying undiagnosed. This
concern was the topic of the journal review, Diagnosis and Management of Addison's Disease. This
article focused on Addison's in South Africa.
Deficiency in glucocorticoid (hydrocortisone), mineralocorticoid (aldosterone)

Major Depressive Disorder Impacts Many People Worldwide
Major Depressive Disorder impacts many people worldwide. According to Devi et al. (2005), the
disorder is characterized by feelings of sadness accompanied by emotional and physical withdrawal,
all thought to result from molecular and cellular abnormalities that interact with genetic and
environmental factors. To date, no concrete neurobiological explanation exists to completely define,
diagnose and treat this illness. Depression debilitates patients, society and economies. An estimated
14.8 million Americans (6.7% of the population) suffer from this disease, costing the economy 83.1
billion US dollars annually (Cook et al., 2009). Those affected do not recover quickly and this
proves a burden to one's personal life, families and the healthcare system. As such, many questions
are raised, such as: Is depression genetic or environment based? Can depression be cured? How do
we select a safe treatment? What cellular pathways are targets for depression therapies? Slide 2
Brain Activity and Depression Figure 1. Increased Brain Activity Patterns in Depression. 2016.
Retrieved from http://brainpictures.org/p/90/depression–brain/picture–90 The brain regulates the
state of mind, moods and numerous capacities. According to Duman et al. (2012), postmortem
investigations of patients, brain imaging studies and research have shown significant changes in the
limbic regions of the brain such as decreased activity in the prefrontal cortex (regulates executive
functions such as

Cortisol Research Paper
Cortisol production is stimulated by ACTH secretion from the anterior pituitary via numerous
feedback mechanisms according to the circadian rhythm, with peak levels in the early morning and
smaller fluctuations throughout the day. ACTH secretion is stimulated by CRH in the hypothalamus
which is stimulated by things such as: decreases in plasma cortisol, hypoglycemia, stress, and
infection. Secretion of ACTH leads to conversion of cholesterol to cortisol in the zona fasciculata of
the adrenal gland via various cytochrome P450 enzymes. Increased levels of cortisol itself cause
negative feedback on the pituitary and hypothalamus. The zona glomerulosa is the site of production
of Aldosterone, the principal mineralocorticoid, via similar mechanisms (cytochrome p 450.)
Aldosterone production is stimulated by activation of the renin angiotensin system in response to
decreased intravascular volume (sensed by baroreceptors), decreased sodium levels sensed in the
macula densa of the nephron, and by the sympathetic nervous system in response to stress.
Over ninety percent of cortisol in the blood is bound to corticosteroid binding globulin, and about
ten percent is in the free, biologically active form, however these levels may vary during times of ...
Show more content on Helpwriting.net ...
In cases such as these, one may check an early morning cortisol level in which levels > 10 mcg/dL
usually suggest there is no impairment in HPA axis. Levels <5 mcg/dL are suggestive of additional
glucocorticoid therapy intraoperatively. In levels between 5–10mcg one may perform a standard
250mg ACTH stimulation test in which cortisol level 30 minutes after injection should have a
minimum value of

Congenital Adrenal Hyperplasia (CAH)
Congenital Adrenal Hyperplasia (CAH) is a family of autosomal recessive disorders caused by
impairment of biosynthesis of cortisol, aldosterone, and androgens. More than 85–90% of CAH is
due to 21–hydroxylase deficiency. This is due to the defect in 2 genes–CYP21P and CYP21. 90% of
the mutated forms causing 21–hydroxylase deficiency and they all recombination between CYP21
and CYP21P. Clinically they all are divided into two forms deficiency are described– the classical
form, which is subdivided into simple virilising form and salt–wasting form and non–classical form.
Treatment includes the glut corticoid treatment with mineral corticoid or without mineralocorticoid
and salt replacement. This review will focus on the basic etiology, epidemiology, pathogenesis,
clinical manifestations, laboratory findings, treatment and prognosis of congenital adrenal
hyperplasia due to 21–hydroxylase deficiency.
Introduction
Congenital Adrenal Hyperplasia (CAH), a group of autosomal recessive disorders characterized by
enzyme defects in the pathways of steroid biosynthesis involved in the formation of cortisol,
aldosterone and androgens. 21–Hydroxylase (21–OH) is the most common of the enzymatic
deficicient being found in 94% of cases, which is formed due to mutation of 21–hydroxylase gene
CYP21A2. Categorizations lead to two forms severe form or ... Show more content on
Helpwriting.net ...
17–hydroxyprogesterone levels should not be maintained in one way of treatment, since the doses of
glucocorticoid that may cause Cushing's syndrome. Rather, 17– hydroxyprogesterone levels should
be partially suppressed to the range of 90 to 1000 mg per deciliter (4 to 33 nmol per liter). only in
Androstenedione and testosterone levels are very important in prepubertal children Pubertal
development should be monitored by regular periodic charts, Radiographs shows skeletal
maturations of the hand and wrist for bone

Parkinson's Disease Essay
Parkinson's Disease–like pathologies are found in different organisms. However, the pathology do
not necessarily result in Parkinson's–like symptoms. In horses, dysfunction of the pituitary pars
intermedia due to the loss of dopaminergic neurons within the hypothalamus is a characteristic of
Cushing's disease (Spelta, 2015). Currently, it is hypothesized that with age, oxidation within the
hypothalamus causes the loss of dopaminergic neurons. In equine Cushing's disease,
proopiomelanocortin peptides (POMC), such as acetylcholine (ACTH), α–melanocyte–stimulation
hormone (α–MSH), and ß–endorphin, are mass–produced due to the lack of dopamine inhibiting
melanotrope cells of the pars intermedia within the pituitary gland (Toribio, 2012). With ... Show
more content on Helpwriting.net ...
In Chinese Crusted dogs, mutation to the PARK2 gene can lead to a condition called Canine
multiple system degeneration (O'Brien, 2005). Affected dogs develop cerebellar ataxia, which later
develops into akinesia and the inability to maintain postural stability. As the disease progresses, it
has been seen that the substantia nigra degenerates, which is similar to Parkinson's Disease
(Montgomery, 1983). Eventually, the dogs are euthanized by age 2. For studies involving
Parkinson's Disease, mice and non–human primates are primarily used as models. 1–methyl–4–
phenyl–1,2,3,6–tetrahydropyridine (MPTP) has been previously shown to selectively target and
breakdown nigrostriatal dopaminergic neurons and cause Parkinson's–like symptoms in primates
within a few days (McCrodden, 1990). With that, the progression of the MPTP–induced Parkinson's
disease is a sped–up model of the actual disease. MPTP is a lipophilic compound that is able to cross
the blood–brain barrier and convert into its fully oxidized metabolite, 1–methyl–4–
phenylpyridinium ion (MPP+) (Monte, 2014). In this state, MPP+ has a higher affinity to bind
dopamine transporters and be taken up by neurons. Beyond this, the mechanism for toxicity is
unknown. However, it is hypothesized that MPP+'s ability to bind neuromelanin causes for the
neuromelanin to act as a toxic reservoir. Nonetheless, it has been shown that neuromelanin
concentration is decreased in those inflicted by Parkinson's Disease

What Is Prednisolone?
M.L. was prescribed Prelone (Prednisolone) to treat the cellulitis noted on the right side of his face.
Prednisolone is a steroid that inhibits the release of substances in the body that result in
inflammation. The mechanism of action acts by altering the body's immune reaction to several
disorders and reducing inflammation. Prednisolone is used to treat various conditions such as
allergic disorders, arthritis, breathing disorders, irritable bowel syndrome, lupus, psoriasis, and skin
conditions. Prelone (Prednisolone) acts by the reducing inflammation by suppression of migration of
polymorphonuclear leukocytes and reversal of increased capillary permeability. It suppresses the
immune system by decreasing activity and volume of the lymphatic

Eshkevari Et Al. Investigate The Effects Of...
Eshkevari et al. investigate the effects of electroacupunture (EA) treatment at stomach meridian
point 36 (St36) in rats exposed to stress. Researchers randomly assigned rats to one of four groups:
the control group that received no treatment; a stress–only group exposed to a deep ice/water
mixture; the sham–EA group exposed to cold stress followed by EA at a random site; and the EA
St36 group exposed to cold stress followed by EA at St36. After fourteen days, rats exposed to
chronic stress and EA St36 and the non–stressed control rats demonstrated similar
adrenocorticotropic hormone (ACTH) levels; corticosterone (CORT) levels between EA St36 and
non–stressed control rats also presented no significant differences. The authors hypothesized ...
The authors effectively establish baseline hormone levels by ensuring the stress hormones measured
during experiments are not solely due to the procedural stress of acupuncture needles. Acclamation
ensures that the needles and procedure are no longer novel to the rats and the stress–related
hormones primarily reflect exposure to the ice/water treatment.
Although Eshkevari et al. engage in clinically worthy research aided by a beneficial acclamation
protocol, major concerns arise regarding the generalizability of the results due to the utilization of
only male rats. The work of Vieira et al. (1) suggests that sexual dimorphism impacts the stress
response and demonstrates that female rats experience enhanced vulnerability to stress–evoked HPA
axis changes. Even if the results of the Eshkevari et al. study propose EA at St36 as a therapeutic
option in male rats, sexual dimorphism may negate any therapeutic effects in female rats and
necessitates future research to determine if EA presents therapeutic benefits in both sexes.
Further concerns arise from the authors' conclusion that EA benefits are specific to St36 stimulation.
Eshkevari et al. cite elevated ACTH and CORT levels in sham–EA rats as evidence that the
suppression of the stress hormones is specific to EA at St36. The results section, however, reveals

Post-Tbi Case Studies
It is evident that there are some solid data for the cause of AI due to TBI along with refuting data as
well. The largest discrepancy among investigating AI in TBI patients, was the varying definitions of
what constituted as AI. As stated in the results section, these measurements and tests included, but
not limited to, baseline cortisol readings, and varying ACTH stimulation tests. It seems that those
investigators who chose to use a baseline cortisol measurement as opposed to stimulation tests,
gathered more data in support of AI post TBI. Heather et al showed a stimulation test referred to as
the metyrapone test. This test not only measures the potential increase in a cortisol level of the
patient, but also causes the shunting of endocrine products to make more cortisol due to inhibiting
the further progression of precursors to other hormones such as sex hormones. This type of
stimulation test was not found in other articles that were reviewed for this paper. It would be helpful
to see how often and how beneficial a test such as the metyrapone test is over a possible standard
ACTH stimulation test (high or low dose). ... Show more content on Helpwriting.net ...
It seems that the low dose ACTH test was more sensitive in diagnosing AI post TBI, possibly even
with an over diagnosing of this insufficiency. (Mirzaie, et al., 2013) The high dose ACTH test also
had differing results depending on when the samples were taken from the patients; 30 min or 60 min
post administration. A 60min sample seemed to have given the strongest correlation between TBI
and a resulting AI in the patient. (Bernard, Outtrim, Menon, & Matta,

Congenital Adrenal Hyperplasia Essay
Congenital adrenal hyperplasia is a well–known autosomal recessive disorder and the vast majority,
approximately 95%, of cases are due to a deficiency of 21–alpha–hydroxylase. The other common
type of CAH is caused by a deficiency of 11–beta–hydroxylase. In both types of the disorder, the
adrenal gland is unable to produce sufficient amounts of cortisol and aldosterone. CAH is estimated
to manifest in 1 of every 15,000 live births. In the United States, the prevalence of the disorder is
lower in African–American children in comparison to Caucasians. Moreover, the decreased
synthesis of cortisol results in diminished negative feedback of adrenocorticotropic hormone
(ATCH) and over–secretion of ACTH. This pathological increase of ACTH in an attempt to increase
serum cortisol levels is prevented because of the lack of appropriate enzymes and actually results in
increased androgen ... Show more content on Helpwriting.net ...
On the other hand, affected males present normally at birth with some showing signs of
hyperpigmentation of the scrotum or a large phallus. It is recommended that surgery on females with
ambiguous genitalia has the most positive outcomes between two and six months. Individuals with
CAH are also at higher risk of early pubertal development and short stature as adults. Additionally,
fertility rates in women with classic 21–alpha–hydroxylase CAH are low, while most males with the
disorder are fertile as adults with a minority exhibiting evidence of Leydig cell failure and impaired
spermatogenesis. In patients with classic 21–alpha–hydroxylase CAH there is an elevated serum 17–
hydroxyprogesterone concentration of higher than 1200 ng/dL. In fact, most of the neonates found
with the disorder have serum concentrations of 17–hydroxyprogesterone that exceed 3500

Addison's Disease Research Paper
Addison's disease
Addison's disease
Sierra Payne
Addison's disease
Addison's disease is a rare disorder that occurs when the adrenal glands do not produce enough
hormones. It occurs in all age groups and affects all genders equally. This disorder is characterized
by weight loss, muscle weakness, fatigue, and low blood pressure and oftentimes darkening of the
skin in both exposed and unexposed parts of the body.
Thomas Addison first described the clinical presentation of primary adrenocortical insufficiency
(Addison's Disease) in 1855 in his classic paper, On the Constitutional and Local Effects of Diseases
of the Supra–Renal Capsules.
Addison's disease occurs when the adrenal glands do not produce enough of the hormone cortisol. ...
This can be done with once–or twice– daily tablets of hydrocortisone, a steroid hormone. If needed,
aldosterone can be replaced with a synthetic steroid, fludrocortisone acetate, which is taken orally
once a day. These medications need to be increased during times of stress, infection, surgery, or
injury. With hormone therapy, many people with Addison's disease are able to lead a nearly normal
life.
Although it is a relatively rare disease, occurring in only about 1 in 100,000 people, there are
multiple online support groups via the NADF, National Adrenal Disease Foundation website and on
social media websites such as

Blood Sugar and Click
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Endocrine System Physiology
O B J E C T I V E S 1. To define the following terms: metabolism, hormone replacement therapy,
type 1 diabetes, type 2 diabetes, and glucose standard curve. 2. To explain the role of thyroxine in
maintaining an animal's metabolic rate. 3. To explain the effects of thyroid–stimulating hormone on
an animal's metabolic rate. 4. To understand how estrogen affects bone density. 5. To explain how
hormone replacement therapy works. 6. To explain how fasting plasma glucose is used to diagnose
diabetes. 7. To understand how levels of cortisol and ACTH can be used to diagnose endocrine
diseases.
T
he endocrine system exerts many complex and interrelated effects on the ... Show more content on
Helpwriting.net ...
Also on the screen are three white rats in their individual cages. These are the specimens you will
use in the following experiments. One rat is normal; the second is thyroidectomized (abbreviated on
the screen as Tx), meaning its thyroid has been removed; and the third is hypophysectomized
(abbreviated on the screen as Hypox), meaning its pituitary gland has been removed. The pituitary

gland is also known as the hypophysis, and removal of this organ is called a hypophysectomy. To
the top left of the screen are three syringes with various chemicals inside: propylthiouracil, thyroid–
stimulating hormone (TSH), and thyroxine. TSH and thyroxine have been previously mentioned;
propylthiouracil is a drug that inhibits the production of thyroxine. You will perform four
experiments on each animal to: (1) determine its baseline metabolic rate, (2) determine its metabolic
rate after it has been injected with thyroxine, (3) determine its metabolic rate after it has been
injected with TSH, and (4) determine its metabolic rate after it has been injected with
propylthiouracil. You will be recording all of your data on Chart 1. You may also record your data
on–screen by using the equipment in the lower part of the screen, called the data collection unit.
This equipment records and displays data you accumulate during the experiments. Check that the
data set for Normal is highlighted in the Data Sets window; you will be experimenting with the
normal rat first. The Record Data button lets

Cushings Disease Research Paper
Cushing's is a disease in which you have an abnormally elevated level of cortisol. There are two
major types of Cushing's. The first type of Cushing's is rare and is called "Cushing's Disease", it's
cause by an endogenous factor, which means that something goes wrong inside your body. This type
is usually characterized by the body's own overproduction of ACTH, Which controls Cortisol. Other
internal factors that may cause Cushing's Disease is a pituitary gland tumor (can be benign or
cancerous and is the most common), an ectopic tumor that secretes ACTH, an adrenal adenoma
(benign) and adrenal carcinomas (cancerous). In very few rare cases people can inherit a
predisposition to developing endocrine tumors (Toft 2016). The second type of Cushing's ... Show
The hypothalamus will send a signal to the pancreas to release glucagon, the hormone responsible
for increasing glucose, to the blood. After glucagon enters the blood it will go to the target cell to
bind to the receptor. After it reaches the receptor, glucagon stimulates the breakdown of glycogen,
which will then secrete glucose to the blood thus increasing the blood glucose levels. This is an
example of positive feedback. Once the receptors in blood detect that the glucose in the blood is
increasing, the target cells will then send a signal to the to stop the stimulation of glucagon. This is
called negative

Anemia and Disorders Blood Tests
Lethargy 1. A lowered level of consciousness, with drowsiness, listlessness, and apathy. Lethargy is
a fairly imprecise description of the feeling or slowness, sluggishness, tiredness, or lack of energy.
Lethargy in common usage may mean many things, including fatigue, drowsiness (sleepiness),
lethargy, tiredness, malaise, listlessness, or weakness (including muscular weakness). The causes of
these other similar symptoms also need to be investigated in researching a symptom of lethargy.
Nevertheless, any type of lethargy symptom can indicate a serious medical condition and needs
prompt medical investigation. Diagnosis of Lethargy * Blood tests * Full blood count and ESR *
Electrolytes including calcium and magnesium – ... Show more content on Helpwriting.net ...
* CBC * CRP * Ferritin, iron saturation * LFT– liver disease * Creatinine with eGFR * Electrolytes
* Calcium, phosphate * TSH– Thyroid dsy function * Fasting glucose – Type 2 diabetes *
Urinalysis– Renal impairment * ANA Comments: This wide range of test reflects the increased risk
that older people have of many diseases and the difficulty of reaching a diagnosis in chronic
tiredness.
http://www.bpac.org.nz/resources/campaign/tiredness/bpac_tiredness_clinical_audit_wv.pdf Pallor
Pallor is abnormal paleness or loss of skin color, which may develop suddenly or gradually.
Although generalized pallor affects the entire body, it's most apparent on the face, conjunctiva, oral
mucosa, and nail beds. Localized pallor commonly affects a single limb. How easily pallor is
detected varies with skin color and the thickness and vascularity of underlying subcutaneous tissue.
At times, it's merely a subtle lightening of skin color that may be difficult to detect in dark–skinned
persons; sometimes it's evident only on the conjunctiva and oral mucosa. Causes of Paleness: The
following medical conditions are some of the possible causes of Paleness. There are likely to be
other possible causes, so ask your doctor about your symptoms. * Stress * Physical exertion * Lack
of sun exposure * Normal genetic variation * Illness * Fever * Some causes of sudden pallor
include: * Fainting * Shock *

Case 10 Nicholas Mysterious Suntan 1 Essay
Student's Name: Marylene Mosburg Date: 11/31/2014
BIO169 Case_10: Nicholas's Mysterious Suntan
This case study presents a clinical situation related to the endocrine system. The questions at the
each segment of the case will test your understanding of the endocrine system.
Nicholas T., age 32, is a busy systems analyst for a computer manufacturer. Working his way up the
corporate ladder, he travels extensively, putting in many hours without much sleep. Nicholas has a
tendency to be overweight but continues to eat fatty foods and does not have an exercise program.
He craves salty pretzels and potato chips. ? In recent months, however, he has often felt weak, and
occasionally experiences dizziness when moving from a lying down to a ... Show more content on
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He experiences severe pains in his abdomen, back, and legs. ? Feeling extremely weak, he catches a
flight home, and contacts his family physician, Dr. Ortega. Dr. Ortega measures his blood pressure
at 70/50 and then orders a series of laboratory tests. ? He asks Nicholas how long he has had the
"tan" and the other symptoms he describes. Nicholas indicates he only noticed them within the last
year.
Q. What might cause the pain in the abdomen, back and legs? Electrocytes imbalances and/or
dehydration.
Q. The viral infection poses a kind of stress. Why might Nicholas have such a severe reaction? He is
already in a compromised state; people who are not "healthy" have bodies that are not equipped to
handle additional stressors.
Results of the lab tests on Nicholas are summarized below: low serum Na (<130 mEq/l) high serum
K (>5 mEq/l) ? ratio of serum Na:K (<30:1) elevated hematocrit ? low WBC count decreased
plasma cortisol and aldosterone urine ? shows increased excretion of Na and decreased excretion of
K low levels of hydroxycorticosteroids in the urine
Q. How do the abnormal Na and K levels relate to adrenal function?
The mineralocorticoid (aldosterone) is normally released by the adrenal cortex in response to
decreased sodium and increased pottasium levels; the hormonally acts to promote the retention of
Na and the excretion of K. It isn't working; hence the abnormal serum levels.
Q. What does the high hematocrit means?
The ratio of the percentage of

Benjamin Gem: A Case Study
The records have been reviewed. The member is an adolescent male with a birth date of 10/12/2003.
He has a diagnosis of velocardiofacial syndrome. His treating provider, Beth Motzkin Kava, MD
recommended that he be treated with Omnitrope 10mg.
The carrier has denied coverage of Omnitrope 10mg as not medically necessary. There is a letter
from the carrier to the member dated 01/13/2016, which states:
"The denial decision was based on the plan's review of your medical record found no documentation
of medical criteria. Approval for Omnitrope to treat growth hormone dificiency cannot be granted at
this time because per the documentation provided, your height was 141 cm, which is above the 3rd
percentile on a growth chart (you are around 37th ... Show more content on Helpwriting.net ...
The provider is correct that short stature is not necessary for the diagnosis of growth hormone
deficiency if the member is short for expected height; however, this member's height has never
clearly been outside the expected range for family. It also can be argued that delay in growth
velocity can be masked by the pubertal growth spurt. However, review of the growth charts
provided by the member's primary care physician and endocrinologist does not clearly demonstrate
abnormal growth velocity. While he did have one point that dipped down to the 10th percentile,
overall his points are between the 10th and 25th percentiles and generally follow the same curve,
indicating that one point is likely aberrant or perhaps consistent with normal prepubertal slowing in
growth. After puberty started, the member grew at the upper end of the normal range, which is
generally not seen in growth hormone

Hydrocortisone Case Summary
Hydrocortisone has vast uses in general daily practice such as (arthritis – acute adrenal insufficiency
) as well as an emergency drug especially in management of severe allergic reactions (septic shock
).The main action of this drug is to reduce swelling and inflammation.
Allergic status
It is used to control severe allergic reactions or patients who suffer from seasonal allergies such as
(pollen allergies ) etc
It's a treatment of choice to control asthma – contact dermitis – atopoc dermities as well as thr
treatment of hypersensitivity reactions and transfusion reactions
Recommendations from the International Guidelines for Management of Severe Sepsis and Septic
Shock 2012:
–Do not use intravenous hydrocortisone if adequate fluid resuscitation and vasopressor therapy
restore hemodynamic stability
–Use hydrocortisone alone
–Do not administer for sepsis in ... Show more content on Helpwriting.net ...
Usual Adult Dose for Ulcerative Colitis
100 mg rectal suspension (retention enema) nightly for 21 days or until clinical remission occurs.
Difficult cases may require 2 or 3 months of treatment. Clinical symptoms should subside within 3
to 5 days; discontinue use if no improvement within 2 to 3 weeks; some patients may require 2 to 3
months of therapy; if therapy lasts more than 21 days, discontinue slowly by decreasing use to every
other night for 2 to 3

The And Formation Of Chemical Substances
Metabolism
Definition:
The break down and formation of chemical substances in the body that is needed for energy, for
formation and breakdown of tissues and cells, and to maintain homeostasis of the body.
Concept Key Terms: Adrenal: endocrine glands that are located on top of the kidneys and are
responsible for several hormones like aldosterone, corticosteroids,
Aldosterone: hormone secreted from the adrenal gland to signal the kidneys to retain sodium from
the excretion
Autocrine: a hormone that is released and acts on the cells that released it
Calcitonin: hormone release by the thyroid to help with calcium absorption to lower blood calcium
and phosphates
Chvostek sign: a test for hypocalcemia where you tap on the patient's ... Show more content on
Helpwriting.net ...
Glucagon: hormone responsible for keeping blood glucose levels normal by stimulating the
gluconeogenesis or glucogenolysis
Glucocorticoid: hormone produced in the cortex of adrenal glands
Glycogen: the stored form of glucose in the liver
Gluconeogenesis: the process in the liver where glucose is made from substances other than
carbohydrates which can be released into the blood or stored as glycogen
Growth hormone: hormone made and released from the anterior pituitary gland and acts on several
targets that stimulates growth and regulates metabolism
Hormone: a chemical substance that is released by an organ or gland to act on another organ or
gland or itself to stimulate or inhibit a response.
Humoral: refers to chemicals that are found in the blood or body fluids that can aid in immunity or
create or inhibit a response
Insulin: hormone made in the pancreas that is necessary for glucose to get into each cell in the body
Mineralocorticoid: steroid made by the adrenal gland
Osmolarity: the concentration of sodium, potassium, urea, and glucose in plasma expressed as
mmol/L
Osmolality: the concentration of sodium, potassium, glucose, and urea in plasma expressed as
mmol/kg
Paracrine: gland that releases a hormone that acts on cells within the gland the gland
Parathyroid: a gland on the dorsal side of the thyroid gland that is

Metabolic Disorders: A Case Study
Metabolic disorders
– Hyperthyroidism
□ Presentation includes weight loss, increased appetite, enlarged thyroid gland, exophthalmos, heat
intolerance, restlessness, rapid heartbeat, nausea, and vomiting
□ Weight loss and increased appetite are distinguishing features; also enlarged thyroid gland and
exophthalmos
□ Thyroid function tests showing elevated TSH levels are diagnostic
– Adrenocortical insufficiency
□ Presentation includes fatigue, weight loss, muscle weakness, nausea, vomiting,
hyperpigmentation, hypotension, dehydration
□ Dehydration, hypotension, or shock out of proportion to severity of current illness are
distinguishing features
□ Adrenocorticotrophic hormone (ACTH) stimulation test. Low serum cortisol level is ... Show
□ O– One–day duration (four to 72 hours)
□ U– Unilateral location
□ N– Nausea or vomiting
□ D– Disabling intensity
□ Probability of migraine is 92% in patients who report at least four of the POUND symptoms in the
primary care setting 11
□ History and physical examination based on POUND features are diagnostic
○ Urogenital disorders
– Pyelonephritis
□ Presentation includes fever, chills, nausea, vomiting, and flank pain, costovertebral angle
tenderness dysuria, urinary frequency, inability to completely empty bladder
□ Pyuria is present
□ Clinical manifestations are distinguishing features, patient may have a history of nephrolithiasis
□ Urinalysis (bacteriuria), radiography, CT scan, and ultrasonography diagnostic
○ Pregnancy–related disorders
– Preeclampsia
□ Presentation occurs late in pregnancy as opposed to early term occurrence of Hyperemesis
gravidarum
□ Symptoms include sudden weight gain; swelling of hands, legs, and feet; epigastric pain; nausea;
and vomiting

□ Hypertension (blood pressure ≤140/90 mm Hg documented on two occasions, at least four hours
apart)
□ Distinguished by proteinuria ≥0.3 grams in a 24–hour urine specimen
□ Signs of end–organ dysfunction (e.g., platelet count 12 weeks] and total cumulative

A List of Some Medical Specialties
GASTROENTEROLOGIST Gastroenterologist is also a sub–specialty of internal medicine .a
gastroenterologist deals with digestive system problems. They diagnose and treat disorders of the
gastrointestinal tract. ERCP (endoscopic retrograde cholangiopancreatography) – a procedure to
detect disorders in the ducts such as narrowing, gallstones, blockages, tumors and cysts. An ERCP
combines the use of X–rays and endoscope – a long, flexible, lighted tube. The endoscope is
advanced through the mouth and into the small bowel to view the common opening to the ducts
from the liver and pancreas. A contrast material is injected into the ducts so they can be seen on X–
rays. Additional instruments are used to remove stones and or other ... Show more content on
Helpwriting.net ...
Schober's test tests the flexion of the lower back. Multiple joint inspection Musculoskeletal
Examination o Screening Musculoskeletal Exam – a rapid assessment of structure and function o
General Musculoskeletal Exam – a comprehensive assessment of joint inflammation o Regional
Musculoskeletal Exam – focused assessments of structure, function and inflammation combined
with special testing REPRODUCTIVE ENDOCRINOLOGIST A reproductive endocrinologist is a
type of medical doctor who specializes in treating people with reproductive disorders. Many infertile
couples choose to see a reproductive endocrinologist when deciding upon fertility treatments. It is a
reproductive endocrinologist's job to identify factors involved in your infertility and appropriate
methods with which to treat these factors. A reproductive endocrinologist is trained to manage a
number of different problems related to the reproductive system. Reproductive endocrinologists deal
with: hormonal disorders menstrual problems infertility pregnancy loss sexual dysfunction
menopause Treatments Reproductive endocrinologists can perform a wide variety of treatments for
infertility. If you are facing infertility, your reproductive endocrinologist

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