The document provides an overview of several endocrine system diseases. It discusses pituitary gland diseases like acromegaly which results in GH hypersecretion in adulthood causing disfiguring bone and tissue overgrowth. It also discusses thyroid diseases including Graves' disease, a common cause of hyperthyroidism, and hypothyroidism. The document also summarizes parathyroid diseases, adrenal diseases like Cushing's syndrome, diabetes mellitus, and diabetic emergencies.

1. Endocrine System Diseases
Introduction to Human Diseases:
Chapter 14

2. Endocrine System Terminology
• Endocrine
• Exocrine
• Hormone
• Target organ
• Hypersecretion
• Hyposecretion

3. Pituitary Gland Diseases
• Hyperpituitarism
– Hypersecretion of growth hormone (GH) by the
pituitary
• Gigantism
– GH hypersecretion during puberty and growth years
• Person is very tall, proportioned normally
• Acromegaly
– GH hypersecretion during adulthood
– Disfiguring overgrowth of bones & soft tissues

4. Hyperpituitarism
• Other aspects:
– Gigantism:
• Fairly abrupt onset
• Non-life threatening
• Growth up to 6 inches/yr
– Agromegaly:
• Gradual onset
• Decreases life expectancy
• Headache, sinus problems, skin changes, paresthesias, joint
pain, visual disorders

5. Hypopituitarism
• Deficiency of any or all of the pituitary
hormones
• Usually involve GH and gonadotropin
– LH, FSH, Prolactin, Oxytocin
• Less commonly involved:
– ACTH and TSH
• Panhypopituitarism:
– All hormones are deficient

6. Hypopituitarism
• S/S: varies with hormone deficiency and
age of disease onset
– In childhood: S/S are dwarfism and delayed
development of 2ndary sexual characteristics
– In adults: S/S are amenorrhea, infertility,
lowering of testosterone levels, libidy, hair
loss.
– ACTH & TSH deficiency: general S/S:
fatigue, pallor, anorexia, poor stress response

7. Hypopituitarism:
• Treatment: hormone replacement

8. Diabetes Insipidus
• Hyposecretion of vasopressin
– ADH (antidiuretic hormone)
• S/S: extreme polyuria, thirst, very dilute
urine produced, leads to dehydration
• Etiology: anything that destroys the
pituitary or idiopathic
• Treatment: fluid replacement, hormone
replacement (tablet, nasal spray)

9. Thyroid Gland Diseases
• Goiter
– Enlargement or hyperplasia of thyroid gland
• Simple goiter
– Goiter not caused by infection, tumor, other
hypo- or hyperthyroid condition
– More common in females
– Sporadic and endemic types

10. Goiter
• Sporadic type
– Ingestion of certain foods, drugs (goitrogens)
• Endemic type
– Diet deficiency of iodine
• Etiology: hyperplasia due to inability to
make sufficient T3 and T4, compensation
• Treatment: T3 or T4 or iodine
replacements, surgery, dietary changes

11. Thyroiditis
• Inflammation of thyroid gland
• Females more than males
• Etiology & types:
– Autoimmune
• Antibodies to thyroid hormones
• Myxedema, Grave’s disease
• Hashimoto’s thyroiditis (lymphocytes infiltrate)
– Subacute granulomatous
• Follows an infection (mumps, influence, adenovirus)
– Miscellaneous
• Bacterial infections (TB, syphilis, suppurative)

12. Thyroiditis
• S/S: may have no symptoms or thyroid
enlargement, pain and dysphagia
• Autoimmune thyroiditis = most common
type, common in females
• Treatment varies with type:
– Hormone replacement, steroid, antibiotics,
anti-inflammatories, pain meds

13. Grave’s Disease
• Hyperthyroidism
– Grave’s disease is most common hyperthyroid disease
• Hypersecretion of T3 and T4
• May cause thyrotoxicosis
– Diffuse effect, multiple symptoms
• Females mostly, 30-40 YOA
• Etiology:
– Genetic or immunologic

14. Grave’s Disease
• S/S:
• Thyrotoxicosis
– Anxiety, insomnia, heat intolerance, sweating, muscle
wasting, weight loss, tachycardia, hypertension
– Thyroid storm: critical episode of thyrotoxicosis
• Ophthalmopathy: exophthalmos (protrusion of
eyeballs, “frightened” appearance)
• Dermopathy: thickened skin on legs/feet
(“orange skin”
• Exacerbations & remissions

15. Grave’s Disease
• Treatment:
– Varies with disease severity & patient age
– Antithyroid drugs, surgery, radioactive iodine
therapy

16. Hypothyroidism
• Hyposecretion of thyroid hormones
• More common in women, esp. over 40
YOA
• Two versions:
– Cretinism
• Congenital form
– Myxedema
• Starts in childhood or adulthood

17. Hypothyroidism
• Etiology:
– Dietary, metabolic, iatrogenic, congenital,
inflammatory, chronic autoimmune
• S/S:
– Children: growth retardation, delayed sexual
development, impaired intelligence
– Adults: cold intolerance, fatigue, constipation, weight
gain, anorexia, dry skin, brittle hair &nails,
cardiomegaly, myxedema coma
• Treatment: Hormone replacement meds

18. Parathyroid Diseases
• Hyperparathyroidism
• Affects women more than men (2:1)
• Excessive secretion of PTH by gland
causes abnormalities of calcium (Ca++)
and phosphates (PO4--)
• Effects:
– Hypercalcemia (most important effect)
– hypophosphatemia

19. Hyperparathyroidism/
Hypercalcemia
• Primary disease: parathyroid adenoma
• Secondary disease: chronic RF, calcium deficient
diet, calcium malabsorption
– Any condition that tends to reduce circulating levels
of calcium
• S/S: many patients are asymptomatic
– Brittle bones, arthralgias, calcium renal stones,
polyuria, nausea, vomiting, fatigue, muscle weakness
or atrophy, cardiac arrythmias

20. Hyperparathyroidism
• Treatment:
– Surgical removal of gland(s)
– Increasing fluid & sodium intake
– Meds that increase calcium excretion
– Treatment varies with the etiology, primary or
secondary

21. Hypoparathyroidism
• Undersecretion of PTH by gland
– Hypocalcemia
– Excessive calcium deposition into bones
• Etiology: iatrogenic (surgical) or inherited
• S/S: paresthesias of extremities, muscle
cramps (tetany), depresion, irritability,
laryngospasm, seizures, brittle nails, hair
loss

22. Hypoparathyroidism
• Treatment:
– Vitamin D and calcium supplements
– Periodic lab tests to determine serum levels
– High calcium, low phosphorus diet

23. Adrenal Disease
• Cushing’s Syndrome:
– Hypersecretion of hormones by the adrenal
cortex
– Cortisol excess
– More common in women
– May be due to:
• Oversecretion of ACTH
• Benign or malignant neoplasm of adrenal cortex
• Iatrogenic (prolonged steriod treatment)

24. Cushing’s Disease
• S/S:
– “moon facies”, truncal obesity with thin limbs,
“buffalo hump”, decreased glucose tolerance,
muscle weakness, hypertension, anxiety,
depression
• Treatment:
– Surgery for tumor removal, drug or radiation
to decrease ACTH secretion

25. Other Adrenal Diseases
• Addison’s Disease
– Hyposecretion of adrenal cortex hormones
– Decreased ability to handle physiological stress
– Low BP, increased temperature
• Pheochromocytoma
– Tumor of adrenal medulla
– Secretes catecholamines
• Epinephrine
• Norepinephrine
• Like SNS, increases blood pressure, heart rate, skin flushing

26. Diabetes Mellitus
• Chronic carbohydrate metabolism disorder
due to insulin deficiency or inadequate
insulin utilization by cells
• Insulin
– Pancreatic endocrine secretion (hormone)
– Made by islet of Langerhans
– Lowers serum glucose level
– Allows cellular uptake and use of glucose

27. Diabetes Mellitus (DM)
• Disorder characterized by:
– Hyperglycemia
– Ketosis (ketones in the blood)
– Acidosis (excess hydrogen ions in the blood)
– Ketoacidosis

28. Diabetes Mellitus
• Types of DM:
– Type 1 (juvenile onset)
• Immune-mediated absence of insulin
• Often seems to appear abruptly & emergently
– Type 2 (adult onset)
• Able to make insulin
• Often obesity related
– Gestational (GDM)
• Occurs during pregnancy & resolves after delivery
• 25% risk of DM development later in life
• Tend to have large babies (over 9 lbs)

29. Diabetes:
• Etiology:
– Autoimmune, genetic, pancreatic disorders,
drugs, tumors, Cushing’s, cells become
insensitive to insulin in some
• S/S:
– Three P’s: polyuria, polydipsia, polyphagia
– Increased susceptibility to infections &
vascular diseases, retinopathy, renal failure

30. Diabetes:
• Treatment:
– Type 1: insulin administration
– Type 2: diet & exercise
• Oral hypoglycemics
• insulin

31. Diabetic Emergencies:
• Insulin shock (severe hypoglycemia)
• Diabetic Ketoacidosis
– Severe hyperglycemia & ketoacidosis
– Altered mental status, possible coma
– Severe dehydration