Fisiologi endokrin

GENERAL MECHANISMS/PRINCIPLES

Ø FEEDBACK MECHANISMS FAIL TO FUNCTION

Ø FEEDBACK MECHANISMS RESPOND TO INAPPROPRIATE SIGNALS

Ø GLAND FAILS TO PRODUCE ADEQUATE AMOUNTS OF BIOLOGICALLY FREE/ACTIVE HORMONE

Ø GLAND SYNTHESIZES OR PRODUCES EXCESSIVE AMOUNTS OF HORMONE

Ø RELEASED HORMONES DEGRADE AT ALTERED RATE (FAST/SLOW)

Ø RELEASED HORMONES INACTIVATED BY ANTIBODIES BEFORE TARGET CELL

Peran Fisiologi Hormon Thyroid

Ø Sangat penting utk pertumbuhan Anak

Ø Berbagai pengaruh thd Metabolik :

Ø Meningkatkan pemecahan karbohidrat

Ø Meningkatkan pemecahan Lemak

Ø Menentukan laju Metabolik

Ø Tingkat produksi panas

HYPERTHYROIDISM (THYROTOXICOSIS)

F THYROID HORMONES EXERT GREATER THAN NORMAL RESPONSES

ü CAUSES: HYPERTHYROIDISM

Ø GRAVES DISEASE

Ø TOXIC MULTINODULAR GOITER

Ø THYROID CANCER

Ø INCREASED TSH SECRETION

ü CAUSES: ECTOPIC

Ø SUBACUTE THRYOIDITIS

Ø ECTOPIC TISSUE

Ø INGESTION OF EXCESSIVE TH

HYPOTHYROIDISM

F DEFICIENT PRODUCTION OF TH BY THE THYROID GLAND

ü PRIMARY CAUSES

Ø DEFECTIVE HORMONE SYNTHESIS

Ø AUTOIMMUNE (ANTITHYROID ANTIBODIES)

Ø THYROIDITIS

Ø ENDEMIC IODINE DEFICIENCY

Ø ANTITHYROID DRUGS—AFTER TREATMENT OF HYPER-

Ø CONGENITAL DEFECTS

ü SECONDARY

Ø INSUFFICIENT STIMULATION BY TSH DEFICIENCY OF PITUITARY

Ø PERIPHERAL RESISTANCE TO TH

Hyperthyroidism - clinical symptoms

• increase of basal metabolism, O2 consumption

• restlessness, emotional lability

• tremor, sweating, loss of weight, intolerance of warmth

• increased heart rate and output, palpitations congestive heart failure due to thyrotoxic cardiomyopathy (dilated type)

• exophtalmus

Hypothyroidism - clinical symptoms

IN CHILDHOOD - cretinism

endemic iodine deficiency in mountain regions ( addition of iodine to salt)

short stature, big tongue, defective teeth,

rough facial features

IN ADULTHOOD - myxedema

accumulation of mucopolysacharides in corium pale thick (doughlike) skin, namely in periorbital areas

bradycardia, apathy, intolerance of cold, big lips and tongue

enlarged and failing heart with pericardial fluid

coronary arteriosclerosis due to hypercholesterolemia

DISORDERS OF THE ADRENAL CORTEX

DISORDERS OF THE ADRENAL CORTEX

ü CUSHING SYNDROME

Ø HYPERCORTISOLIM

Ø HYPERFUNCTION OF THE ADRENAL CORTEX

Ø WITH/WITHOUT PITUITARY INVOLVEMENT

ü CUSHING DISEASE

Ø EXCESSIVE SECRETION OF ACTH BY ANTERIOR PITUITARY

ü EXOGENOUS: ADMINISTRATION OF CORTISONE (AND ALL ITS FORMS)

Ø MOST COMMON CAUSE