Endocrine Pathology

Overview – Pathologies

• Diabetes Mellitus – Separate Lecture

• Disorders of the Pituitary Gland• Disorders of the Thyroid & Parathyroid• Disorders of the Adrenals• Thermoregulation and Environmental

Conditions• Metabolic Disorders

Introduction – Endocrine System

• Maintain equilibrium• Regulate functions of organ systems, through

hormones– Reproductive– Growth & Development– Defense against stressors– Blood Glucose levels– Core body Temp– Water & electrolyte balance– Metabolism

Anatomy

Anatomy

Glands• Hypothalamus-

• Pituitary Gland-

• Thyroid-

• Parathyroid-

• Adrenal Glands-

• Pancreas-

• Ovaries/Testes-

Body Function Regulation• Body Energy

• Body Temperature

• Body Fluid

• Hormone response to Exercise

Common Signs & Symptoms• Skin changes• Diaphoresis – hyperhydrosis• Body or Breath Odor• Polydipsia or Polyuria• Arthralgia & Myalgia• Muscle Atropy & weakness• Amenorrhea & Impotence• Mental Status changes• Paresthesia• Edema• Polyphagia• Orthostatic Hypotension• Lethargy/Fatigue• Pain Patterns

Disorders of the Pituitary Gland

• Diabetes Insipidus

• Acromegaly

Disorders of the Thyroid

• Hyperthyroidism

• Grave’s Disease

Disorders of the Thyroid

• Hypothyroidism

Disorders of the Adrenals

• Addison’s Disease

• Cushing’s Syndrome

Thermoregulation/Environmental

• Heat Cramps

• Heat Syncope

• Heat Exhaustion

• Heat Stroke

• Exertional Hyponatremia

• Frostbite

• Hypothermia

• Altitude Sickness

Metabolic Disorders

• Gout

• Metabolic Bone Disease– Osteoporosis– Paget Disease

The Tired Athlete

• Psychological Profile of Athletes – Separate Lecture

• Endocrine Disorders

• Infections

• Anemia– Iron Deficiency Anemia– Dilutional Pseudo-Anemia

I’m Still Tired

• Infections:– 1.– 2.– 3.– 4.

Still Tired

• Anemia– Fatigue usually c exertion– Lack of RBC– Most commonly iron-deficiency– Reduction of red cell mass or blood

hemoglobin concentration

Classification of Anemia

• 1. Cell Proliferation– A.– B.

• 2. Maturation

• 3. Destruction

Ineffective Erythropoiesis

• Iron deficiency

• Vitamin B12 deficiency

• Folic acid deficiency

Anemia

• Think about elevation

• S/S:

• At Risk Population:

Laboratory Finding• Hct (%)

• women 36-48 men 40-52

• Hb (g/dl) Normal is 12-16• Anemic when < 12 g/dl

• MCV Normal is 80-100• 60-70 = Micro 100+ = Macro

• RBC count • women 4.0-5.4 men 4.5-6.0

• Anemia = small RBC c low ferritin

Iron Deficiency Anemia - Treatment• 3-6 mg per kg of body weight of

elemental iron

• Better with vitamin C on an empty stomach

• Frequent monitoring

Iron Deficiency in Patients

• Other causes: Chronic Blood Loss

Sports Anemia

• Dilutional pseudoanemia

• Will not respond to tx

• Normal MCV & ferritin

• No affect of performance

How to Assess Patients

• HISTORY, HISTORY, HISTORY

• Cover all organ systems

• Physical Exam – General Affect

• Labs