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Category: Endocrinology

Goiter ?>

Goiter

Goiter Introduction Background In 1656, Thomas Wharton described the distinct nature of what he termed the thyroid gland, distinguishing it from the larynx, as this structure had been considered a laryngeal gland from the time of Andreas Vesalius in the 16th century. It was nearly 200 more years before the function of the thyroid was elucidated. The normal adult thyroid gland weighs 10-25 g and has 2 lobes connected by an isthmus. Nearly 50% of thyroid glands exhibit a pyramidal…

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Diabetes Mellitus, Type 2 ?>

Diabetes Mellitus, Type 2

Diabetes Mellitus, Type 2 Introduction Background Type 2 diabetes mellitus is a group of disorders characterized by hyperglycemia and associated with microvascular (ie, retinal, renal, possibly neuropathic), macrovascular (ie, coronary, peripheral vascular), and neuropathic (ie, autonomic, peripheral) complications. Unlike type 1 diabetes mellitus, patients are not absolutely dependent upon insulin for life, even though many of these patients are ultimately treated with insulin.

Diabetes Mellitus, Type 1 ?>

Diabetes Mellitus, Type 1

Diabetes Mellitus, Type 1 Introduction Background Diabetes mellitus (DM) is a multisystem disease with both biochemical and anatomical consequences. It is a chronic disease of carbohydrate, fat, and protein metabolism caused by the lack of insulin. In type 1 diabetes, insulin is functionally absent because of the destruction of the beta cells of the pancreas. Type 1 DM occurs most commonly in juveniles but can occur in adults, especially in those in their late 30s and early 40s. Unlike people…

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Diabetes Mellitus and Pregnancy ?>

Diabetes Mellitus and Pregnancy

Diabetes Mellitus and Pregnancy Introduction Background Abnormal maternal glucose regulation occurs in 3-10% of pregnancies. Studies suggest that the prevalence of diabetes mellitus (DM) among women of childbearing age is increasing in the United States. This increase is believed to be attributable to more sedentary lifestyles, changes in diet, continued immigration from high-risk populations, and the virtual epidemic of childhood and adolescent obesity that is presently evolving in United States. Gestational diabetes mellitus (GDM) is defined as glucose intolerance of…

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C-11 Hydroxylase Deficiency ?>

C-11 Hydroxylase Deficiency

C-11 Hydroxylase Deficiency Introduction Background Congenital adrenal hyperplasia (CAH) is a general term used to describe a group of inherited disorders in which a defect in cortisol biosynthesis is present with consequent overproduction of adrenocorticotropic hormone (ACTH) and secondary adrenal hyperplasia as a consequence. An enzymatic defect in 11-beta-hydroxylase is the second most common variant of CAH and accounts for approximately 5-8% of cases.

Adrenal Crisis ?>

Adrenal Crisis

Adrenal Crisis Introduction Background Do not confuse acute adrenal crisis with Addison disease. In 1855, Thomas Addison described a syndrome of long-term adrenal insufficiency that develops over months to years, with weakness, fatigue, anorexia, weight loss, and hyperpigmentation as the primary symptoms. In contrast, an acute adrenal crisis can manifest with vomiting, abdominal pain, and hypovolemic shock.

Hashimoto’s Thyroiditis ?>

Hashimoto’s Thyroiditis

Hashimoto’s Thyroiditis (Autoimmune Thyroiditis; Chronic Lymphocytic Thyroiditis; Hashimoto’s Struma) Hashimoto’s thyroiditis is chronic autoimmune inflammation of the thyroid with lymphocytic infiltration. Findings include painless thyroid enlargement and symptoms of hypothyroidism. Diagnosis involves demonstration of high titers of thyroid peroxidase antibodies. Lifelong l-thyroxine replacement is typically required.

Adrenal Disorders ?>

Adrenal Disorders

Adrenal Disorders Introduction The adrenal glands, located on the cephalad portion of each kidney, consist of a cortex and medulla, each with separate endocrine functions. Cortex: The adrenal cortex produces glucocorticoids (primarily cortisol), mineralocorticoids (primarily aldosterone), and androgens (primarily dehydroepiandrosterone and androstenedione). Physiology of the hypothalamic-pituitary-adrenocortical system is further discussed in Pituitary Disorders: Introduction. Glucocorticoids promote and inhibit gene transcription in many cells and organ systems. Prominent effects include anti-inflammatory actions and increased hepatic gluconeogenesis. Mineralocorticoids regulate electrolyte transport across…

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Cushing Syndrome ?>

Cushing Syndrome

Cushing Syndrome Introduction Background Cushing syndrome is caused by prolonged exposure to elevated levels of either endogenous glucocorticoids or exogenous glucocorticoids. Individuals with Cushing syndrome can develop moon facies, facial plethora, supraclavicular fat pads, buffalo hump, truncal obesity, and purple striae. Individuals often complain of proximal muscle weakness, easy bruising, weight gain, hirsutism, and, in children, growth retardation. Hypertension, osteopenia, diabetes mellitus, and impaired immune function may occur. In an emergency situation, remembering that the most common cause of Cushing…

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Addison’s Disease ?>

Addison’s Disease

Addison’s Disease There are two adrenal glands each about the size of a grape and each is attached to the top of the kidneys. Within the adrenal glands are two types of functioning tissues, the adrenal cortex (outer), and the medulla (inner), each with its own unique capabilities.