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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