8/14/2019 Disorder Hyperprolactinema Adrenal Insufficiency 1 (Addisons) FSH, LH

1/2

Disorder Labs Cause Signs/Symptoms Other

Hyperprolactinema FSH, LH Pituitary tumor Bilateral milky discharge,amenorrhea, headaches

Adrenal Insufficiency

1 (Addisons) ACTH Autoimmune destruction of adrenals Weakness, fatigue, anorexia,weight loss, hyperpigmentation,

hypotension, GI problems, salt

craving

Fatal if not tx

Test w/ ACTH stim test

AI= subnormal cortisol

response

2 (Hypopituitarism) ACTH Adrenals atrophyCongenital Adrenal

Hyperplasia

(Adrenogential Syndrome)

Androgens 21--Hydroxylase deficiency mostcommon, adrenal tumor - amt 17-OH-progesterone and pregnenoloneconverted to androgens

Virilization of female fetus

Same effects in male + rapid

genital devo if prepubertal

Most common cause of

ambiguous genitalia in

female babies

Masked in adult male by

testosterone from testes

Cushings Syndrome glucocorticoids (cortisol) Endogenous (excess from adrenals)Exogenous (rx)

Moon facies, red cheeks,

truncal obesity, HTN, thin skin,

striae, m. atrophy ( catabolismfor gluconeogenesis), hirsutism

Test w/ salivary cortisol at

bedtime d/t circadian

rhythmicity

ACTH Dependent ACTH Pituitary tumorEctopic tumor

Same Cushings DzDifferentiate test blood

in petrosal sinus (=pituitary, =ectopic)

ACTH Independent ACTH Adrenal tumor - cortisol w/o ACTH SameGH Excess IGF-1 GH secreting pituitary tumor Tall stature

Large forehead, tongue, nose,

jaw, hands, etc

Pre-puberty-gigantism

Post-puberty-acromegaly

GH Deficiency Stimulation test Hypopituitarism Short stature, thin

Hypothyroidism tT4 TBG fT4 TSH Cretinism in children

1 (Hashimotos

Thyroiditis)

N Autoimmune antithyroid Ab Myxedema - GAGs pull H2O

into skin2 N /N Hypopituitarism

Hyperthyroidism

1 (Graves Dz) N Autoimmune stim TSH-R via TSI Pemberton sign

2 N TSH secreting tumor Very rare

8/14/2019 Disorder Hyperprolactinema Adrenal Insufficiency 1 (Addisons) FSH, LH

2/2

Disorder Labs Cause Signs/Symptoms OtherDiabetes Mellitus

Type I fasting glucose Autoimmune islet cell destruction

Type II fasting glucose Insulin resistance

Retinoptahy, nephropathy,

neuropathy, CV dz, poor wound

healing

Tx: insulin

Sulfonylureas - insulinMetformin - hepatic

gluconeogenesisGlitazones - insulinsensitivity

GLP agonist/GLP

metabolism inhibitors - insulin secretion, cellmass

Gestational Diabetes size of baby, problemsSecondary Hyperglycemia fasting glucose counter-regulatory hormones (d/t

acromegaly, Cushings, etc)

Hyperparathyroidism Ca+2 PTH Diagnostic Test

1 PO4-3

Parathyroid adenoma PTH causesusual effects, but

Ca+2

in urine (filtered load >Tm)

Hypercalcemia

2 1,25-(OH)2-D Renal failure, malabsorption (sprue) Hypocalcemia

Hypoparathyroidism

1 Iodogenic, idiopathic, familial Hypocalcemia

2 PTHrp Vit. D

Hypercalcemia of malignancy

Vit. D Intoxication (rare)

Hypercalcemia

Hypogonadism in Male

1 Testosterone Loss of testes Loss of 2 sex characteristics,

obesity, tall stature (if lostbefore puberty)

2 Testosterone Gonadotroph deficiency ( GnRH)