Subject: PATHOPHYSIOLOGY, 2023-2024

Place: Department of General and Experimental Pathology, room 371 

Division: FACULTY OF MEDICINE

YEAR: 3

CLASS no: 1
Pathophysiology of the endocrine system – part 1

Goal: to explain etiology, pathogenesis, manifestations, and consequences of selected diseases
          of the endocrine system

Time: 4 hours

Didactic tools: multimedia presentation

Before the class students should revise anatomy, histology and physiology of the endocrine system.

Topics:

1. Aspects of altered endocrine function:
   1.1. Hypofunction, Hyperfunction and Hormone resistance
   1.2. Primary, Secondary and Tertiary Disorders.
   1.3. Ectopic hormone synthesis
2. Pituitary and Growth Disorders
   2.1. Pituitary tumors
   2.2. Hypopituitarism
   2.3. Growth and Growth hormone disorders
   2.4. Antidiuretic hormone (vasopressin) excess and deficiency
   2.5. Hyperprolactinemia
3. Thyroid disorders
   3.1. Hypothyroidism
   3.2. Hyperthyroidism
4. Parathyroid glands:
   4.1. Hyperparathyroidism
   4.2. Hypoparathyroidism & pseudohypoparathyroidism

References:

Porth's Pathophysiology: Concepts of Altered Health States - Tommie L Norris; Wolters Kluwer; 10^th Edition, International, (November 3, 2018), chapters: 40, 41, 8 - regarding dysfunction of parathyroid glands.

Color Atlas of Pathophysiology - Stefan Silbernagl, Florian Lang,  Thieme; 3^rd Edition, 2016.

Dideases:
Sheehan syndrome: etiopathogenesis, manifestations
Central and nephrogenic diabetes insipidus: etiopathogenesis, manifestations
SIADH: etiopathogenesis, manifestations
Acromegally: etiopathogenesis, manifestations
Gigantism: etiopathogenesis, manifestations

Laron syndrome: etiopathogenesis, manifestations
Hyperprolactinemia: etiopathogenesis, manifestations
Graves disease: etiopathogenesis, manifestations
Toxic goiter: etiopathogenesis, manifestations
Hashimoto disease: etiopathogenesis, manifestations
Endemic goiter: etiopathogenesis, manifestations

Topics’ details
Hypothalamus and pituitary
Causes of endocrine hypothalamic insufficiency.
Causes of primary and secondary pituitary hypofunction.

Manifestations of pituitary hypofunction.

Causes of primary and secondary pituitary hyperfunction.

Manifestations of pituitary hyperfunction.

Pathogenesis of agalactorrhea in Sheehan syndrome.

Pathogenesis of altered vision in the course of pituitary disorders.

Pathogenesis of hyperglycemia in acromegaly/gigantism.

Pathogenesis of polyuria in diabetes insipidus.

Pathogenesis of polydipsia in diabetes insipidus.

Pathogenesis of hypertonic dehydration in diabetes insipidus.

Pathogenesis of hyponatremia in SIADH.

Thyroid gland
Causes of primary thyroid gland hyperfunction.

Causes of secondary and tertiary thyroid gland hyperfunction.
Hyperthyroidism vs tyreotoxicosis.
Manifestations of hyperthyroisism.
Pathogenesis of hyperthyroidism in Graves disease.

Consequences of autoimmune process in the course of Graves disease.

Consequences of increased basal metabolic rate in hyperthyroidism.

Pathogenesis of:
- hypertension in hyperthyroidism
- exophtalmos in Graves disease
- goiter in hyperthyroidism
- pretibial edema in Graves disease
- hypocholesterolemia
- hypermetabolic coma
 

Causes of primary thyroid gland hypofunction.

Causes of secondary and tertiary thyroid gland hypofunction.

Manifestations of hypothyroidism.
Consequences of decreases basal metabolic rate.
Consequences of glycosaminoglycans accumulation in the course of hypothyroidism
Pathogenesis of hyperprolactinemia in hypothyroidism.

Pathogenesis of:
- myxedema in hypothyroidism
- goiter in hypothyroidism
- amenorrhea in hypothyroidism
- hypercholesterolemia in hypethyroidism
- hypometabolic coma

Parathyroid glands

Causes of primary hyperparathyroidism.
Causes of secondary hyperparathyroidism.
Causes of tertiary hyperparathyroidism.
Manifestations of hypeparathyroidism, especially from:
- bones
- kidneys
- gastrointestinal tract
- nervous system
Pathogenesis of hypercalcemia in hyperparathyroidism.
Pathogenesis of hypophosphatemia in hyperparathyroidism.

Pathogenesis of polyuria in primary hyperparathyroidism.

Causes of primary hypoparathyroidism.
Causes of secondary hypoparathyroidism.
Manifestations of hypoparathyroidism.
Pathogenesis of hypocalcemia in hypoparathyroidism.
Pathogenesis of hyperphosphatemia in hypoparathyroidism.

Causes of pseudohypoparathyroidism.