Subject: PATHOPHYSIOLOGY

Place: Department of General and Experimental Pathology, room 371 

Division: FACULTY OF MEDICINE

YEAR: 3

CLASS no: 2

Pathophysiology of the endocrine system – part 2

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. Diabetes Mellitus: types, etiology, pathogenesis, manifestations.
2. Acute complications of diabetes mellitus:
   - diabetic ketoacidosis and coma,
   - hyperosmolar hyperglycemic state,
   - hypoglycemia.
3. Diabetic complications related to counter-regulatory mechanisms:
   - Somogyi effect,
   - Dawn phenomenon.
4. Chronic complications of prolonged diabetes mellitus:
   - microvascular complication (microangiopathy): diabetic retinopathy, diabetic nephropathy
   - diabetic neuropathy: autonomic, peripheral
   - macrovascular complications (macroangiopathy): coronary artery disease, cerebrovascular disease  
     and stroke, peripheral vascular disease.
5. Pancreatic endocrine neoplasms: insulinoma, glucagonoma, somatostatinoma.
6. Disorders of adrenal cortical function:
   6.1 Causes and consequences of mineralocorticoid deficiency and excess,
   6.2 Causes and consequences of glucocorticoid deficiency and excess,
   6.3 Causes and consequences of adrenal sex hormones deficiency and excess.
7. Congenital adrenal hyperplasia: types, manifestations.
8. Adrenal medulla disorders – pheochromocytoma: causes, manifestations.

References:

Porth's Pathophysiology: Concepts of Altered Health States - Tommie L Norris; Wolters Kluwer; 10^th Edition, International, (November 3, 2018), chapter: 41.

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

Diseases:
Diabetes mellitus type 1
Diabetes mellitus type 2
Gestational diabetes mellitus
Latent autoimmune diabetes in adults (LADA)
Maturity-onset diabetes of the young (MODY)
Cushing syndrome
Cushing disease
Conn syndrome
Addison disease
Congenital adrenal hyperplasia
Pheochromocytoma

Problems
Pathogenesis of diabetes mellitus type 1.
Manifestations of diabetes mellitus type 1.
Pathogenesis of diabetes mellitus type 2.
Causes of insulin resistance.
Manifestations of diabetes mellitus type 2.
Pathogenesis of gestational diabetes mellitus.
Complications of gestational diabetes mellitus.
Impaired metabolism of carbohydrates in diabetes mellitus.
Impaired metabolism of proteins in diabetes mellitus.
Impaired metabolism of lipids in diabetes mellitus.
Pathogenesis of diabetic ketoacidosis and diabetic coma.
Pathogenesis of hyperosmolar hyperglycemic state.
Pathogenesis of hypoglycemia in diabetes mellitus.
Somogyi phenomenon.
Dawn phenomenon.
Pathogenesis of diabetic retinopathy.
Pathogenesis of diabetic nephropathy.
Pathogenesis of peripheral neuropathy in diabetes mellitus.
Pathogenesis of autonomic neuropathy in diabetes mellitus.
Pathogenesis of macroangiopathy in diabetes mellitus.
Pathogenesis of diabetic foot ulcers.

Etiopathogenesis of ACTH-independent Cushing syndrome.
Etiopathogenesis of ACTH-dependent Cushing syndrome.
Manifestations of primary adrenal cortical hyperfunction.
Manifestations of secondary adrenal cortical hyperfunction.
Etiopathogenesis of primary hyperaldosteronism.
Manifestations of primary hyperaldosteronism.
Etiopathogenesis of secondary hyperaldosteronism.
Etiopathogenesis of Addison disease.
Manifestations of primary adrenal cortical insufficiency.
Etiopathogenesis of secondary adrenal cortical insufficiency.
Manifestations of secondary adrenal cortical insufficiency.
Congenital adrenal hyperplasia (CAH):
- consequences of 21-hydroxylase deficiency,
- consequences of 11-βhydroxylase deficiency.