March 2022 ~ Medical diseases and trems ,symptoms causes TREATMENT

Medieducator.com

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Simmonds disease || cause || sign symptom || Management

Simmonds Disease

                It is a condition of panhypopituitarism, in this condition  all the hormone of pituitary gland become decreased.

  Cause 

               Trauma of pituitary gland 

               Suppressing tumor 

               Hypophysectomy and necrosis

Assessment finding/ sign symptom

               The symptom of all hormone deficiency will appear .

Management 

                HRT will be require .

 

Syndrome of inappropriate ADH || Cause || Sign and SYMPTOM || Management

 SIADH

             In this condition ADH Hormone production or function may be increase .

Cause 

             - Adenoma in the hypothalamus .

             - Hyper activity of ADH .

Assessment finding 

            * Oliguria 

            * Hypervolemia 

            * hypertension 

            * Blood osmolarity decrease 

            * urine osmolarity increase 

            * Hypo natremia 

Management 

        Immediate treatment

                       In case of severe hyponatremia the 3% NS should be started when the serum sodium become normal the diuretics can be provided to decrease the blood volume .

        Medical management 

                       Drug can be administer which decrease the activity of ADH receptor .

                        Example - lithium 

       Surgical management

                       The hormone secreting tumor should be remove . 

Diabetes Insipidus || cause || Types of Diabetes insipidus || sign and symptoms || Diagnosis || Management



 Diabetes Insipidus

                                 Decrease secretion or functioning of the ADH hormone is called diabetes insipidus.

 Cause of D.I.-

                         * Trauma 

                         * Suppressing  tumor

                         * Resistance of receptor

                         * Behavioural problem

  Types of Diabetes Insipidus

            1. Cranial Diabetes Insipidus -

                        *  In this condition the abnormality occur in Hypothalamus or posterior pituitary so the                               production and release of the ADH hormone become decrease.

                        * Serum ADH level - Decrease.

           2. Nephrogenic Diabetes Insipidus

                       *   In this condition the ADH receptor become resistance .

                       *  The serum ADH level become Increase due to positive feedback mechanism .

          3. Psychogenic Diabetes Insipidus

                        * It is also known as polydipsic diabetes Insipidus in this condition the individual drink excessive water due to psychological problem it occur in schizophrenia  patient and female 

                        * Serum ADH level normal.

 Assessment finding 

                       * Polyuria 

                       * Polydipsia 

                       * Hypovolemia 

                      * Hypotension 

                      *  Dehydration  

                      * Shock

                      * Blood osmolarity increase 

                      * Urine osmolarity decrease 

                      * Hyper natremia

                      * Excessive water loss 

                      * Hypokalemia

 Diagnosis

                       Water deprivation test 

                               In this test the water intake is stope for some time and then amount of urine is                                     assessed . If water intake is stope but polyuria occur , it indicate Diabetes insipidus.

 Management

                        The treatment depend on the types and cause of DI

     A.   For Cranial DI 

                                The HRT should be provided. The synthetic hormone available is Desmopressin , it                             also known as DDAVP { 1 - de amino - 8- D- arginine vasopressin }.

    B. For nephrotic DI

                              In this condition the drug are administer which stimulate the activity of ADH                                          receptor. Example - Carbamazepine and chlorpropamide

    C. For Psychogenic DI     

                               Behavioural modification therapy should be provided.

 

Hormone of posterior pituitary Gland || Disorder of posterior pituitary





1. Anti Diuretic Hormone

                       It is also Known as Vasopressin or Water regulating hormone of the body.

   Function of ADH

                 *    It cause vasoconstriction .

                 *     The ADH receptor present on the DCT and CT of Nephron and this hormone cause                                       reabsorption of water.

                 *     It decrease blood osmolarity and increase urine osmolarity.

                 *     The posterior pituitary stimulated to release the ADH when the blood osmolarity                                      become decrease.

  Disorder of ADH

               1. Hyposecretion of ADH

                                    -  Diabetes insipidus

               2. Hyper secretion of ADH

                                    -   SIADH  { Syndrome of inappropriate ADH}.

2. Oxytocin 

                It is also known as Galactokinetic hormone or love hormone

   Function of Oxytocin 

                In Female 

                       - This hormone increase uterine contraction

                       - It is responsible for ejection of milk.

               In Female 

                     - This hormone increase contraction of vas deference during sexual intercourse and help                          in the Ejaculation .

Disorder of oxytocin

         *    Hypersecretion of Oxytocin will cause hypertonic uterine contraction.

         *   Hyposecretion of oxytocin will cause Uterine Inertia { hypotonic contraction } 

 


Myxoedema Coma || Risk factor || Diagnosis || Management

Myxoedema Come

                   Sudden and severe deficiency in the level of T3 and T4 hormone is called myxoedema                         coma.

                  It is life threatening condition .

   Risk Factor

                  missed dose of levothyroxine.

 Assessment Finding

                  * Bradycardia

                  * Hypotension  

                  * Bradypnea

                  * Hypothermia

                  * Hypoglycaemia

                  * Respiratory failure 

                  * Hyponatremia { due to shock the blood supply of adrenal cortex become decrease . so the          aldosterone hormone also decrease and serum  sodium level decrease }.

                  * Coma

 Diagnosis-

               *   Weakness

              *  Cold intolerance

             *   Central and physical slowness

             *   Dry skin

             *   Typical facies

             *   Hoarse voice. 

Management

            *  Maintain patent airway.

            *  Provide Oxygen therapy

            * Start the iv Fluid and administer levothyroxine therapy.

Prolactin hormone || Disease of prolactin hormone || cause hyper and hypo secretion ||



Prolactin 

           It is also known as Galactopoietic hormone .

   Function 

                 In male - no specific effect .

                 In Female - It is responsible for breast milk synthesis.

  Disorder of Prolactin

 A.  Hyper secretion of Prolactin

            Cause of hyper secretion

                       1. physiological hypersecretion

                                  - Pregnancy 

                                  - lactation

                                  - Chest wall stimulation  

                                  - Sleep

                        2. Pituitary hypersecretion

                                   - Adenoma in pituitary gland

                         3. Idiopathic hyperprolactinemia {40%}.

              Assessment Finding

                            In Male - 

                                        -   Gynecomastia { Breast tissue enlargement in male }

                                        -   Impotence

                            In Female -

                                          - Galactorrhea{ excessive breastmilk production }

                                          - Menstrual cycle irregularity .

               Management

                           1. Medical management

                                            - Drug of choice for gelactorrhea Bromocriptine this drug is dopamine agonist so it increase dopamine level in brain. Dopamine act as PIH.{ Prolactin inducing hormone}

                           2. Surgical management

                                           - Hypophysectomy is performed.

           

 B.  Hyposecretion of prolactin

                Etiology

                            - Trauma 

                            - Hypophysectomy

                            - Suppressive tumor

                Assessment finding 

                           - in  male No symptom

                           - In female Lactational failure.

       Management 

                        Drug can be administer to increase the breast milk production and improve lactation.

                     Example -   Metoclopramide

                                      - oxytocin 

                                      - HRT


Dwarfism and Acromicria || Hyposecretion of Growth || Sign and symptom of Hyposecretion of growth hormone

 


Dwarfism 

               It occur due to hyposecretion of growth hormone in children . it is also known as lorain - levi syndrome . A common cause of dwarfism is a genetic mutation that affects bone growth.

Etiology -

              -    Trauma 

              -   Hypophysectomy 

              -   Suppressing tumor

 Sign and symptom 

               - Height less then 2-3 feet

               - decrease physical growth and it is symmetrical .

               - The IQ level is normal because the growth hormone is not responsible for growth of brain.

Acromicria 

            It is occur due to hyposecretion of growth hormone in adult.

   Assessment finding- 

                 - Height is normal 

                 - IQ level normal

                 - Bone become weak and thin.

Management 

           * Surgical management 

                              Surgical management that may correct problems in people with                                              disproportionate dwarfism include:

  • Correcting the direction in which bones are growing.
  • Stabilizing and correcting the shape of the spine.
  • Increasing the size of the opening in bones of the spine (vertebrae) to alleviate pressure on the spinal cord.
  • Placing a shunt to remove excess fluid around the brain (hydrocephalus), if it occur   -     
         * Medical management
                      
                                    -For individuals with dwarfism due to growth hormone deficiency, treatment with injections of a synthetic version of the hormone may increase final height. In most cases, children receive daily injections for several years until they reach a maximum adult height — often within the average adult range for their family.

Treatment may continue throughout the teen years and early adulthood to ensure adult maturation, such as appropriate gain in muscle or fat. Some individuals may need lifelong therapy. The treatment may be supplemented with other related hormones if they are also deficient.

Treatment for girls with Turner syndrome also requires estrogen and related hormone therapy in order for them to begin puberty and achieve adult sexual development. Estrogen replacement therapy usually continues throughout life until women with Turner syndrome reach the average age of menopause. 

          

               

Gigantism and Acromegaly || Disease of Growth hormone || Symptom of gigantism and Acromegaly || Management of Growth hormone hypersecretion in children and adult



 Gigantism 

                    This condition occur due to excessive secretion of growth hormone in children.

  Sign and Symptoms of gigantism -

           1. Hight more then 7-8 feet.

           2. Hyperglycaemia 

           3. Glycosuria

           4. Headache 

           5. Visual disturbance { due to compression of optic  chiasm by tumor}

           6. Organomegaly 

           7. In late condition Diabetes can occur.

  Acromegaly -

                    This condition occur due to hyper secretion of growth hormone in adult.

   Assessment finding -

                      1. Enlargement of extremities

                      2. Hyperglycaemia

                      3. Gorilla face appearance  { Prominent supraorbital recess ,broad nose , thick lip , wrinkle on the forehead.

Management of hypersecretion of growth hormone

     - Surgical management is available 

    - Hypophysectomy -

                          It can be performed by two procedure

              1. Craniotomy { chances of bleeding are present }

              2. Trance nasal hypophysectomy also known as trance sphenoidal hypophysectomy

                           { Chances of CSF leakage are present } 

 * * * After the surgery life time HRT { Hormone replacement Therapy} is require .

  ** CSF checked by glucose analysis in nose running fluid .


Growth Hormone || Effects of Growth hormone|| Function of growth hormone

  


Growth Hormone 

                        It is responsible for the overall physical growth of individual . It released in higher amount during initial stage of sleeping { 3rd stage of sleeping}.

 Function of growth hormone

  1. Effect on metabolism -

               A. On Protein metabolism-

                                                              This hormone increase protein synthesis and this protein is                                                         utilized for tissue formation.

              B.  On fat metabolism -

                                                              This hormone increase fat metabolism . Excessive hormone                                                         release can produced ketogenic effect due to fat breakdown.

               C. On Carbohydrate metabolism h-

                                                                This hormone cause hyperglycaemia by decrease the peripheral                                                  utilization of glucose.

  2. Effect on the Bone -

                        This hormone stimulate the osteocytes and osteoblast cell so bone length and strength                        become increase .

  3.  Effect on organ and muscles -

                         This hormone increase the growth of internal organ and muscles.

Note - The growth hormone dose not have effect on the brain , genital organ , nail and hairs.


Pituitary Gland || Hormone of Pituitary Gland

 


Pituitary Gland

                           Also known as master gland and hypophysis cerebri.

Gross Anatomy of Pituitary Gland

Location 

               It is present in the cranial cavity . it is situated in the Hypophysial fossa { sella Turcica}

colour - Brownish pink

Shape - Pea shaped

Diameter - 1 cm

Weight - 500mg

Part of pituitary gland

 1. Anterior pituitary Gland { Adenohypophysis}

 2. Posterior pituitary Gland {Neurohypophysis}

Cells of anterior pituitary Gland

    1. Chromophobic - It  is non secretary cell . It provide support to the Chromophilic cell .

    2.Chromophillic cell - It is secretory cell , it is two types

  A. Acidophilic cell - -{35 %}

                      a.   Somatotropin- It release Growth Hormone

                      b.   Lactotropic - it release prolactin 

B. Basophilic cell { 15%}

                      1. Thyrotropes  - It release TSH.

                      2. Corticotropes - It release ACTH.

                      3. Gonadotropin - It release FSH and LH. 

Cells of post pituitary gland 

   1. Unmyelinated neuron - non secretary cell.

   2. Myelinated neuron - secretary cell

Hormones of Pituitary Gland

   A. Anterior pituitary - 

  1. Growth Hormone
  2. Prolactin Hormone
  3. TSH
  4. ACTH
  5. FSH And LH
  6. MSH           

    B. Posterior pituitary

  1. Oxytocin 
  2. ADH       


Hypothalamus Gland|| Hormones of Hypothalamus

     


HYPOTHALAMUS

                          It is also known as master of master gland because it control the pituitary gland .

        It secrete two type of hormones 

A.   Releasing Hormone {Stimulating Hormone}

              There are 6 type of releasing hormones

1. G.H.R.H. {Growth hormone releasing hormone}

                      It hormone release from hypothalamus and do stimulate to the anterior pituitary gland for releasing Growth Hormone for physical growth of body.

2. P.R.H. {Prolactin Releasing hormone}

                     It hormone release from hypothalamus and do stimulate to the anterior pituitary gland for releasing the prolactin hormone for stimulating mammary glands for milk secretion.

3. T.R.H. { Thyrotropin releasing hormone}

                     It stimulate to anterior pituitary gland for releasing TSH .

4. C.R.H. {Corticotropin Releasing hormone}

                 It stimulate anterior pituitary gland for ACTH {Adrenocorticotropic hormone}in adrenal cortex for steroid production.

5. G.N.R.H. {Gonadotropin releasing hormone}

                  It stimulate to anterior pituitary gland for secretion of FSH, LH.

6. M.S.H.{ Melanocyte stimulating Hormone}

                  It stimulate skin for melanin production for dark skin /

B. Inhibitory Hormone

                1. Growth hormone inhibitory hormone 

                2. Prolactin inhibitory hormone also known as dopamine 

C.  Other hormone of hypothalamus

               1. A.D.H. {Antidiuretic Hormone}

                                  Synthesized by Supraoptic nuclei

               2. Oxytocin 

                                   Synthesized by paraventricular nuclei 



Gland of Human Body || Exocrine Gland || Endocrine Gland || Definition of Gland || Type of gland

 


DEFINITION OF GLAND -

                                                The structure which is formed of cell or group of cell and also release deferent enzyme and hormone is called gland.

TYPE OF GLAND   
           There are 2 type of gland 


1. Exocrine Gland 
                             In this type of gland the duct are present. by this duct the glands are transfer secretion to the target organs. Example - Liver , sweat glands


2. Endocrine gland
                              In this type of glands ducts are not present. It release secretion directly into the blood . the secretion reach up to the target organ by the circulatory system, Example - Pituitary Gland


                                             Endocrine gland

                                  🠟

         ⮟                                                       ⮟     Purely endocrine gland                      Mix endocrine gland        

1. Pituitary gland                                                     1. Hypothalamus gland

2. Thyroid gland                                                      2. pancreas gland

3. Parathyriod Gland                                               3. Kidney 

4. Adrenal gland                                                      4. Ovary

5. Pineal Gland                                                        5. liver

                                                                                 6. Testes

                                                                                 7. thymus

                                                                                 8.stomach

                                                                                 9. Placenta

                                                                                 10. heart [ ANP, BNP]