HormonesHormones

Hormones

Hormones: Hormones: compounds which are synthesized and compounds which are synthesized and secreted from special secretory or endocrine secreted from special secretory or endocrine glands.glands.

Hormones

Hormones release is regulated by either:Hormones release is regulated by either:

1.1.Other hormones (feedback mechanism)Other hormones (feedback mechanism): : e.g. e.g. TSH stimulates the thyroid gland to secrete thyroid TSH stimulates the thyroid gland to secrete thyroid hormones.hormones.2.2.Chemical agents;Chemical agents; e.g. e.g. glucose glucose in bloodin blood insulin insulin secretion. secretion. NaNa in blood in blood aldosterone aldosterone.. CaCa2+2+ in serum in serum parathyroid parathyroid (PTH)hormone.(PTH)hormone.

3. 3. Nervous systemNervous system::e. g.:e. g.: Sympathetic activationSympathetic activation AdrenalineAdrenaline secreted from adrenal medullasecreted from adrenal medulla

Hormones

Clinical disorders of endocrine system:Clinical disorders of endocrine system:

1.1.Overproduction of a certain hormone Overproduction of a certain hormone (hyperfunction).(hyperfunction).

2.2.Deficency or absence of a certain hormone Deficency or absence of a certain hormone (hypofunction).(hypofunction).

Hormones

The case will be divided into:The case will be divided into:1.1.Chief complaintChief complaint: : the symptoms the patient is the symptoms the patient is complaining from and they are the first guide lines complaining from and they are the first guide lines for diagnoses of the case.for diagnoses of the case.2.2.History of patient illnessHistory of patient illness: : it includes the pt’s it includes the pt’s age-physical examination (heart rate, blood age-physical examination (heart rate, blood pressure)- any apparent features that may lead to pressure)- any apparent features that may lead to the diagnosis of the cause of his complain (skin the diagnosis of the cause of his complain (skin swelling, tremors, convulsions, fatigue, etc…..)swelling, tremors, convulsions, fatigue, etc…..)

Hormones

3.3. Family history: Family history: illness history of his family, illness history of his family, which may help if his illness related to which may help if his illness related to inheritance (genetics).inheritance (genetics).

4.4. MedicationsMedications: : any drug the pt takes either for any drug the pt takes either for treatment of a chronic disease as hypertension treatment of a chronic disease as hypertension of diabetes. Or a drug he recently took before of diabetes. Or a drug he recently took before the appearance of the symptoms he complains the appearance of the symptoms he complains from.from.

Hormones

Laboratory values Laboratory values (lab values): these values may (lab values): these values may include parameters which are directly related the include parameters which are directly related the case, e.g. the level of Tcase, e.g. the level of T33 and T and T4 4 in case of simple in case of simple

goiter.goiter.

Hormones

•ALT (alanine transaminase) SGALT (alanine transaminase) SGPTPT: : used to used to determine liver damage.determine liver damage.

•AST (asparatate transaminase) SGOAST (asparatate transaminase) SGOTT: : found in found in high conc. in heart muscle, liver cells & skeletal high conc. in heart muscle, liver cells & skeletal muscles muscles used to determine liver damage ( used to determine liver damage (NON NON specificspecific).).

•Prothrombin time (PT): Prothrombin time (PT): time taken for blood time taken for blood (plasma ) to clot.(plasma ) to clot.

Hormones

Hormones

•Bilirubin: Bilirubin: it is a product that results from the breakdown of haemoglobin, used to monitor liver or gallbladder problems.Most of bilirubin is chemically attached to another molecule before it is released in bile (Conjugated=direct) while unconjugated bilirubin is called indirect.

- Impairment of liver function indirect bilirubin-Impairment of liver secretion to gall bladder due to biliary stone direct bilirubin.N.B. liver disease should be monitored using combination of ALP, ALT, AST & bilirubin..

Hormones

Hormones

•Blood urea nitrogen (BUN): urea nitrogen is product as result of breakdown of protein used to evaluate kidney function. BUN liver failure, low protein diet or malnutrition. BUN Xss protein, kidney diseases. Heart failure ( blood flow to the kidney) GIT bleeding (ulcers) (blood clots degradation in GIT nitrogenous compounds urea in blood  

Hormones

Hormones

Mean cell haemoglobin (MCH): the average haemoglobin content of red blood cells.(Hb/RCC).•Basophils (Basos): the number of basophils/litre.•Platelet count (Plt): the number of platelets/litre.•Lymphocytes (Lymphs): the number of lymphocytes/litre.• White cell count (WBCs): the number of white cells/litre.•Monocytes (Monos): the number of monocytes/litre.• Erythrocyte sedimentation rate (ESR): the velocity of sedimentation of red cells in 1st hour (mm/hr). It is a non-specific measure of inflammation and infection..

Hormones

Hormones

Hormones

-Endocrine dysfunctionDiabetes mellitus Ketoacidosis.Cushing syndrome metabolic alkalosis.

Lung function-Hypoventilation accumulation of CO2 and consequently carbonic acid respiratory acidosis-Hyperventilation flushing CO2out of the blood respiratory alkalosis.

Hormones