Endocrine! ogy Ree Golgi. Prepro-> prose B- c-pephde. (watte-sol.) removéa Ve pephacs + mech. vid Cell membrane, ate AS, camp. — GTP-y come. Pic 2 PKA ke fe "5 DAG 1P3 protems/ a enzymes) Shmulaes iets ensanes] Cottab. *« v Le AN P,BNE, (petabioceers, NO. PES: etc). enzyme! peoiem. (used foe (crane = nea ACa**+ Calmodulw ) VO Aiveec.(arnh spyrorine Kinase ¥ paetot the protein go t+ can aun®, THEN work in nucleus >ble bul ders: Hoemones (pra soble). Thyroid Ltuage= toyraglobulon-> cotioid ) ~Stewoid. (no erage form). salrectiy nett on the nucleus, Cack as ranseryphen. facie! Minseew b a ato mnaiiee ma BIE binding IC on, BAP * coympteready, proreunt => Thyroid > Tyronne-—> catecholamines /TH'S. ~necd BHentme L7?esenhal blecames 1324 ttr-C1— = From phenylalanine. cactitly) stereoids > eum cholesiceo! (eepro) ~ cornsols & Zn Fingers. - vitamin D. Hoemone. proteins ° (riences 5° SEH (conadi) cholesteean -de/meli, eanenolene AlaOSKA igeygoy Androgens Epi» can be &/Breceptoe, Jo CAMP § DAGIPS GH CAMP # TE(f2 proian syntnestt)How to Approach Endocrine ble wecreted blood. H' PO No oryivein/a Target. testrogen =e eatack a tew sore Think Anatomically Think Physiologically. + (yner)= Hyperplana, © eebback at hghdore 1° = source oF hoemone. Iocahon Corb ee) 31 ra at 2 2nd, i relahons. Cinsteull) EP (coectve). Ademoma. d (S04). Cac imorna. pituitany gland ~Thvridpavatmyroid Crave). “sphenordalginuo —rosat gland (Abd) * Utypo)s — Suruatiy noartant. sopre chim exert -destruchea (hicmenal naam ne PN Sirucreren ischemia, Attics ‘usually non-selective.” pineal giand we cpeanpbc. Traumalwe.surgeri) + ‘ 4 Jegeniclen ecm eee bleeding insite. oa Siatorhons eatin land, congenial Ente det. i fone e roid brain ~fuperiur Colliculas. © €> (Eu) Sma > carcinoma. “Thyroid trachea, e1vpragys, Recurtent laryryeat nerve. thats Pe aac He ah epee) oneness ag iS wally won i enkephalin: e ae only ve-sowece oF ACTH 15 the pinata’ sidneys, Retroperitoneal ~ B-HeG-usually comes SO" all oF there pituiaey gland). ie pea nye er eee phyoPDNeos5- (alse eevubunit). Piturtaey Gland exh oF Ogdpharyrw—> Ants Pituitary, ‘Gevaginate- hypo tnalareus ad = pork: pila lamas ‘paraventricular Infundrbulum. wh—— «|; Zembrypiogical Remnant. hah can cause tesion (willbe Cale Lydamage stalk 1 RH'S heom hypotina annus ‘A prolachn (bic no dopamine). —_ i # CUS ae. Chromophobic (acelsary-——— > sinue non- funchonal. AnatVonniting, headache *CRANIOPHARYNGIOMA blurred ston Pel vphenoidal sinus, ophc chasm > batemp. hem! anopre ~mamly boys. Phyl port frannentiy hic. Ant> hyper protaumemra Coynecomana.ete).Posiceir: Hypothalamus. Bm. OS? f parenting | cupradphecncnar soxytocin >aoH | - ADH Doxytoan- Fs axons. Cyntrachare 123) pah = co oxytocin -Vasopresnin ~ Smooth muscles of UteUS -> fo CORPO post-parchum. = hw okmypenitnens — becdng. ne on Ve distal DoT cele oF brearr frtue Ca AE yiegtecton of wt ral oot eondieetal cei. = Neuestranin ter behon' a = peegnancy a Est te Prag.) p ~vaseconsTi ch Te eng. oS progesiorene. manta preg. ee ve Ve medal relaxing finorth muscle. V. a Aut. 2 Toxyren: (sotx ot “vee. ut Peed sera sean + hemophilia). Ve3 geabs of tree tropa Reabt. of urea (inne ned: prog = feemninate. ea, seovad) how oiytoen 1s free 19 norie ah ¥ne receptor. - post-partum hemorrhage A” ADHISAD} (vent uteeus-p nozmaity shou Wb H innoH Brain lesions. foahact, alee deleey = weak “te gwe inluston of axyrocin) (mainly accidents) = ge open 42 weer IV ocho ay paraneoplaine. wil help contract Lerystotogical ger) small cent carcinoma.) Lung tenons: (abies, Th ete) Ply q =v t Dip =watere deprwanea (4 P1, F0M-same- dveechon = noeval AH). - Tr Demet tocy cme (pe gesreeree 5 SAIL nigh) Clace of oxyroewy associaied wi polygon ble mares you want mane) IMT sl Hypothalamus part of It funchon = emohonal 1 (0 maintain Yhewuntercunenk). cAMP. DI aaah nice =esdney probs. Tegenthe penitane. a nga ny mber tone m1 BH), wwe Tepstruchon (ve: pyetonertan! ~Demeciocyctine- = Linum: —> Te AMMOR eS t DID =-piyerogente Cu. palydvien ~caebamazepne- # = Oineprareie, (Pet). aTeAte SoUgsMUZENG inbrain (SADA) Serornceart = nor cones. ax! Thranides( 4 Reabl ar DET, A PCT IO J water) ~ waite RerichoAcidophilic 2 New ‘Peolachn PROLACTING ed Meese * (A protachnenul, Hypothalamus 5 DIL | epi Lantegon fopamine)- Ant) Pt Acidopnitic © / ¢camPoeTK), i ( Adenoma 4 prolacm | + Breast hsrue fe | Grands —> mite dgatacorancn. Pathological ~> 3 Wually Pit glanced. (yupsetectveh et * GRomth > 2°40 Ert/ Probes Castocrated w YTEHs (475,74) L Db VACTH=MsH)s yan rs * INdieechy > gonads. gneve * mec? peolachnom ones > Est) progest oe # Hyper prota = 7 at ves Hyper protactinemia. | ~Stmmond’s ® iho A an onists Syndrome. _/- Schemia Gat ea =ck-mernu| aut have Hn” eis — bleeding inside poe k. di oe emus StRC55 > Inhibits penta vase cece Cauming Bregnancd) GnRH [by shmulahyy | gt adenoma > Aporexy. of peolachn. abgiaw protachn). estlO2 prolactin. Ly mates = Liter: = Inapotence,mnberbhly Ls femaleszamtmnonesy tafertilshy ~1*hypotnyro.aacm (473174 > 4TRHY TRH shmulates proach “xt Somatostatin? Froth £8romocriphne —DA agonut furnue- SURgiaaIy remove (Acro roeglly -» Protachnl GH gee simile in struchoe’) PCobe. GROWTH Hormonis? GH Hypothalamus, (schondroptana—axtal : noemals hr ae 7 * QHeH fn | CHIH guenoemal)- oa J cLagon — propemianate Shortnes, wat GH= noeMnal)- when bl ny cod. teste tmaginy. — Indvecty \e vee somalomdit 1. Ue = cartilage |bove- enatwally, neepP® GH So when UGH s wantto fhmulat fp checle- Arginine 2(rnare. proteins) ble eS 7° esrennaL- expect GH be eeleased- 4 protein synthase{TK). Asince foe mud, do imbih jettfo gue Bz Gelber mimics inculin)« Giucore Rieranle. teh 2hrt a G inculi i (Hor ula al ve Nee lipolysis: Clean muscle: (qa) ened Jer rupees Os — A giuore by Auviae Fame i (ean ve yea 0 caer eee : Ke Be huconengenct Cetin | tomonconly GH 4 DwnReniea (roped) Bowyiogeno'y de Ammo Acids-Arginmeountce meguicrray to insulin. ¥steep- erpecrsit marvee for GH). a auth gato maa ae ‘nso 7 mertten mwe, — -T:SOMAR TaN LruRoer.BaSOpniiics rominaciM, ron Thyroid Gland « Thyroglossal duct (should be obliterated) cyse Some have. mrmiddle Aceessory tise. ae Puingual thyerd. mores up and down. pyeamtd. sHhyr0g los siete uPree nak ID te cyst: Branchal cyst not midline. toner neck, se note-the thyroid isnt Supplied by the Vagus o€ I's branches nose aveto Supply posterior Shreuchures . The Hayrord gland 1s associated wisymparhencs, {hormones Lateral view? pretracneal fascia~ tnisis why swattonang/ protrusion ot ‘tongue, tne mass more ue f down. pecurrent lacyngeal neeve- Internal Jugs vein Le. vagus sme ob Rat x ee renportant one i (ELN) Ts posterioe cricoarytenald fun) mugcle ble It does << Se Seon. 4o tne vocal cords S° es. we can breathe. : [> hoarseness. iN | | =SuttecattenTY ws ae sH—> somatic function ~hyperplasic(qastein esteogen: ACTH vTSH). uptate of iodine = actve. © perchlorate © pertechtonate © tmiocyanares: ‘xp block receptor). Corgambeatel) © '- ¢ @ ioaination, Cyrosine #1") @ Courting —rTS ~All Hnese Steps= peroxidase, except uptake (TSH watt actwate PerOXIdAS®) ces paranutocytosis (ul (oxidation geacton).’ %satee in Pred Smethimazle- er fevte nbc ete. now @S'deiodinasefio recycle rodme grour). Le 1 you dont have 1h can lead to gortee (ake lack of iodine causes) © ExocysOss (THyoy tobulin) =Cotlord- © Endocytosis through whole cell membrane @ Peripheral conversion (S- deiodinase enzyme) Loimp. to create more achvines pera Bocrees whiort (conteod syne.) ~propanclol- = Rodioachve- Jodide-inhwbtts peripheral Conversion (most commonly used) - made by Wwers ®, nT R6> P01! Vota) Stimulated by estvogens Total T3= Free T3+ TB Tae ie +186.7 achve: form. estrogen Liver disease —e VTBG = ¥ taking 13 excess (pur Hee. form = always constant not converted toanytnng dnieh 15 why you give TA dnich ean be converted to 73. (iveeversible rn8)- Parafolliculae cell's pur origin = neural crest) ° ei K> ° 75.50 a hyde of neuRoendacrine celts. z © bysecrete calertonin work on CNS, © Freee T: cause: oFamylo:dosis J ‘ ° bene ean) Creed 2. ag gasal meraballc Ratke-LMdKe wtewe). Feee T4 rg vee SE aenin Lonced 0a for ATO. 73/74 upregulates + -Ppen astrin tes mannan aR MOLE ceeulAnen) advenergté BEE: gels Lyfe. Lbgieres ‘cppepmissive hee sterolds tase bration S. ie oF catecholauing MEN WA? « 50 up requiate fr Be» to be bette.Thyroid A Hyper =~ Thyro toxt cos 15 (hard nodules). + Dsympathenc +distacnen (brain) +4 PR (palpitanen) Tavehythmiatheaet) > Doutput HE. + HTN + 4Re (lungs) + Diarvhea (y weight-z61)) “ reguiak menses (Repro) * Heat intolerance. ONDITIONS * piftuse entaeged +2ye probs + mayyedema = Graves Cooth aze Autotmmune) toxic multinodular —Plummers disease- “no eye probs ~ enlargement of try rota, TSH= %- isH eH a nas No eae ice ntbrtien- Inperp a. IS pic sh keers Shrauating tr +374 Hs type Ht no Intlaamnahun. TX! Anti-thyroid hormones. Ls anh-intiammatoey tproptypsis, 11d tag, Cxopthalamus, ete =D eye probs ~ fat pad behind eye gets intlammed. > gets pushed. oub- LtHypo_ - wsyme. Everything down except have “weight gain + menorrhagia. > Voone.-> forgettulness. ~ bradycardia. (@) ~ hypovenhianen. = weatness (ck *->myopatny at = Anemia (N ONC Chronte) =non-megatoblashe macrocy He anemia. b> eid bs GI: conshpanen Sarvibathe hae, VE veey young, CRETNISM~ mental retardahor (preventable) ‘Shoes (pone growth). =S0 Rourinely want 10 Check: foe TSH. Lecongenttal (absence o@ Autoimmune aHack Causes: © Autolamune- Hashimoto's Moe Lego othee Autoummune’s as well Lopist of NHL = infiltration wliyraphocytes th he germmal centee (inmaics LN'S) . Ly quemie cens mech Auto ABS: cells. Anti-miceosomal Uperoxiaase)- © thyroiditis > Acute: StaphAuvens> abscess PAINE 4+ SUBACUTE DE QUERVEIN Ge = Granuloma oF IbYOSIS - Riedel's Thyrorditt S-mumicS Anaplastic Ca. Lacan cause Compression = Can be histolody cassoctatea =other Abroic Condinons- <> puptyrene contraction, etc. *peUas! Lithium, Arniodazone, Sulfonamides ny Rone das. LOMATON: + Sulfa. aivegie eenMass in thyvoid, but hoemones are noemal = Suthyroid. =>most likely cancer. -Cine needie aspiahen, take fluid. -ultvasound will help diffevenhate between cyshe vs. solid. LIE cold! —> adenoma benign co the Capsule /BM Is in tac+(Hurthle's), “S CaRCINDMA + @papiioey | aR -me. @potieu! Medulley alana - excellent prognosis _~ 400d Prognosis ~Sporanie Krapiashe. > young females -seeit BM IS (Farms _eldeely, rates Qynghone in tack fo feet associated ™) ~pasrstoryor ota people. yu Adenoma oe carcinoma) “etederes. huge gle unaly wf = Hurthie!s aes ~ golds SOY juin hate 0 © © @ See had noltles.So par noe J en hitivey oF reli yroS> —psomomma body ‘BLOODY goes fo i IRLRED. —_ previems Hasiniono -oRphan annie lungs. Cay, eran nutiel -RAS genemutaho = RET (other than, (Bebe: mass +hng tetas) RAS anytiny tire -uvenioegetten 7 sultrasound fine needle asp. + biopsy “suegery.DIABETES ae inflammatory 5 NO B-cells ‘intl: ihitration. insulins =NO INSULIN kids. f+ Autoimmune AuloAb ~ Anth6DA- a “vray ‘AnH Glutamate Decorboyiare- = wort Fe eiycogen “HU De3/4 + Hemachcomatoeis otnep aut)” (Fe deporinon) Tmmune. | *Chtont. pancreahtis, om -kips pad frie, -wually thin. -es3 ~ Ketone bodies. Cell destemjed. Emergenty: DEA ® anion fap muraloolie acidosis ~ preceded by stress /intecton- ~give IV Fluid/ insulin. gue kt ble P can lead to hypokalemia If 1S gH) heeds 10 be managed = No Insulin FA oridahon > ketone bodies: + Hloemone venrinve lipase. =D breaks down TAG fp FFAS. Ic ~ Funchnonal = Hiustologtcally=oK - Release [Retpnre (sensitivity / Pesipheal®) ~ usually obese > 2 BS years - FH Strongly asroctated. ~ Acanthoses ~# peristance fp insult. Lageew/| Pod. % Alse wimetabolic syndrome. ‘scanee: Kisney, 4b * Enzymanhe => MoDy-.- ~ Giucorinase deticiency =pnotsevere, controlled. ( Gestational diabetes 241# enzyme deh). lack of achvines Human Placental Lactogen (HPL) > hormone. 446 —0mrathnt pretend. venicles movte and. exocy tors Rerease: “they teaver insu rAmytio 2 brueagen- go hus why Hype lI amnylodouses- ‘Drug vimlaz to amyline Premalatide. gh yd) Aiea we) mi : ar) Complicahonss (ar) ae lon: enaymnahe Glycosylation eee Hb Ale ~ ( CaCO em mm, -So Biest cign = ULE OF etamimy insulin, - ro Diora — =No Ketone. badtes bic enoagh insulin neopathy. micro: Retnopa tay, neehrPAtnh Cleo ak picture). @ osmotic (soebitol) e F tarde lee eee orien Ceatarat) ,fenwanncetiReryreaL Wate) Lose vibration senses Autonomic. ns (para 2rymp)- she Stomach=2gastropaeens. Le give hima gues wunen comes in ble hypogean: ~Erecnle Dyshnchn > weaknest wn erection. Uleot vascular + PS) symmernoal, bilateral, to inhiint HSL- =notretone corru.=?¥. high sugar => hyperosmnotaerty SH" cells severe potyuen rel wetud (earvutm). Coma sw & give tnigmn® nalosenc Laatteleraites PRN.Treatment Type] Insuli Aspart £- short-acting (ater meal ) DEA- insulin @ DOC: IV Pee Ls not complying cd qideyacdicen z aeqines i compart nyponytnna. * ME HS > create Ab against th =tyrell ~ Sullony)ueeas. (so one ot the bert). =mumnieS phvsiologica | acton ~centak sue = has noting to do w/Yens tame. => kept pirk of hypoglyemia- base f C-pepnde, _ Deug-Peug im+eeachon, swinich anti-ttTN deuq pottluy ? Edraxoide >mmoxidil. (ce Adiponectin . wore on pesirtanely tt). * weight gain Le “goed rerponie edema $0 ¢/1 many > « -¥ C/v complications. - Another. eerstame? (DOC). METFORMIN 7 peripheral * cenral. ty twee , + Bluconcogenesis. No hypoglyiemia, No welght gain cused (n preggers (euglycemic) Cftin aciaies: ~My RE > bert synergistic = Combieahon, of Tulfonyren+ medfoemin (M release £4 resistance). AcaskeisloPauT eet ce HEGRE. Acaebore — (-dusauwundsse) Inhibit Rush boedee entymer SE! Ql. ~ given postprandial.Adrenal Gland ap cae Adrenal Me Pregang ionic. ee. NO post-gang ionic fibers: “Cells ehromathn cell. PHEOCHROWIOC yTDM A Zalseare of sympatwete ganglia. ‘spean tect ymp-chasd = 207. benign sAdtempedullay ‘#hetuahng ep, ete 27H. ~ Acatechiamines = 4 BP SURGERY - Prenton “Prenoxybensonne. “canwe g-rwoceer’ bur usually Andi anybrny. ee canbe Wed. : a Chave tule of Fresh treng) 1 reteulanis tee ane (it befoee puberty precocious pubes) Lab est: check andraqens, combined. Clonidine Suppression, 1 levels dont Fall ely agortts Shope From presynephe Fon olerelensed Rom. w1suitate, most hiely adrenal gland. “hoe (ror gpa) eer all A Aldorterone. =f egehy ei tall Hypotinataanls ce. We Crt ekoHrenera in 27 Also Foe growth ot Hevue, so FACT, hhyberplanie, ALTHAMSHA- Hy Pereig. unde control of RARS snot speciheation , All Hvee lay errchn FOSCICUMME -yorsol Sanhimmune 60 infecrore be opp foinslln patina te re ine ag tn tee BUS), eh mmaldh str union AURIS eweate tenure 1s caacornss, emaey gland) hyporigmen Bugera a asia Pte eigmenstes Ectopic CcoRMSENE-=PmediCahon oe paraneoplashe. © cei, ACTH ,cowtsol- So cantts top fortune: allofasuaien, Sotaper. " Sinerplaii ne pigment — Dexamethasone Suppression tert Normal: toe isol 4 in morning. 1hgve- pm at night (except fred back) > MSH fo met ere. i ? extept cortyol to be W.llimall da! CONN S: = 2 two =16 coRtsol 15 FhII nigh, Adose- ce 7 Sh tumve [Eta ememneds =1£ unemveantey m0 corto s then prob Gah - A Renin |oan reTenerd 2 = Pthattaey.” ohio | tie a {= IE GHIT highy nothing 10 do w)Wxs, meaniKetis’ |—arn->walem Sonemeperit SO mort tiely Qararieoplaste. -rapoaeme | ARnyjan MREEPY i rmetabelt ve ace mimes. [Rite gy Pee hace ‘oak Leoerisa |v Aldosterone! pare? aestruchve. 1esion(+he whale “Brey staat by “Autoimmune fase || * appisonls a earn) laintection : Tb. hw w/a enn) Acute> Meningococcernta. Neisseria (n brood > sephcshock hypotension > petichae on water howe | FCO's, Seneca | a 5 Seach > damages au $ tvers, eo 4 fehaatet = demayes but gona abner loneecae erate one, Get mpi eid Rime raacyonie Aer ah (Bren =U Aide. ends oF NACHO, Cee TeralemiA, mela a 40115. ingensionCongenital adrenay hnyPerpus ia. Chol Lys fingoaads XL gonial. wd) Ach °- Desmelase io L 4% x lou vo. t v EL Androger syndrome - Vv Corti}, ~ hnypotenrion Jo Aldon. “sone Radosts. Aan SDpe vnuleaton 4 Anat logy teeme tH 8 A ii-deon! 1 Lack of mineyalpcuetwotds. PANCREAS? WDHA- pancrealte cholera. HCl = Q=MHCl. Kens. Elicogeogen ne Geseraroe. Glucagon =7 T= towwcase- 7 at poe: > weceoiytt cs (tar cee Raed, Fibs ter an erate ecytmaius —Anemie (NCNC). fat bFypteally affecting the gfoin area, — Skin lesion 7 1 Stomahhs, Chei losis, Sicoakl pans INSULIN’ Ainsuiin Y insulin, Somandann = insunnonta shypergyeoma | VERB H, Pyloki = C-pephde. (om). Le causes hyperacidiy- ase Mmiad? Supresses Seccehens D <0 A= Somatoctarnoma. Bots na petoreded sina guy dextrore. Ve BUR a Om ) SUs OF inypogly Cena. LGiPe vag pr gluwe lon. UCR) NEESAdpenal Glad saypotratenns cece. af A Mine Adrenal Wedutla. Pregang lioa'c. gee. NO post-gengiionic bes’ o “Cells Chromathn Celle PHeEoCHeONInC “aitseare of ryenpatneic ganglia. 450 can attect symp-chasn 407. benign Aan madulias +ichuatiny “gp. ete. 27H. = Acatechitamines = 4 BP TR:CURGERY - phentolamine ~Prenoxybensamnne. “can we prtocker’ but ~ A Anapogens usually anytiung @e can be wed. a Chave bute ot Pest, tneng) IP reheularis amor. wenina Ue betoee puberty precocious puberty) ‘Clonidine. Suppression Lab tes+2 check andregent, 1 combined 18 levels don't fall fly agornits Stops From prerynapne Flow. ‘bic released Gam fumows net nerve- wlsuitate, most hely adrenal gland. “ree (not nada ot A renbs. of Nal Hid AD Aldorerne <4. Si0-ob enue. 27 Also Foe growtin of Hs/ue, so ACTA, ‘hpoerplasi, EALTHAMSH A> Hy PerPig. unde Contaol of RAAS penot spectheatun , All Hivee layerrcen FR SCiCuahS eoprsol santimmune 80 resins opp alas : se mate ae tee BVS), fact tale sb + rasciculate] “tune | Sunon mort hkely paraneoplastic. : my L chyporaiemia | Aitiomayare RUMEN aes. [eit ime Page oe TAtdeadena gland A Corrisol | 1 Aldosterone ~‘heenin Cturion’ eee aestruchve tesion(the whale rete “fitoreonne asseettienel = ADDISON'S? sneenns TV. Appison's: Gat wireenin) Lainfeehon : Te. Acutes Meningotoccemnia Neisteeia in blend > sepheshock hypotension ->petichee oa chert. fae worerhowe- Friederichvon's hemaberite # a ‘syndrome. 5 Weoetsot> damages ait 8 laverss feereutarit = damayed, but gonads ll weplae 1 br ne glucyiamia. “* Aer neh remperla bl gnd Ot relahve). “hyperpiganeniags “anages) ‘lds eeabs of NaCl Hi D020 Ef ‘hyper tater, metatolic at dosts- hypotension.Parathyroid PONCE thyroid- Aeenoey ee > Hypieally 4ycan bee most commonty found hee Ink Pr Ath pharyngeal pouth. (gives superior). 39 pharyngea) (int. + +hymus), inteewe implant area> Areaem Fite eT eee DiGeorge- Absence of pouches 374.0 Hever taymus/parathyrord. = Day I hypocalemia (signs: tetany s@erobs) ~4-lo mo. ales Immunpdehtiency. vial mkechon (notreally problem. wi bacterial ). ~Chr. 22. is CON TOR (erantopharyngeal abnormality. (ie free. ae low) © wer, (PTH > balanced by calcrionin) vCot ~2 pry => Fla’ (cnet cells). cAMP. ig? nected. oe re per ves ce @osteoviasts {@ ean brewmae + yotep ne estan psteoclast (mp). a pt eod-0H (wit .p3)- + Mesa ° h& peabs- Poe Resorption of (a excrehon ): Cae POA” ay meron PCat hoe. apiorenen | of Cats Pow -yitD abr: tn esses terminal ile ereeat ile mica hQprens im jerminal ieum-Coord). (gehve ores) “Total Ca**= Alb.Ca™ + Ca**ltree) ~UAlb> mal nubihen, hvee, Krdney ere but Free form 1s always sable In Alaline dqvieonment, Alb wilt gain aneg chaege so t+ will take the Free hem, PTH. F E | c | oca\eemia caleermwa So a2" A- Hyper parathyroid, Be rarathy rovdicm, (io ble Catcameditter) = hyper planiaadenonnaca¢cinoHa, Grmphomane*carwually 7). Grrcopp vo 2° (Stinulated by lon Ca), Causes? kxdney) 6) probe. renal fnflure not ; CCRF) cesyordiny PTH (can be pant ot MEN If Na), Fear. ~pubular Frlure—PTHS Cyperus to hear = Hypoparatnyroidem bie, (eidneys |bohe) to Keer 2°) ~Caured by hyperca’> vangfaa? reenbay m bane ( ae ssa ga nh Coseits, ovat et) cant Lrenal osteodyst Y. a Took. Ike Spotty Lesions. a ee =G i probs ->fat matablorehon. : tae bane (Pta” Can aise be tow) - excert we wie of antncids thar Bue > Lee, biliaey ecancee ‘track prob (obriruchwe Jamnave} iymetartans tobene. Problem m pancreas (big head) panifeahhs )oe willi Probs oe 2) multipiemyetoma— In Fermiral ileum (crohns) spatlect nol Pac: 3)Paranéopiastic syndrome EF. ADEK.[bleding unight bhirdee ue). 7 ir Is A looks 2 Kcidiney probs, fo PTH ranough on bone, © granu loma-> multinucleated to mate Ca® 27 Be ey Win), Squamous Celi Carcinosna. oiaores-ponronic-Tb Vlaey PPTH. Hypocalcemia - spasm , bkeno calcium, ‘tetany, sChevorsrks ign, Trousceau,, hyper jar reHex(ranant smatelee peer , ~Heaet prolonged OT ast hytnwniA. Hypeecalemia— tetany ~short @T, @l-consheahon, SEVERE epigastric Pan. (gastein). Ls panered nhs ,Pephe ulcer dente Lytenas fo hypocalcemia! “Renal stones + Nephrogenie- DI - rota 1 damage, V2 Rec ADH= nora — Hupo Paeatn = [2s dyease in gland tirel =Di George sno gland suegery (Hnyroidectomy)- = destruction (Al, intechan, ischema)- = Ving?» synthesis. = far abprocphen charehen. ‘oe Alcohones - E = Normal Fe PTH: noemal sate ve => RetepTOR PRODI Albi yht's, pe \~ PCT: DCT pe ONLY DCT. 20AMP inuEe. Cusé came nucine-to citterentate). “Precocious puberty “geteral probs (shortening) Lm metzacyat -2¢ofmphatio ian 4 Hyper thyradism ant celts > o-0H achutty- -Y mates ofteoclarts = a" AEs gi ee, Be Hast . Test0n: jtostsX=> dest bone. = SBDInsulin - Anabolic hoemone , promotes Fuel oorage. Glucagon responds rapidly to decreased blood glucose. glevels by promotm g the synthesiS and release. of giwose into the cieculaton. Well-Fed (AbsorpHve) State > RIGHT AFTER A MzAL: ~ Blood. glucose level rises =7 @ retease of imsulin. ee Liver: glycogen synthesis, after that 1s Filled Insulin ce, Converts excess glucose. +0 Fatty acids #76, ao 3 Promotes TG synthest S, and glucore entey. MUSCIeS Promotes protemn syntnesis Tglucose entey - AMER a meal, most ofthe lees energy needs are met by oxidizating amino acids . Brain $ RBCs ave insensihve to insulin (independent). = get enengy From oxiat2ing glucose to COz and water Cohanges in prolonged. Farting). “ALL the hme, Pbe'S USE glucore anaerobically Postalweptve Sate + ~ Glucagon and Epinephrine levels e1se Prom an overnight fast. too 4. Jet Glycogen degradahon and the release oF glucese. into : a a nate 1S also stimula ted (but sioner tran glycogenoly is ]Reei chmnulates the releare © muscle/ Adipose W insulin, PS a amino acids (AA? FA ore uptaken by wer >AR age He Cavbon skeleton S oxidation of FA= +he- ‘ANP need foe. giuoncogenesI=)- Glucagon Epmephrine- Prolonged Fast (Starvation) + = Glucagon * Epinephrine. = elevated ~Lapolysis 1S rapid. resutting in excess aceryco s. (poth lipids # Fetores are 1 in blood) 7 7: oassees use FA'S as the major fuel and the bram adapts to use ae Some energy. ~ Abteg severa | weeks of Fasting , brain uses 2encrgy brom Ketbnes, Ye Prom giucose Ghis dmunishes the amount of proren thar needs 10 be degraded ) RRC's(and Renal med ulaey cei\s) Continue to be dependent on glucose fre eneegy. A used for Ketone synthesis .