Questions to prepare for classes and examination
• General etiology and pathogenesis of endocrine disorders.
• Typical forms of functional pathology of adenopituitary. Hypopituitarism: types, causes, mechanisms of development and manifestations. The Sheehan's syndrome, dwarfism, hypogonadotropic hypogonadism.
• Hyperpituitarism: types, causes, mechanisms of development and manifestations. Acromegaly and gigantism hyperprolactinemia.
• Typical forms of disorders of neurohypophysis. Diabetes insipidus and syndrome of inappropriate arginine-vasopressin secretion.
• Typical forms of adrenals' dysfunstion. Hypercortisolism: types, pathogenesis and manifestations. The Cushing's disease and syndrome, hyperaldosteronism.
• Hypocortisolism: types, pathogenesis and manifestations. The acute adrenal failure and Addison's disease, hypoaldosteronism, syndromes of adrenal androgen excess.
• Disorders of adrenal's medulla. Manifestations and consequences of phyochromocytoma.
N 124
A 56-year-old patient T. has met his relative after six years living apart. The relative was amazed by dramatic changes in T.'s appearance: thickened and ridged skin on the forehead, deepened frontal and nasolabial folds, the nose and lips enlarged, the mandible and malar bones were prominent with protrusion of orbital ridge, and the teeth became widely separated.
T. has visited his physician who suspected acromegaly, and sent the patient's blood to laboratory to test the level of growth hormone. The results of the test showed that growth hormone level in the T.'s blood is within the normal range. Further examination revealed a decreased glucose tolerance, an increased level of glucose in the blood (8.3 mmol/L), the presence of hyperphosphatemia and glucosuria; pH of the blood 7.34, plasma concentration of ketone bodies 2.8 mg/dl (N: 0.5-2.5 mg/dl), and that of lactic acid 2.2 mmol/L (N: 0.99-1.75 mmol/L).