By C.R. Kannan
This paintings, crucial Endocrinology: A Primer for Nonspecialists, is written with twin reasons in brain: first, to supply a framework of easy endocrinology and diabetology to the scientific scholar, and moment, to supply a brief, con cise, and convenient "guide" to the junior citizens of their early years of teaching who desire to receive a operating wisdom approximately endocrine problems that have an effect on their sufferers. one of many remarkable merits of being a instructor of en docrinology to scholars and junior citizens is that it bestows a standpoint from a special vantage element. Books written for the junior participants of our occupation have suffered from extremes of quality, starting from excellence past their comprehension to unbearable mediocrity. Textbooks in en docrinology which are easy adequate to hide the foundations of that speciality and but finished sufficient with out treading into debatable quicksand are few and much among. This booklet is geared toward filling that hole and is written with out different criterion than simplifying a posh material. From this touchstone, the paintings hasn't ever rather departed. A decade of expertise as a instructor and doctor within the box of endo crinologyhas inspired on me that the method of "simplification" rests on 4 uncomplicated ideas: an realizing of endocrine ideas, the applying of those ideas to the knowledge of illnesses, the transference of knowl facet to scientific occasions, and the combination of the sufferer with the labo ratory, the final word trying out floor the place scientific diagnoses stand or fall.
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Extra resources for Essential Endocrinology: A Primer for Nonspecialists
Introduction Pituitary hyperfunction usually involves hypersecretion of a single pituitary hormone. The three common examples of pituitary hypersecretion involve growth hormone, ACTH, and prolactin, resulting in the clinical syndromes of acromegaly, Cushing's disease, and galactorrhea, respectively. Rarely, hypersecretion of TSH may result in hyperthyroidism. Hypersecretion of gonadotropins, ~-lipotropins, or endorphins is extremely rare, often diagnosed by extracting these hormones from tumor tissue.
The demonstration of an elevated basal ACTH in the presence of a low serum cortisol is TESTING PITUITARY FUNCTION 37 diagnostic of primary adrenal insufficiency (Addison's disease), whereas the demonstration of a low serum ACTH in the presence of hypocortisolemia is indicative of secondary adrenal insufficiency (hypopituitarism). 2. In the evaluation of patients with hypercortisolism. The measurement of basal plasma ACTH in patients with hypercortisolism (Cushing's) is an adjunctive test to delineate the etiology in the following manner: (a) the combination of a high serum cortisol and a normal or minimally elevated plasma ACTH is suggestive of pituitary-dependent Cushing's disease; (b) the combination of a high serum cortisol and a low (or undetectable) ACTH is suggestive of adrenal tumor causing Cushing's syndrome; (c) the combination of a high serum cortisol and a high plasma ACTH is highly indicative of ectopic ACTH secretion causing Cushing's syndrome.
The FSH secretion by the gonadotroph is negatively controlled by the protein inhibin. This substance, secreted by the Sertoli cells of the testes, correlates with spermatogenesis. A low sperm count is associated with a low level of inhibin, which stimulates the synthesis and release of FSH and spermatogenesis (Figure 3). Although the feedback mechanism is compartmentalized in the above manner, persistent adminstration of testosterone will suppress the hypothalamus (GnRH), resulting in a . lowering of both LH and FSH (Chapter 33).