Pathophysiology

Are done when a hypofunction or hyperfunction of an endocrine organ is suspected. 

Hypo: stimulated hormone is administered and increase of production from organ is measured

Hyper: ( ?? I assume a hormone that stops production is administered and after the hormone production is measured ??)

Is a very expensive test. Only some endocrine related disorders have specific genetic markers which can be used for testing

Important for diagnosis and follow-up (often cheaper). MRI, CT (provide information of structural changes of tissues) and Ultrasound (advantage of real time) can be used.

PET scans are common: Isotope is administered that is selectively picked up by tissue being investigated

It occurs within the follicles (sacs filled with fluids), of the thyroid gland which sits below the adams apple in humans

T4 and T3, whereas T4 is more present but in inactive form (T3 is active).
T4 has a much longer half life and can bee converted into T3 if needed

Thyroid stimulating hormone (TSH) of pituitary gland releases the hormones into blood and bind to plasma proteins. Only free T3 and T4 can enter cells, the protein bound act as a reservoir

Increases the metabolism and protein synthesis
Necessary for growth in children including mental, sexual development. Mainly mediated by T3 where it binds to receptor which results in transcription of hormones from genes

Altered levels of T3,T4 affect all major organs

Congenital: occurs before birth, often lack of gland, or abnormal synthesis of hormones (usually not seen at birth due to supply from mother).

Aquired: general slowing down of metabolis, destruction or dysfunction of gland (primary) or impaired pituitary function (secondary).
Surgical removal, or Hashimoto disease (autoimmune disorder) are common reasons for destroyed thyroid

Essential for normal growh and brain deelopment. Causes impaired physical growth and itellectual disabilities.

Treatment by hormone replacement therapy. Early T4 replacement is important fo psychomotor and menatl development

Hypometabolic state of body tissues (gradual onset of weakness and fatigue). Tendency to gain waight despite loss of appetite. GI motility is decreased, flatulence. CNS is involved in mental dullness, and impaired memory

Hyperactivity of hyroid gland. Caused commonly by Graves diseas accompaigned by thyroid eye disease (TED), skin conditions and abnormal enlargement of gland.
Tumor of gland, or swelling/inflammation are other causes

Manifestations result from high metabilism. High O2 consumption, and increased symphathetic nervous system activity. Weight loss despite appetite gain, nervousness, irritability, or tachycardia. Excessife sweating and muscle cramps

Reducing the level of thyroid hormones -> surgical removel of part os gland, or supressio with drugs.

Measurement of T3, T4 (total and free) and TSH are used to determine if secondary or primary.

Radioiodine uptake test can measure the ability of the gland to synthesise the hormones

Twisting of spermatic cord and loss of blood supply to testicle

Considered emergency to preserve testicle and fertility

Intravaginal torsion: more common and occurs in adolescence due to increased weight of testicles and contraction of muscles. 

Extravaginal torsion: Occurs in newborns (testicles not yet descended and thus immobile). Shofr or twisted spermatic cord is the reason

Intravaginal: distress, nausea, vomitting, tachycardia. Affected testicle is larg and tender with radiating pain

Extravaginal: scrotal swelling and redness, firm and tender testes. Cremasteric reflux (pull in testes) frequently absent

Inflammation of epididymis (tube from testicle to vas deferens) due to microbial infections

Bacerial agents, which ones is depending on age and sexual practices.

Urinary tract pathogens (age 14-35) , or secondary to urinary outlet obstruction (older), trauma

Gradual onset of posterior testicular pain (unilateral). Swelling and inflammation (longer than 6 weeks if chronic), discharge, discomfort when urinating (dysuria).

Standing decreases pain (elevation of testicles)

Acute inflammation of testis secondary to infection.

Usually caused by viral mumps (or other bacterias, virus). Complication of systemic infection

Enlarged and tender testis, red scrotal skin, edema (swelling by excess fluid) of scrotum and stiffnes of testis

Undescendent testes, they fail to descent from abdomen or scrotum to scrotal sac.

Primary: remain in pararenal (next to kidneys) origin
Secondary: placed in a scrotal position that can be pulled down

Patophysiology: Unknown, uncorrected leads to fertility complications

Clinical manifestations: missing one or both testes, histological abnormalities to delay in development (most common in premature babies)

Benign Prostatic Hyperplasia

Enlarged but not cancerous prostate gland

Not fully understood. But age over 40, family history, obesity, diabetes type 2, lack of physical activity.

With age testosterone production decreases which makes estrogen increase relative to it -> could promote growth.
So could Dihydrotestosterone which continiues to be produced

Weak urinary stream, postvoid dribbling, frequent urination (also at night), urinary urgency (not able to hold back), urinary incontinence, pain after ejaculation/urination.

Symptoms often from blocked urethra or bladder that is overworked (pressing urine through)

Prostate gland grows -> obstructs urine flow/urethra -> bladder wall thicens (gets stronger) -> bladder weakens and looses ability to empty completely

Changes in breasts, uterus, skin, ovaries and affects fertility, reproduction, sexualit and femaleness

Involves maturation and release of oocytes (eggs) from ovaries, sheding of edometrial lining in vagina

Menarce (first) to menopause (last).

Occurs every 28-30 days and lasts for 2-7 day. With approached menopause the duration shortens

Female sex hormone

Secreted in ovaries, adrenal cortex (E1 estrone, E2 Estradiol and E3 estriol)

Female physical maturation.

Together with other hormones reproductive process of ovulation, pregnangy and lactation.
Important role of growht of uterine muscle and endometrial lining (lining of uterus)

Gonadotropin releasing hormone GnRH, Hypothalamus: stimulates other hormones e.g. ->

Follicle stimulating hormone FSH and Luteinitzng hormone LH, anterior pituitary: regulate growht, puberty, reproductive cycle, sex hormone secretion,  promote growth of cells in ovaries and testes

Hormone associated with pregnancy (but also in normal menstrual cycle)