Hypercalcemia, Hypocalcemia, Osteoporosis, Diabetes mellitus, Obesity, Hyperthyroidism, Hypothyroidism, Hypercortisolemia
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Definition: Above normal levels of calcium (Ca2+) in the blood
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Risk factors & causes: Hyperparathyroidism or malignancy
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Signs & symptoms:
- Cognitive dysfunction - Fatigue - Muscle weakness - Constipation - Decreased appetite - Polyuria (↑ urination) - Polydipsia (excessive thirst) |
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Pathophysiology & mechanism: Changes in Ca2+ concentration in the blood cause alterations in the balance of electrical charges of cell membranes leading to sluggish neuronal activity → ↓Ca2+ causes a ↓ in the permeability of collecting duct membrane in the nephrons → ↓ Ca2+ leads to increase in Na/Cl into tubule lumen (nephrons) with osmotic effects → leads to less water reabsorbed into the blood; & more water eliminated in the urine
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Complications: Ca deposition in different parts of the body causing stones (urolithiasis), flank pain (not specific)
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Treatment: Medication & surgery
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Definition: Imbalance of bones formation & reabsorption leading to brittle bones
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Risk factors & causes:
- Females more likely - Age - White or Asian - FHx - Small body frames |
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Pathophysiology & mechanism: In osteoporosis imbalance in bone reabsorption vs bone formation leading to a ↓ in bone density & bone mass → ↓ serum concentrations of vitamin D lead to a decrease in Ca2+ available for the mineralisation of bone
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Signs & symptoms:
- Pain (from fractures & other conditions associated with osteoporosis) - Postural changes - Fractures - Loss of height |
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Complications: Bone fractures (mainly spine & hips)
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Treatment: Prevention - Supplements & weight bearing exercise
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Definition: Thyroid gland doesn't produce enough thyroid hormone (underactive thyroid)
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Risk factors & causes:
- Autoimmune diseease - Thyroid surgeery - Radiation therapy - Thyroiditis - Medicine (e.g. lithium used to treat severe depression) - Pituitary disorder (insufficient produce of thyroid-stimulating hormone) - Women, FHx, Type 1 diabetes |
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Pathophysiology & mechanism: Impaired function of the gland & a ↓ in the secretion of thyroid hormones T3 & T4 → engages number of mechanisms (circled in red)
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Signs & symptoms:
- Thinning/losing hair - Eyebrow hair loss - Puffy face - Enlarged thyroid - Dry & coarse skin - Slow heartbeat - Poor appetite - Constipation - Infertility / heavy menstruation - Cool extremities & swelling of the limbs - Carpal tunnel syndrome - Weight gain - Poor memory - Fatigue |
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Complications:
- Goiter - Cardiac problems - Peripheeral neuropathy - Infertility - Birth defects |
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Treatment: Medicaation
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Definition: Low Ca2+ levels in the blood serum
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Risk factors & causes:
- Hypoparathyroidism - Vitamin D inadequacy or resistance - Renal disease - Terminal liver disease with vitamin D inadequacy |
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Pathophysiology & mechanism: Ca2+ changes lead to a change in cell membrane polarisation → ↓ in the threshold for cell depolarisation causing an increase in neuronal excitability → Sx & SSx
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Signs & symptoms:
- Paraesthesia (burning/prickling sensation) - Numbness - Chvostek's sign (twitching facial muscles) - Trousseaus's sign (hand & wrist twitching) |
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Complications:
- Ventricular tachycardia - Seizures - Respiratory disease |
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Treatment: Iv infusion & medication
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Definition: Body can't produce enough insulin (high blood sugar levels)
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Risk factors & causes: Unhealthy lifestyle → intraperitoneal cavity accumulates visceral fat (endocrine organ that secrets 'bad' hormones)
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Pathophysiology & mechanism: Manifested by a state of resistance to the effects of insulin, consequently →
- various organs are less able to use glucose as a source of energy - There's hyperglycaemia leading to glucotoxicity, i.e. damage to pancreatic cell that produce insulin - Deficient insulin causes diabetes |
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Signs & symptoms: Depend on the specific body system affected
- Frequent urination - Excessive thirst - Unexplained weight loss - Extreme hunger - Sudden vision changes - Tingling or numbness in the hands or feet - Feeling very tired much of the time - Very dry skin |
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Complications:
- Cardiovascular disease - Nerve damage - Kidney damage - Eye damage - Foot damage - Skin & mouth conditions - Hearing impairment |
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Treatment: Prevention - Healthy diet & exercise
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Definition: Thyroid creates excessive thyroid hormones → speeding up the body's metabolism
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Risk factors & causes:
- Graves' diseases (attacks thyroid) - Overactive thyroid nodules (toxic adenoma) - Thyroiditis (inflamed thyroid) - FHx - Recent pregnancy |
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Pathophysiology & mechanism: ↑ in production of thyroid hormone → abnormal ↑ in its endocrine effects over various organs & systems
=> Includes ↑ cardiac output, gut hypermotility, CNS overstimulation, increased thermogenesis, ↑ in osmotic pressure behind the eyes & changes in the dermis & subcutaneous tissues |
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Signs & symptoms: May occur in various body systems → eyes / systemic signs / heart / nervous system / GI system / nutritional state / thermoregulation
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Complications:
- Cardiac problems - Brittlee bones - Discoloured / swollen skin - Vision problems |
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Treatment: Medicine, therapy &/or surgery
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Definition: Abnormal ↑ of cortisol in the blood → ↑ in the effects of cortisol on various systems of the body
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Risk factors & causes: Cortisol is normally released in the blood in response to stress
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Pathophysiology & mechanism: ↑ in circulating cortisol → generalised catabolic state, i.e. the body breaks down / burns tissues & reserves in order to release energy → most systems are affected
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Signs & symptoms:
- Easy bruising - Supraclavicular & dorsal fat pads - Central obesity - Round face - Proximal muscle weakness - Purple striae - Hypertension - Arrhythmia, paralysis, cramps - Hirsutism, acne |
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Complications: Affects all the systems
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