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Part I: Developement, structure, and Function 1

1.Overview of the Endocrine System 3

Introduction 3

Mechanisms of hormone activity 3

Preface 3

Acknowledgements 7

Dedication 8

2.The Hypothalamus and Pituitary gland 17

Organization 17

Hormones of the hypothalamus 21

Hormones of the anterior pituitary gland 22

Hormones of the posterior pituitary gland 24

Endocrine function of the pineal gland 25

3.The Pineal Gland 25

Structure of the pineal gland 25

4.The Thyroid Gland 27

Organization 27

Thyroid hormones 29

5.The Adrenal Glands 33

Organization 33

Hormones of the adrenal cortex 35

Hormones of the adrenal medulla 40

6.The Pancreas and the Gastrointestional System 43

Organization of the endocrine pancreas 43

Hormones of the endocrine pancreas 44

Endocrine control of the glucose homoeostasis 49

The endocrine role of the gastrointestinal tract 52

7.Endocrine Control of Fluid Balance 55

Mechanisms involved in fluid balance 55

Hormones involved in fluid balance 57

8.Endocrine Control of Calcium Homoeostasis 63

Mechanisms involved in calcium homoeostasis 63

Hormones involed in calcium homoeostasis 65

9.Endocine Control of Growth 71

Normal growth 71

Cellular growth and proliferation 71

Hormones/factors directly involved in the control of growth 72

Hormones indirectly involved in the control of growth 74

10.The Reproductive System 75

Embryological development of gender 75

Puberty 77

Organization of the female reproductive organs 79

Hormones of the female reproductive system 82

Hormonal changes and the menstrual cycle 85

The male reproductive organs 89

Testicular hormones and spermatogenesis 91

11.The Process of Reproduction 95

Coitus 95

Fertilization 95

Implantation 96

Contraception 97

Therapeutic abortion 100

The placenta 100

Reproductive hormones in pregnancy 100

Internal adaptations to pregnancy 103

Parturition 106

Lactation 107

Part II: Clinical Assessment 111

12.Taking a History 113

Introduction 113

The structure of a history 113

Common presenting complaints 115

13.Examination of the Patient 125

General inspection 125

Examination of the hands, nails, limbs, and feet 126

Examination of the head and neck 128

Examination of the thorax and breast 130

Examination of the abdomen 131

Examination of the female reprlductive system 132

Examination of the male genitalia 134

14.Further Investigations 137

Investigation of endocrine function 137

Routine investigations 142

Imaging of the endocrine and reproductive systems 144

Part III: Basic Pathology 149

15.Pathology of the Endocrine Glands 151

Disorders of the pituitary gland and hypothalamus 151

Thyroid disorders 155

Parathyroid disorders 160

Disorders of the adrenal cortex 162

Disorders of the adrenal medulla 168

Disorders of the endocrine pancreas 169

Multiple endocrine neoplasia syndromes 175

Ectopic hormone syndromes 175

16.Pathology of the reproductive System 177

Menstrual disorders 177

The menopause 179

Infertility 180

Sexual dysfuntion 181

Disorders of the placenta and pregnancy 182

17.Pathology of the Female Reproductive System 187

Disorders of the vulva 187

Disorders of the vagina 188

disorders of the cervix 188

Disorders of the endometium and myometrium 190

Disorders of the ovaries and fallopian tubes 193

Disorders of the breast 195

18.Pathology of the Male Reproductive System 199

Disorders of the penis 199

Disorders of the testes and epididymis 201

Disorders of the prostate gland 204

The male breast 206

Part IV: Self-assessment 209

Multiple-choice Questions 211

Short-answer Questions 215

Essay Questions 216

MCQ Answers 217

SAQ Answers 218

Index 221