Basic of Endocrinology

 

 Aliran darah darah

Ductus Endocrine Glands

Exocrine Glands

Target Organ

 

Konsep dasar dari endokrinologi Ilmu pengetahuan yang membicarakan tentang keadaan klinik sehubungan dengan keadaan yang tidak tidak normal dari kelenjar endokrin : satu cabang dari ilmu biologi MASALAH MASALAH ENDOKRIN 1. Mek Mekani anisme sme Pengat Pengaturan uran 2. Efe Efek k Fis Fisiol iologi ogik  k  3. Pa Pato tofi fisi siol olog ogii 4. Ras Rasion ional/ al/Int Interp erpret retasi asi 5. Car Caraa pen pengob gobata atan n

 

DIDALAM TUBUH

NERVOUS SYSTEM

Flow of Information (Communication) 

ENDOCRINE SYSTEM

GLANDS   ENDOCRINE = DUCTLESS GLANDS

RECEPTOR Reactions / EFFECTS

+

secrete  Acts HORMONES (internal secretion)

Free  _  Hormone

+

TARGET ORGAN Substances other than Hormones = LIGANDS

Berikatan dengan Plasma Protein Melalaui ALIRAN DARAH

 Agonist ?  Antagonist ?

 

Menghasilkan energi, Pe Pema ma Kaian dan penyimpanan Pertumbuhan & perkembangan Kerja dari Hormon

Pemeliharaan lingkungan internal R e p r o d u ksi

 

MEKANISME MENAMBAH DAN MENGURANGI (UP AND DOWN REGULATION) MENGURANGI Kadar Hormone Serum

Jumlah Receptor

Sensitivitas to Hormone (Hormone Resistance)

MENAMBAH Kadar Hormone serum

Jumlah Receptor

Sensitivitas pada Hormone

 

KELENJAR ENDOCRINE Hypothalamus Hypophysis (= Pituitary gland) Thyroid & Parathyroid glands β and α cell of Pancreatic Islets. Adrenal gland (Cortex & Medulla) Ovarium, Testes (Sex Organs) and Placenta Adiposit (Fat Tissues), Cardiomyocytes (?) Others : Juxtaglomerula Juxtaglomerularr apparatus (?)

 

ENDOCRINE SYNDROMES Due to Overproduction / Hypersecretion or Underp roduction / Hyposecretion Hyposecretion of one or some hormone Example :  Change of Body Weight



anabolic or catabo-

lic abnormalities  Increased Blood Pressure  kortisol, Aldoste-

rone, Cortisol, Catecholamines excess.

 

MEKANISM MEKANISME E PENGA PENGATURAN TURAN DARI SEKRESI HORMON 1.Feedback mechanism 2.Autonom mechanism

 

DASAR2 PEMERIKSAAN LABORATORIUM 1.- SCREENING TESTS 2.- DEFENITIVE TESTS

SPECIMENS : BIASANYA SERUM ATAU PLASMA

 

HORMONES Amino Acid TYROSINE

1. Po Poly lype pept ptid ides es - Anterior pituitary hormones - insulin

3. Catecholamines - epinephrine (adrenalin) - norepinephrine norepinephrine

- parathyroid hormone

2. Cholesterol

4. Iodothyronine

- cortisol

- thyroxine (T4)

- aldosterone

- triiodothyronine (T3)

- androgen (testosterone) - estrogen (estradiol)

 

HYPOTHALAMUS

-

(releasing factors)

(Portal System)  _ 

HYPOPHYSIS ANTERIOR 

-

(trophic hormone)

 _ 

ACTH +

 _ 

TSH +

 _ 

FSH

FSH

LH

ICSH

+

+

ADRENAL

THYROID

OVARIUM

TESTIS

cortisol

T3 

estrogen

testosteron

aldosteron

T4 

progesteron

 

HYPOTHALAMUS (Paraoptic Nuclei) (JALUR HT- HP)

POSTERIOR HYPOPHYSE (Neurohypophyse)

 A.D.H (Oxytocine) ……….(Vasoppressin)  Kontraksi dari Collecting Duct dari Ginjal (reabsorbsi air)

uterus  Vasoconstrition  Vasoconstritio n

 

TIDAK ADA HUBUNGAN DENGAN FEEDBACK MECHANISM INSULIN GLUCAGON CATECHOLAMINES PARATHYROID HORMONE (P.T.H) INTESTINAL HORMONES (Secretin GLP, etc)

 

PROTEIN BOUND HORMONES Steroid Hormones Thyroid Hormones

PROTEIN UNBOUND HORMONES Polypeptide (eg Insulin) Catecholamines

 

RECEPTOR dan HORMONE 1. CELL MEMBRANE / SURFACE RECEPTOR  Corticotropine Thyrotropine Prolactin Parathyroid hormone Insulin .

2. CYTOPLASMA / NUCLEAR RECEPTOR  Cortisol Testosterone Estradiol

 

Endocrine, metabolic disorder and nutrition  Endocrinological disorders  IDDM 1 2 3A  3A 3B 3B 4 NIDDM 3B Complication of DM (acute and chronic) 11 22 3A 3A 3B 3A  3B 44 Hypoglycemia 1 2 3A  3A 3B 3B 4 Diabetes incipidus 1 2 3A 3B 4

 

 Acromegaly,, gigantism  Acromegaly Growth hormone deficiency Hyperparathyroidism Hypoparathyroidism Hyperthyroidism Hyperthyroi dism

1 2 3A 3B 4 1 2 3A  3A 3B 3B 4 1 2 3A 3B 4 1 2 3A 3B 4 1 2 3A  3A 3B 3B 4

Hypothyroidism Thyroiditis Cushing's disease  Adrenal cortex failure failure Primary hyperaldo hyperaldosteroidism steroidism Phaeochromocytoma

1 2 3A 3B 4 1 2 3A 3B 4 1 2 3A 3B 4 1 2 3A 3B 3A 3B 4 1 2 3A 3B 4 1 2 3A 3B 4

Precocious puberty Testicular feminization syndrome Hypogonadism

11 22 3A 3A 3B 3B 44 1 2 3A 3B 4

 

 Adrenogenital syndrome  Addison's disease Multiple endocrinological neoplasia (men syndrome) Tumor with ectopic production of hormone Nutritional deficiency  Marasmus Kwashiorkor  Vitamin deficiencies

1 2 3A 3B 4 1 2 3A 3B 4 1 2 3A 3B 4 1 2 3A 3B 4 1 2 3A 3B 4 1 2 3A 3B 4 1 2 3A 3B 4

 

Error of metabolism  Hyperlipoproteinemia Hyperlipoprote inemia 1 2 3A 3B 4 Porphyria 1 2 3A 3B 4 Gout 1 2 3A 3B 3A 3B 4 Obesity

1 2 3A 3B 4

 

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