Course Title

Medial Endocrinology

Course Number

7710357

Instructor Name

محمد حايك

Contact Information

[email protected]

Semester(s) and academic year(s)

Second Semester 21
First Semester 21

Compulsory / Elective

Compulsory

he principle of clinical toxicology practice is an important part of health care providers’ knowledge. This course is planned to correlate between the toxicological and pharmacological principles and the management of poisoned patient. This course will cover several substances that are commonly encountered in the intentional and accidental poisoning. The student will be able to assess the symptoms and signs, the type and extent of poisoning, and to develop a specific treatment plan. Additionally, the student will be able to assess the patient, monitor him, create the management plan that includes laboratory tests, stabilization, antidotes administration. This course would enable the health care provider to take a part along with health care team in management of poisoning cases.

This course is olso designed to provide a broad overview of vertebrate endocrinology. Course topics will
include the various classes of hormones, sources of hormones, production and synthesis of hormones, receptors and target tissues, mechanisms of action and regulation, and methods used in endocrinology. Lecture and readings from the primary literature will focus on classical endocrine systems.

Upon completion of this course students should be capable of effectively communicating how endocrine systems function. Students should develop the ability to integrate across multiple endocrine systems to better understand the complexity of endocrine-related disorders. Students should also be capable of critically evaluating information provided by the media and literature on the topic. Lastly, students should gain a general understanding of the approaches used to study various facets of endocrinology.

Week 1 • Assign a “chart of basic endocrine function” to be tested by multiple choice questions in week 3 • Assign the Introductory pages in the reader covering basic concepts • Introduce the system and concepts of signaling • Explain the biochemistry of hormones (peptides, steroids, catabolic anabolic) • Emphasize the significance of the steroids to the clinical realm • Begin the explanation of basic endocrine function with the pineal gland and melatonin • Describe the anatomical relationships of the Pituitary Gland and Hypothalamus • Introduce the hypothalamus as the true master gland with Releasing hormones and inhibitory substances • Examine the neurohypophysis and its secretions – ADH and Oxytocin

Week 2 + 3 - Continue the survey of Gland – Hormone – Target/ General effect • Discuss anterior pituitary secretions and target organs of LH, FSH, TSH, GH, • PRL, ACTH • Explain mechanisms of hormone action: synergism, antagonism, permissive effects

Week 4 • Finish the survey of all hormones including leptin. Explain measurement of hormones, titers, and radioimmunoassay • Explain control of secretion by neural, endocrine, and humoral factors • Explain target- receptor interactions: up and down regulation, dose- responsiveness, and mimicry • Describe mechanisms of elimination and their significance to health

Week 5+6 Begin coverage of “Details and Diseases” portion of the course • Repeat the function of the Pineal Gland including traditional and current concepts regarding melatonin • Repeat coverage of the Posterior pituitary gland with pathology of ADH – (vasopressin) – diabetes insipidus Oxytocin-positive feedback • Explain the significance of intracranial pathology-adenomas and ischemia • Explain the Anterior Pituitary Gland histopathology including adenomas and shock pituitary (Sheehan’s Syndrome)

Week 7+8 • Repeat growth hormone and its mechanism of action to include its diabetogenic effect • Discuss GH pathology: acromegaly, gigantism, dwarfism, and progeria • Describe detailed prolactin pathways, the Lactation Amenorrhea method of birth control and the pathology associated with prolactinoma

Week 9+10 • Describe corticotropinoma and Cushing’s disease • Explain the role of TSH in hypo and hyperthyroidism • Repeat thyroid function - thyroxine and triiodothyronine • Explain thyroid pathology including Grave’s disease, Hashimoto’s dx, • myxedema, and cretinism • Define goiter: toxic, nontoxic, and endemic • Present cases of thyroid panels Approved OAA/Department | September 2019 4 | Page to explain negative feedback • Present cases of thyroid panels to determine hypo or hyper thyroid dx • Challenge the student to correlate thyroid levels with metabolism and clinical presentation

Week 10+11 • Repeat the difference between parafollicular cells – calcitonin and parathyroid with PTH • Review parathyroid hormone – calcium and phosphate concentrations • Discuss Vitamin D synthesis, bone synthesis, PTH action • Explain primary and secondary hyperparathyroidism • Discuss the clinical considerations of hypoparathyroidism • Define the terms: nephrocalcinosis, osteoporosis, rickets, and osteomalacia

Week 12+13 • Explain the details of the Adrenal Gland and the catecholamines • Indicate the relationship between the medulla, the sympathetic nervous system, and the acute stress response • Point out the layers of the adrenal cortex and their secretions • Explain the role of the adrenocortical hormones in the chronic stress response • Discuss the zona glomerulosa – aldosterone as mineralocorticoid; mechanisms of action, regulation, relationship to kidney • Discuss the zona faciculata – cortisol as glucocorticoid; mechanisms of action, relationship to immunity and structural integrity • Discuss the zona reticularis -sex hormone production • Discuss the significant adrenal pathology including pheochromocytoma, primary and secondary hyperaldosteronism, Cushing’s syndrome, Addison’s Disease, and adrenogenital syndromes

Week 14+15 • Point out in detail the beta and alpha cells of the islets of Langerhans • Review the regulation of insulin • Review its effects on carbohydrate, lipid, and protein metabolism • Briefly review glucagon • Explain the difference between diabetes insipidus and mellitus • Begin to differentiate the Types of diabetes through insulitis • Explain how autoimmune insulitis generates insulin dependence • Show a comparison between Type I and Type II • Challenge the student to contrast these types by at least 5 ways • Present/read cases of the two types over time • Define conditions of insulin shock • Define conditions of ketoacidosis • Explain Hb A1C and diagnostic markers • Present diabetic sequelae

Weeks 16 • Briefly review endocrine control of reproductive function including the hypothalamic/ pituitary/ gonadal axis • Review the female menstrual cycle • Examine endometriosis and polycystic ovarian syndrome • Review male hormones and conversion of testosterone to DHT • Examine benign prostatic hyperplasia and Leydig cell tumors

Satisfactory completion of this course will provide the student with the foundation necessary for understanding future clinical problems of the endocrine system.

The student will demonstrate an understanding of the anatomy of the endocrine system.

2. The student will demonstrate an understanding of the basic properties of hormones.

3. The student will demonstrate the role of hormones in maintaining body function.

4. The students will demonstrate those endocrine details helpful in the clinical realm.

5. The student will demonstrate knowledge of the major endocrine disorders.

Clinical Rounds in Endocrinology: Volume I - Adult Endocrinology 2015  Anil Bhansali & Yashpal Gogate. ndocrinology-volume-i-adult-endocrinology-e176072758.html