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Is Ketoacidosis Hyposecretion Or Hypersecretion

Hyper And Hypo Function Of The Pancreas

Hyper And Hypo Function Of The Pancreas

Transcript of Hyper and Hypo Function of the Pancreas Hyper and Hypo Function of the Pancreas Hypoglycemia, Hyperglycemia, Diabetes. Pancreas α - alpha cells - glucagon (increases the glucose in the blood β - beta cells - insulin (decreases the glucose in the blood) γ - gamma cells - PP (pancreatic polypeptide) Δ - delta cells - somatostatin (regulates/stops the α and β cells) There are four main types of cells that can be classified by their secretion. Hyper and Hypo function Hyper function - high secretion of hormones by some cell types. Hypo function - low secretion of hormones by some cell types. There are some conditions that might occur if the pancreas is not working properly. Hypoglycemia Hypoglycemia - abnormal diminished content of glucose in the blood. What it can cause: mild dysphoria seizures unconsciousness neuroglycopenia death Hyperglycemia Hyperglycemia - higher than normal blood glucose level. Chronic hyperglycemia can lead to: neurological damage cardiovascular damage damage of the retina damage of the feet and legs kidney damage diabetic neuropathy Diabetes Diabetes Mellitus Diabetes mellitus (DM) is a metabolic disease in which a person has high blood sugar. Complications : diabetic ketoacidosis (DKA) fatty acids ketone bodies acetoacetic acid acetone Type 1 It results from the body's failure to produce insulin. a) "juvenile diabetes" usually appears in childhood; b) "Brittle" diabetes (unstable diabetes). Symptoms: vomiting dehydration confusion deep gasping breathing coma hyperosmolar hyperglycemic state (HHS) results: dehydration, increases of osmolarity, coma, death. It can be accomplished by some other serious cases. Type 2 It is characterized by insulin resistance which can be combined with relatively reduced insulin secretion. Early stag Continue reading >>

Chapter 18. Dysfunction Initially Described Excessive – Hypersecretion Insufficient - Hyposecretion Today Abnormal Receptor Function Altered Intracellular.

Chapter 18. Dysfunction Initially Described Excessive – Hypersecretion Insufficient - Hyposecretion Today Abnormal Receptor Function Altered Intracellular.

Presentation on theme: "Chapter 18. Dysfunction Initially described Excessive – hypersecretion Insufficient - hyposecretion Today Abnormal receptor function Altered intracellular."— Presentation transcript: 2 Dysfunction Initially described Excessive – hypersecretion Insufficient - hyposecretion Today Abnormal receptor function Altered intracellular response Circulating inhibitors * water-soluble hormones (not steroids – lipid- soluble) 4 Alterations of the Hypothalamic – Pituitary System “ interruption of the pituitary stalk ” Destructive lesions Rupture after head injury Surgical transaction Stem tumor 6 Diseases of the Posterior Pituitary Syndrome of inappropriate anti-diuretic hormone secretion (SIADH) Hypersecretion of ADH Ectopically produced (small cell carcinoma) Brain injury or infection (pulmonary disease) Psychiatric/drugs Water intoxication ( ↓ Na +, hypo- osmolality) 7 Diseases of the Posterior Pituitary Diabetes insipidus Insufficiency of ADH Polyuria and polydipsia Partial or total inability to concentrate urine Neurogenic Insufficient amounts of ADH Nephrogenic Inadequate response to ADH Psychogenic 9 Diseases of the Anterior Pituitary Hypopituitarism – “spectrum” Pituitary infarction Sheehan syndrome ( pituitary necrosis) Hemorrhage Shock Other: head trauma, infections and tumors 14 Diseases of the Anterior Pituitary Hyperpituitarism Commonly caused by a benign slow- growing pituitary adenoma Manifestation Headache and fatigue Visual changes Hyposecretion of neighboring anterior pituitary hormones 15 Diseases of the Anterior Pituitary Hypersecretion of growth hormone (GH) Acromegaly Hypersecretion of GH during adulthood Gigantism Hypersecretion of GH in children and adolescents 21 Diseases of the Anterior Pituitary Hypersecretion o Continue reading >>

Human Anatomy & Physiology Ninth Edition

Human Anatomy & Physiology Ninth Edition

PowerPoint® Lecture Slides prepared by Barbara Heard, Atlantic Cape Community College © 2013 Pearson Education, Inc. © Annie Leibovitz/Contact Press Images C H A P T E R 16 © 2013 Pearson Education, Inc. Endocrine System: Overview Acts with nervous system to coordinate and integrate activity of body cells Influences metabolic activities via hormones transported in blood Response slower but longer lasting than nervous system Endocrinology Study of hormones and endocrine organs © 2013 Pearson Education, Inc. © 2013 Pearson Education, Inc. Endocrine System: Overview Controls and integrates Reproduction Growth and development Maintenance of electrolyte, water, and nutrient balance of blood Regulation of cellular metabolism and energy balance Mobilization of body defenses © 2013 Pearson Education, Inc. © 2013 Pearson Education, Inc. Endocrine System: Overview Exocrine glands Nonhormonal substances (sweat, saliva) Have ducts to carry secretion to membrane surface Endocrine glands Produce hormones Lack ducts © 2013 Pearson Education, Inc. © 2013 Pearson Education, Inc. Endocrine System: Overview Endocrine glands: pituitary, thyroid, parathyroid, adrenal, and pineal glands Hypothalamus is neuroendocrine organ Some have exocrine and endocrine functions Pancreas, gonads, placenta Other tissues and organs that produce hormones Adipose cells, thymus, and cells in walls of small intestine, stomach, kidneys, and heart © 2013 Pearson Education, Inc. © 2013 Pearson Education, Inc. Figure 16.1 Location of selected endocrine organs of the body. Pineal gland Hypothalamus Pituitary gland Thyroid gland Parathyroid glands (on dorsal aspect of thyroid gland) Thymus Adrenal glands Pancreas Gonads • Testis (male) • Ovary (female) © 2013 Pearson Continue reading >>

Med Term Quiz4

Med Term Quiz4

Home > Preview Hormone produced by pancreatic alpha cells that increases the blood glucose level by stimulating the liver to change stored glycogen (a starch form of sugar) to glucose Relative constancy or balance in the internal environment of the body, maintained by processes of feedback and adjustment in response to external or internal changes Hormone produced by pancreatic beta cells that acts to remove sugar (glucose) from the blood by promoting its storage in tissues as carbohydrates (glycogen) * Ovaries - in females, stimulates egg production; increases secretion of estrogen * Hyposecretion causes failure of sexual maturation * Testes - in males, stimulates sperm production * Hypersecretion has no known significant effects * Bone, cartilage, liver, muscle, and other tissues - stimulates somatic growth; increases use of fats for energy * Hyposecretion in children causes pituitary dwarfism * Hypersecretion in children causes gigantism; hypersecretion in adults causes acromegaly * Ovaries - in females, promotes ovulation; stimulates production of estrogen and prgesterone * Testes - in males, promotes secretion of testosterone * Hyposecretion causes failure of sexual maturation * Hypersecretion has no known significant effects * Hyposecretion in nursing mothers causes poor lactation * Regulates calcium levels in the blood in conjunction with parathyroid hormone * Secreted when calcium levels in the blood are high in order to maintain homeostasis * The most significant effects are exerted in childhood when bones are growing and changing dramatically in mass, size, and shape * At best, calcitonin is a weak hypocalcemic agent in adults * Increases energy production from all food types * Increases rate of protein synthesis * Hyposecretion in infants causes cretinism; hy Continue reading >>

Common Disorders Of The Pituitary Gland: Hyposecretion Versus Hypersecretion.

Common Disorders Of The Pituitary Gland: Hyposecretion Versus Hypersecretion.

Abstract An understanding of pituitary disorders requires much more than a knowledge of the definitions associated with them. To grasp fully their complexity, one must recognize not only the powerful role the pituitary gland plays in the endocrine system, but also its effects on homeostasis throughout the entire human body, its association with the hypothalamus, and ultimately its associated end organs. Because of the many hormones stored or produced by the pituitary, associated disorders often are confusing and challenging. However, by simplifying the classification of these disorders into the categories of hyposecretion and hypersecretion, the understanding of pituitary disorders is made simple, and the associated interventions become apparent. Continue reading >>

8.01 Identify The General Functions Of The Endocrine System.

8.01 Identify The General Functions Of The Endocrine System.

The endocrine system is responsible for coordinating and regulating body cells, tissues, organs, and systems to maintain homeostasis by secreting chemicals known as hormones. Unlike the nervous system, the effects of the endocrine system are sustained and work for longer periods of time. The endocrine system works primarily on negative feedback mechanisms. 8.02 Describe a “hormone†and how it functions in the body. Hormones are chemical messengers released by one tissue (gland) and transported by the bloodstream to reach the target tissues. The target tissue is where the effect of the hormone actually occurs. Over 50 different hormones 8.02 Describe a “hormone†and how it functions in the body. Regulates chemical and volume of the body’s internal environment Regulates metabolism and energy balance Regulates contraction of cardiac and smooth muscle Regulates certain activities of the immune system Maintains homeostasis despite emergency environmental interruptions infection - trauma - starvation dehydration - hemorrhage emotional stress - temperature extremes Plays a role in normal growth and sequential development Contributes to the process of reproduction 8.03 Describe the locations, secretions, and functions of the major endocrine glands. Hypothalamus Pituitary Thyroid Parathyroid Thymus Pancreas Adrenals Gonads Testes Ovaries Pineal Thalamus Kidneys Liver Stomach Lungs Heart Small Intestine Skin Placenta 8.03 Hypothalamus Coordinates the Endocrine System activities to maintain Homeostasis A small portion of the diencephalon located below the thalamus partially protected by the sella turcica of the sphenoid bone One of the main regulators of homeostasis in the body production and secretion of hormones that control other Endocrine Glands Lack Continue reading >>

Chapter 13 Endocrine System

Chapter 13 Endocrine System

Thyroid-stimulating hormone (TSH) Stimulates thyroid gland to produce & secrete its own hormones, thyroxine & thriiodothyronine Target-Thyroid gland to stimulate secretion of thyroid hormone Hyposecretion- cretinism (infants) Hyposecrecretion- myxedema (Adults) Hypersecretion0- Graves Disease ANTERIOR PITUITARY Cretinism (TSH) Infants Mental retardation Impaired growth Low body temperature Abnormal bone formation Etiology: Hyposecretion of TSH (Anterior Pituitary Gland) I. Missing or poorly developed thyroid gland II. Pituitary gland does not stimulate the thyroid gland III. Thyroid hormones poorly formed or do not work STATE REQUIRES BLOOD WORK & REPORTS Myxedema (TSH) Hypothyroidism in adults Edema Low blood levels of T3 & T4 Weight gain Cold intolerance Fatigue Depression Muscle/joint pain Sluggishness (Name due to edemenous appearance of individual) ANTERIOR PITUITARY Graves Disease (TSH) Hyperthyroidism Excessive secretion of T3, T4 or both Elevated metabolic rate Abnormal weight loss Excessive perspiration Muscle weakness Emotional instability Exophthalmos- eyes protrude due to edema in the tissues behind the eyes ANTERIOR PITUITARY Cushing Disease Increases amount of cortisol, adrenocorticotropic hormone or both in blood Long-term steroid use Adrenal tumor Alters carbohydrate and protein metabolism Electrolyte imbalances Hyperglycemia Sodium retention Edema Weight gain Moon-shaped face Large abdomen and thin extremities Hypertension *Hirsutism* Tx: medications, radiation, surgery Antidiuretic Hormone (ADH) or Vasopressin Prevents excessive water loss Target- kidney to increase water reabsorption Hyposecretion: Diabetes Insipidus- decrease ADH causes increased urine output (NOT DIABETES I or II!) SOMETIMES CAUSED BY HEAD INJURY/INFECTION/TRAUMA/SURGERIES/MEDICATIO Continue reading >>

Reports In Endocrine Disorders: Open Access

Reports In Endocrine Disorders: Open Access

Reports in Endocrine Disorders: Open Access is an open access journal designed for the wide promulgation of research in this field. New developments in methodology and treatments are important resources for the research community. The main goal of the journal is to act as a platform for publication, gaining knowledge, exchange of opinions, and to promote research and publications worldwide. The journal scope embrace the knowledge in medical research of the topics related to diseases or disorders caused by the failure of endocrine system in arthropods. Introduction: Endocrinology is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions known as hormones. The endocrine system is the collection of glands of an organism that secrete hormones directly into the circulatory system. The major endocrine glands include the pineal gland, pituitary gland, pancreas, ovaries, testes, thyroid gland, parathyroid gland, and adrenal glands. The endocrine system involves a number of feedback mechanisms, so that often one hormone will control the action or release of another secondary hormone (such as thyroid hormone). If there is too much of the secondary hormone, it may provide negative feedback to the primary hormone, maintaining homeostasis. Endocrinology also involves study of the diseases of the endocrine system. These diseases may relate to too little or too much secretion and action of a hormone or problems with receiving the hormone. Types of disease (disorders) Subdivided into three groups: 1. Endocrine gland hypo secretion (leading to hormone deficiency). 2. Endocrine gland hyper secretion (leading to hormone excess). 3. Tumours (benign or malignant) of endocrine glands. Endocrine disorders are often quite complex, involvin Continue reading >>

Hyperglucagonemia

Hyperglucagonemia

Background Hyperglucagonemia is a state of excess glucagon secretion. In healthy individuals, insulin has a suppressive effect on alpha-cell function and on glucagon secretion. The most common cause of hyperglucagonemia is an absence or deficiency of the restraining influence of insulin on glucagon production. Although rare, hyperglucagonemia can be caused by an autonomous secretion of glucagon by a tumor of pancreatic alpha cells (glucagonoma syndrome). In 1942, Becker and colleagues described the first case report of what, in retrospect, appears to have been a classic presentation of glucagonoma syndrome. The patient presented with diabetes mellitus, weight loss, severe depression, and an unusual erythematous migratory skin rash associated with a malignant tumor of the pancreas of an unknown cell type. The patient later died, following an acute thrombosis of the left iliac vein. In 1965, glucagon was positively identified by radioimmunoassay (RIA) in the tumor and plasma of a patient who presented with symptoms similar to those of the patient from 1942. The patient also had a tumor of the pancreas, with metastasis to the liver. In 1974, in a review of a series of 9 patients who had necrolytic migratory erythema (NME), normochromic normocytic anemia, and diabetes mellitus, with markedly elevated glucagon levels (among other features), Mallinson and colleagues suggested that these findings constituted glucagonoma syndrome. [1, 2, 3, 4, 5, 6, 7, 8] Continue reading >>

Unit 8 Pathophys

Unit 8 Pathophys

Endocrine Alterations - Learning Objectives Question Answer What are the mechanisms of hormonal alterations? Hypersecretion or hyposecretion of various hormones; target cells failing to respond to hormones What are the causes of hypersecretion or hyposecretion of various hormones? Faulty feedback system, dysfunction of an endocrine gland, altered metabolism of hormones, or hormones are produced by nonendocrine tissues causing elevated levels What do alpha cells secrete? Glucagon What do beta cells secrete? Insulin Which hormone promotes glucose uptake (lowers glucose level in the blood)? Insulin Which hormone increases blood glucose by stimulating muscle glycogenolysis and gluconeogenesis and adipose tissue lipolysis? Glucagon What are classic symptoms of Type 1 and Type 2 diabetes mellitus? Polyuria, polydipsia, polyphagia How do cells compensate when they are not receiving glucose (due to insulin deficiency)? Lack of glucose in cells results in catabolism of fats and proteins. What usually results from cells catabolizing fats and proteins when they lack glucose? Leads to excessive amounts of fatty acids and their metabolites, known as ketones, in the blood (ketoacidosis). Diabetic ketoacidosis can result and is life-threatening. What type of diabetes has the possible complication of diabetic ketoacidosis? Type 1 What type of diabetes does hyperosmolar hyperglycemic nonketotic syndrome most often occur in? Type 2 The Somogyi effect is thought to be caused by what? Too much medication in the system at the wrong time (counterregulatory hormones are released in response to detected hypoglycemia, resulting in hyperglycemia). Describe the Dawn Phenomenon. Early morning rise in blood glucose concentration with no hypoglycemia during the night. It is related to nocturnal elev Continue reading >>

Chapter 14

Chapter 14

hormones affect although hormones travel throughout the body in blood and lymph, they only go to the target tissues or organs that have specific receptors for the hormone adenohypophysis hormones adrenocorticotropic hormone, follicle-stimulating hormone, growth hormone, luteinizing hormone, prolactin, and thyroid-stimulating hormone FSH ovaries- stimulates egg production and increases secretion of estrogen; testes- stimulates sperm production (follicle-stimulating hormone) TH function increases the rate of oxygen consumption and, thus, the rate at which carbohydrates, proteins, and fats are metabolized; also influences growth hormone and plays an important role in maintaining blood pressure calcitonin disorders the most significant effects are exerted in childhood when bones are growing and changing dramatically in mass, size, and shape; and also a hypocalcemic agent in adults sex hormones help maintain secondary sex characteristics, such as the development of the breasts in females and distribution of body hair in adults; includes androgens, estrogens, and progestins dysfunction not caused by a deficiency in the secretion of the adrenal medulla hormones because they merely intensify activities set into motion by the sympathetic nervous system insulin clears glucose molecules from the body by promoting their storage in tissues as carbohydrates when blood glucose levels are high (hyperglycemia), thereby lowering the blood glucose level and enabling the cells to use glucose for energy treatment for hyperthyroidism may involve drug therapy to block the production of thyroid hormones or surgical removal of all or part of the thyroid gland; administer a sufficient amount of radioactive iodine to destroy the thyroid secretory cells Addison disease clinical manifestations incl Continue reading >>

Shared Flashcard Set

Shared Flashcard Set

Details Title Endocrine Module Description Endocrine Module Total Cards 72 Subject Medical Level Undergraduate 3 Created 04/10/2012 Click here to study/print these flashcards. Create your own flash cards! Sign up here. Additional Medical Flashcards Cards Term Anterior Pituitary Definition 1. Thyroid Stimulating Hormone (TSH or thyrotropin) 2. Follicle Stimulating Hormone (FSH, a gonadotropin) 3. Luteinizing Hormone (LH, a gonadotropin) 4. Adrenocorticotropic Hormone (ACTH, or corticotropin) 5. Growth Hormone (GH) 6. Prolactin (PRL) Term Targets and Functions of the Anterior Pituitary Hormones Definition 1. TSH – target thyroid gland and stimulates secretion of thyroid hormone (TH). 2. FSH – targets follicles in the ovaries of females and stimulates growth of follicle and production of estrogen. In males it targets the testes and stimulates sperm cell production. 3. LH – targets follicle, triggers ovulation and increases secretion of progesterone. In males, it stimulates testosterone production. 4. ACTH – targets the adrenal cortex and causes the secretion of glucocorticoids. 5. GH - targets most bodily tissues and stimulates metabolism and growth of those tissues. 6. PRL - targets the breasts in females. Stimulates breast development and lactation. Of the six anterior pituitary hormones, four directly stimulate other endocrine glands and are known as tropic hormones (TSH, ACTH, FSH, LH). Term Posterior Pituitary Definition Targets and Functions of the Posterior Pituitary Hormones 1. ADH- antidiuretic hormone (vasopressin) – stimulates water reabsorption by kidneys. 2. Oxytocin – stimulates labor contractions during birth. Term Hormonal Regulation Definition Hypothalamic-Pituitary (hypophysis) Regulation • Controls many functions of several endocrine glands Continue reading >>

Endocrine Disorders – Outline Notes

Endocrine Disorders – Outline Notes

Hormones are chemical messengers. They are a major way in which our body communicates with itself. If our messages are unable to do their job, i.e. too much *hypersecretion or too little *hyposecretion, serious problems can result. The following are common endocrine disorders. Diabetes Mellitus (DM) -hyposecretion / hypoactivity of insulin -without insulin, glucose cannot enter most cells -without glucose in cells, the cells will turn to lipids for fuel -lipidemia – high lipid in blood -cells use lipids for fuel — byproduct is ketones (organic acids) -Ketoacidosis – high ketones will decrease pH – also see ketones in urine (ketonuria) 3 signs of Diabetes Mellitus 1. Polyuria – increased urine output -loss of electrolytes can lead to abdominal cramping 2. Polydipsia – increased thirst 3. polyphagia – increased hunger 2 types of DM 1. Type I diabetes mellitus / insulin-dependent DM / juvenile onset -symptoms appear suddenly before age 15 -autoimmune response destroying B-cells of pancreas for long period -no insulin produced -because of high lipidemia and cholesterol –vascular problems —atherosclerosis, strokes, MI, gangrene, blindness -neuropathies – loss of sensation, bladder functions, impotence 2. Type II diabetes mellitus / non-insulin DM / mature onset -after age of 40 usually -familial predisposition – hereditary -usually insulin receptors are not responding -obesity can also bring this on HORMONE Growth Hormone HYPOSECRETION (not enough); Dwarfism – children, HYPERSECRETION (too much); Gigantism – children; Acromegaly – adults; thickening of bony areas still sensitive to GH (hands, feet, face) Thyroid Stimulating Hormone and Thyroid Hormones HYPOSECRETION; Myxedema – aldults; decreased metabolism, lethargy; goiter – if from lack of Continue reading >>

Endocrine Disease

Endocrine Disease

Endocrine diseases are disorders of the endocrine system. The branch of medicine associated with endocrine disorders is known as endocrinology. Types of disease[edit] Broadly speaking, endocrine disorders may be subdivided into three groups:[1] Endocrine gland hyposecretion (leading to hormone deficiency) Endocrine gland hypersecretion (leading to hormone excess) Tumours (benign or malignant) of endocrine glands Endocrine disorders are often quite complex, involving a mixed picture of hyposecretion and hypersecretion because of the feedback mechanisms involved in the endocrine system. For example, most forms of hyperthyroidism are associated with an excess of thyroid hormone and a low level of thyroid stimulating hormone.[2] List of diseases[edit] Glucose homeostasis disorders[edit] Diabetes Type 1 Diabetes Type 2 Diabetes Gestational Diabetes Mature Onset Diabetes of the Young Hypoglycemia Idiopathic hypoglycemia Insulinoma Glucagonoma Thyroid disorders[edit] Goiter Hyperthyroidism Graves-Basedow disease Toxic multinodular goitre Hypothyroidism Thyroiditis Hashimoto's thyroiditis Thyroid cancer Thyroid hormone resistance Calcium homeostasis disorders and Metabolic bone disease[edit] Parathyroid gland disorders Primary hyperparathyroidism Secondary hyperparathyroidism Tertiary hyperparathyroidism Hypoparathyroidism Pseudohypoparathyroidism Osteoporosis Osteitis deformans (Paget's disease of bone) Rickets and osteomalacia Pituitary gland disorders[edit] Posterior pituitary[edit] Diabetes insipidus Anterior pituitary[edit] Hypopituitarism (or Panhypopituitarism) Pituitary tumors Pituitary adenomas Prolactinoma (or Hyperprolactinemia) Acromegaly, gigantism, dwarfism Cushing's disease Sex hormone disorders[edit] Disorders of sex development or intersex disorders Hermaphrodi Continue reading >>

Disorders Of Endocrine System

Disorders Of Endocrine System

Responsiveness of target cell to hormone depends on: 1- Plasma concentrations *Feedback mechanisms - hypo- and hyper-secretion of hormone (ex: thyroid) 2- Number of receptors *Down-regulation - desensitization – prolonged exposure of high levels of hormone -example: Grave’s disease (autoimmune – thyroid) *Up-regulation - Disorders of the Endocrine System Addison's disease Caused by hyposecretion of the hormones produced by the cortex of the adrenal gland Cretinism Condition resulting from a congenital deficiency of thyroid secretion or hypothyroidism Cushing’s syndrome Disorder that causes hyperactivity of the adrenal glands, which is triggered by the oversecretion of the pituitary hormone ACTH Diabetes insipidus From an acquired or inherited decrease in the antidiuretic hormone secreted by the pituitary Diabetes mellitus A disorder of carbohydrate, fat, and protein metabolism resulting from insufficient insulin production by the pancreas Dwarfism Results from hyposecretion of the growth hormone of the pituitary gland, which has been caused by a tumor, infection, genetic factors, or trauma Gigantism An excessive growth of the long bones caused by hypersecretion of the somatotropic hormone Graves’ disease Caused by hyperthyroidism or thyrotoxicosis Hyperparathyroidism Causes hypercalcemia, an increased calcium blood level Hypoglycemia Results from increased insulin production by the pancreas Hypoparathyroidism A decreased secretion of parathyroid hormone that causes tetany Hypothyroidism Also called Hashimoto's disease, results from an insufficient production of thyroxine I. Alterations of the hypothalamic - pituitary system Deficiency of hypothalamic hormones Variety of manifestations can be seen: - In adult women: menses cease- absenc Continue reading >>

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