Title Louisa Leone MD1 2023 Block 6 Endocrine Notes.pdf ✅

Louisa Leone - MD1 2023 - Block 6 (Endocrine) Notes 1 MD1 2023 Block 6 Endocrine Summaries Written by: Louisa Leone (SUMS Education Advocacy Officer 2024) Using a combination of SMP resources, and additional research and reading. These notes are based the teaching of the 2023 SMP MD1 Endocrine block, and as such, may reflect an outdated course or block structure. They were written for the purposes of personal study and as such may contain more or less information than what is needed. They are intended to supplement but not replace teaching in MD1 2024. The best guide as to what will be assessable in future iterations of the course is the up-to-date SMP content and learning outcomes. In any case – I hope you find these resources helpful for your learning. All the best with your studies – you’ve got this!

Louisa Leone - MD1 2023 - Block 6 (Endocrine) Notes 3 Androgen Problems ...................................................................................................................... 62 Insulinoma ..................................................................................................................................... 63 6.2.9 Metabolic Syndrome ................................................................................................................ 63 Traditional Cardiovascular Risk Score ......................................................................................... 63 New Risk Factors .......................................................................................................................... 63 The Randle Cycle – Metabolic Consequences of Energy Excess ................................................. 63 Why is Hyperglycaemia Bad? ....................................................................................................... 64 Dyslipidaemia ............................................................................................................................... 64 Triglyceridaemia ........................................................................................................................... 64 Dietary Interventions .................................................................................................................... 65 PCSK9 Inhibitors .......................................................................................................................... 65 Fibrates .......................................................................................................................................... 66 6.2.10 Obesity, Weight Loss and Pre-Diabetes ................................................................................. 67 Introduction to Obesity ................................................................................................................. 67 Assessment of Patients with Obesity ............................................................................................ 68 Management of Obesity ................................................................................................................ 69 Obesity Pharmacotherapy ............................................................................................................. 70 Predictors of Long-Term Weight Loss Success ............................................................................ 73 Outlook on Obesity Management ................................................................................................. 73 6.2.11 Management of T1D and T2D in Ambulatory Care ............................................................... 74 Case 1: Type 1 Diabetes ................................................................................................................ 74 Case 2: Type 2 Diabetes ................................................................................................................ 74 Case 3: MODY 3 (HNF1A-MODY) ............................................................................................. 75 Case 4: Hyperglycaemic Hyperosmolar Syndrome ...................................................................... 76 6.2.12 Metabolic and Molecular Determinants of Ageing ................................................................ 78 Week 6.3 The HPA Axis ........................................................................................................................ 79 6.3.1 Understanding Diabetes in Aboriginal and Torres Strait Islander Populations ........................ 79 Sociocultural Determinants of Health ........................................................................................... 79 Complications and Co-Morbidities ............................................................................................... 79 Prevention and Management ......................................................................................................... 79 Diabetes Policies and Strategies ................................................................................................... 80 Models of Care at the Primary Healthcare Setting ........................................................................ 80 Conclusion .................................................................................................................................... 80 6.3.2 Physiology of the HPA Axis ..................................................................................................... 81 Six Classes of Steroid Hormones .................................................................................................. 81 Steroid Biosynthesis ...................................................................................................................... 81 The Adrenal Gland ........................................................................................................................ 82
Louisa Leone - MD1 2023 - Block 6 (Endocrine) Notes 4 The HPA Axis ................................................................................................................................ 82 ACTH ............................................................................................................................................ 83 Cortisol .......................................................................................................................................... 83 The Hypothalamus ........................................................................................................................ 85 The Hypothalamic Hypophyseal Portal System ........................................................................... 85 Anterior Pituitary Hormones ......................................................................................................... 85 The Posterior Pituitary .................................................................................................................. 86 6.3.3 Anatomy of the Liver, Spleen, and Pancreas ........................................................................... 88 The Liver ....................................................................................................................................... 88 The Extrahepatic Biliary System .................................................................................................. 89 The Pancreas ................................................................................................................................. 90 Spleen ............................................................................................................................................ 90 6.3.4 Pituitary Clinical Cases ............................................................................................................ 92 6.3.5 Clinical Syndromes of Adrenal Excess and Deficiencies ........................................................ 94 6.3.6 Pathology of the Pituitary Gland .............................................................................................. 96 Classification of Pituitary Pathology ............................................................................................ 96 Pituitary Adenomas (PitNETs) ...................................................................................................... 96 Pituitary Apoplexy ........................................................................................................................ 97 Craniopharyngioma ....................................................................................................................... 97 Week 6.4 The HPG Axis ....................................................................................................................... 99 6.4.1 Anatomy of the Breast.............................................................................................................. 99 External and Internal Features ...................................................................................................... 99 Functional Unit of the Breast ...................................................................................................... 100 Blood Supply of the Breast ......................................................................................................... 100 Lymphatic Drainage .................................................................................................................... 101 Innervation of the Breast ............................................................................................................. 101 6.4.2 Physiology of the HPG Axis .................................................................................................. 102 Overview of the HPG Axis ......................................................................................................... 102 The HPG Axis in Males .............................................................................................................. 102 The HPG Axis in Females ........................................................................................................... 102 6.4.3 Physiology of the Female Reproductive System and Pregnancy ........................................... 105 Meiosis: Gametogenesis in Females ........................................................................................... 105 Structure of the Mammalian Ovary and Growth of Ovarian Follicles ........................................ 105 Fertilisation ................................................................................................................................. 106 Early Embryonic Development ................................................................................................... 108 Physiology of Pregnancy and Maternal Adaptations .................................................................. 110 6.4.4 Pharmacology – Contraceptives............................................................................................. 115