11

General Functions of HormonesGeneral Functions of HormonesFigure 11.2 page 278Figure 11.2 page 278

A.A. Help regulate:Help regulate:1.1. extracellular fluidextracellular fluid2.2. metabolismmetabolism3.3. biological clockbiological clock4.4. contraction of cardiac & contraction of cardiac &

smooth musclesmooth muscle5.5. glandular secretionglandular secretion6.6. some immune functionssome immune functions

B.B. Growth & developmentGrowth & developmentC.C. ReproductionReproduction

22

Types of Endocrine GlandsTypes of Endocrine GlandsA.A. Exocrine glandsExocrine glands

1.1. secrete products into ducts which empty into body secrete products into ducts which empty into body cavities or body surfacecavities or body surface

a)a) sweat, oil, mucous, & digestive glandssweat, oil, mucous, & digestive glands

B.B. Endocrine glandsEndocrine glands1.1. secrete products (hormones) into bloodstreamsecrete products (hormones) into bloodstream

a)a) pituitary, thyroid, parathyroid, adrenal, pinealpituitary, thyroid, parathyroid, adrenal, pineal

2.2. other organs secrete hormones as a 2nd functionother organs secrete hormones as a 2nd functiona)a) hypothalamus, thymus, pancreas,ovaries,testes, kidneys, hypothalamus, thymus, pancreas,ovaries,testes, kidneys,

stomach, liver, small intestine, skin, heart & placentastomach, liver, small intestine, skin, heart & placenta

33

Hormone ReceptorsHormone Receptors

A.A. Hormones only affect target cells with specific Hormones only affect target cells with specific membrane proteins called receptorsmembrane proteins called receptors

44

Steroid HormonesSteroid HormonesA.A. SteroidsSteroids

1.1. lipids derived from lipids derived from cholesterol cholesterol

2.2. different functional different functional groups attached to core groups attached to core of structure provide of structure provide uniquenessuniqueness

3.3. Lipid-solubleLipid-soluble

55

Nonsteroid HormonesNonsteroid HormonesA.A. Amine, peptide and Amine, peptide and

protein hormonesprotein hormones1.1. modified amino acids or modified amino acids or

amino acids put togetheramino acids put together2.2. e.g. serotonin, melatonin, e.g. serotonin, melatonin,

histamine, epinephrine and histamine, epinephrine and some glycoproteinssome glycoproteins

B.B. EicosanoidsEicosanoids1.1. derived from arachidonic derived from arachidonic

acid (fatty acid)acid (fatty acid)2.2. prostaglandins or prostaglandins or

leukotrienesleukotrienes

66

Action of Steroid HormonesAction of Steroid HormonesFigure 11.3; page 279Figure 11.3; page 279

1.1. Hormone diffuses Hormone diffuses through phospholipid through phospholipid bilayer into cell bilayer into cell

2.2. Binds to receptor, w/in Binds to receptor, w/in nucleus, turning on/off nucleus, turning on/off specific genesspecific genes

3.3. New mRNA is formed New mRNA is formed & directs synthesis of & directs synthesis of new proteinsnew proteins

4.4. New protein alters New protein alters cell’s activitycell’s activity

77

Action of Nonsteroid HormonesAction of Nonsteroid HormonesFigure 11.4; page 280Figure 11.4; page 280

1.1. Can not diffuse through Can not diffuse through plasma membraneplasma membrane

2.2. Hormone receptors are Hormone receptors are integral membrane proteins integral membrane proteins

a)a) act as first messengeract as first messenger

3.3. Receptor protein activates Receptor protein activates G-protein in membrane G-protein in membrane

4.4. G-protein activates adenylate G-protein activates adenylate cyclase to convert ATP to cyclase to convert ATP to cAMP in the cytosolcAMP in the cytosol

88

Water-soluble Hormones (2)Water-soluble Hormones (2)5.5. Cyclic AMP is the 2nd Cyclic AMP is the 2nd

messengermessenger6.6. Activates kinases in the Activates kinases in the

cytosol to speed up/slow cytosol to speed up/slow down physiological down physiological responsesresponses

7.7. Phosphodiesterase Phosphodiesterase inactivates cAMP inactivates cAMP quicklyquickly

8.8. Cell response is turned Cell response is turned off unless new hormone off unless new hormone molecules arrivemolecules arrive

99

Cholera Toxin and G ProteinsCholera Toxin and G Proteins1.1. Toxin is deadly because it produces massive Toxin is deadly because it produces massive

watery diarrhea and person dies from watery diarrhea and person dies from dehydrationdehydration

2.2. Toxin of cholera bacteria causes G-protein to Toxin of cholera bacteria causes G-protein to lock in activated state in intestinal epitheliumlock in activated state in intestinal epithelium

3.3. Cyclic AMP causes intestinal cells to actively Cyclic AMP causes intestinal cells to actively transport chloride (Na+ and water follow) into transport chloride (Na+ and water follow) into the lumenthe lumen

4.4. Person dies unless ions and fluids are replaced Person dies unless ions and fluids are replaced & receive antibiotic treatment& receive antibiotic treatment

1010

Control of Hormone SecretionControl of Hormone SecretionA.A. Regulated by signals from nervous Regulated by signals from nervous

system, chemical changes in the blood or system, chemical changes in the blood or by other hormonesby other hormones

B.B. Negative feedback control (most Negative feedback control (most common)common)

1.1. decrease/increase in blood level is reverseddecrease/increase in blood level is reversedC.C. Positive feedback controlPositive feedback control

1.1. the change produced by the hormone causes the change produced by the hormone causes more hormone to be releasedmore hormone to be released

D.D. Disorders involve either hyposecretion or Disorders involve either hyposecretion or hypersecretion of a hormonehypersecretion of a hormone

1111

Gland Overview and Experts Gland Overview and Experts Gallery TourGallery Tour

Overview: male and female postersOverview: male and female posters Gallery Tour: expert brochures and Gallery Tour: expert brochures and

presentations presentations

1212

Overview GuidelinesOverview Guidelines

Male/ Female posters need...Male/ Female posters need...– Correct anatomical drawings and locations of Correct anatomical drawings and locations of

the endocrine glandsthe endocrine glands– Listing of hormones produced by each glandListing of hormones produced by each gland

1313

Experts Gallery TourExperts Gallery Tour Each group will be assigned a particular glandEach group will be assigned a particular gland A brochure must be produced that is visually A brochure must be produced that is visually

appealing and provides the following appealing and provides the following information…information…– Anatomy details of the glandAnatomy details of the gland– Key hormones produced and the physiology of how Key hormones produced and the physiology of how

they functionthey function– Control mechanism(s) for the hormoneControl mechanism(s) for the hormone– Medical conditions associated with the hormoneMedical conditions associated with the hormone

1414

Negative Feedback SystemsNegative Feedback Systems

1.1. Decrease in blood Decrease in blood levelslevels

2.2. Receptors in Receptors in hypothalamus & hypothalamus & thyroidthyroid

3.3. Cells activated to Cells activated to secrete more TSH or secrete more TSH or more T3 & T4more T3 & T4

4.4. Blood levels increaseBlood levels increase

1515

Positive FeedbackPositive Feedback

1.1. Oxytocin stimulates Oxytocin stimulates uterine contractionsuterine contractions

2.2. Uterine contractions Uterine contractions stimulate oxytocin stimulate oxytocin releaserelease

1616

Pituitary Gland Pituitary Gland (Figure 11.7; page 298)(Figure 11.7; page 298)

A.A. Two parts: anterior and posteriorTwo parts: anterior and posteriorB.B. Anterior lobe controlled by hypothalamic hormonesAnterior lobe controlled by hypothalamic hormonesC.C. Posterior lobe controlled by nerve endings from the Posterior lobe controlled by nerve endings from the

hypothalamushypothalamus

1717

Human Growth HormoneHuman Growth Hormone1.1. Within target cells increases synthesis of Within target cells increases synthesis of

insulin-like growth factors that act locally or insulin-like growth factors that act locally or enter bloodstreamenter bloodstream

a)a) common target cells are liver, skeletal muscle, common target cells are liver, skeletal muscle, cartilage and bonecartilage and bone

b)b) increases cell growth & cell division by increasing increases cell growth & cell division by increasing their uptake of amino acids & synthesis of proteinstheir uptake of amino acids & synthesis of proteins

c)c) retard use of glucose for ATP production so blood retard use of glucose for ATP production so blood glucose levels remain high enough to supply brainglucose levels remain high enough to supply brain

d)d) Know dwarfism vs gigantismKnow dwarfism vs gigantism

1818

Regulation of hGHRegulation of hGHa)a) Low blood sugar stimulates Low blood sugar stimulates

release of GHRH from release of GHRH from hypothalamushypothalamus

anterior pituitary releases more anterior pituitary releases more hGH, more glycogen broken hGH, more glycogen broken down into glucose by liver cellsdown into glucose by liver cells

b)b) High blood sugar stimulates High blood sugar stimulates release of GHIH from release of GHIH from hypothalamushypothalamus

less hGH from anterior less hGH from anterior pituitary, glycogen does not pituitary, glycogen does not breakdown into glucosebreakdown into glucose

1919

Thyroid Stimulating Hormone (TSH)Thyroid Stimulating Hormone (TSH)

1.1. Hypothalamus regulates thyrotroph cellsHypothalamus regulates thyrotroph cells2.2. Thyrotroph cells produce TSHThyrotroph cells produce TSH3.3. TSH stimulates the synthesis & secretion of TSH stimulates the synthesis & secretion of

T3 and T4T3 and T44.4. Metabolic rate stimulatedMetabolic rate stimulated

2020

Follicle Stimulating Hormone (FSH)Follicle Stimulating Hormone (FSH)

1.1. FSH functions FSH functions a)a) initiates the formation of follicles within the ovaryinitiates the formation of follicles within the ovaryb)b) stimulates follicle cells to secrete estrogenstimulates follicle cells to secrete estrogenc)c) stimulates sperm production in testesstimulates sperm production in testes

2121

Luteinizing Hormone (LH)Luteinizing Hormone (LH)

1.1. In females, LH stimulatesIn females, LH stimulatesa)a) secretion of estrogensecretion of estrogenb)b) ovulation of 2nd oocyte from ovaryovulation of 2nd oocyte from ovaryc)c) formation of corpus luteumformation of corpus luteumd)d) secretion of progesteronesecretion of progesterone

2.2. In males, stimulates In males, stimulates interstitial cells to secrete interstitial cells to secrete testosteronetestosterone

2222

Prolactin (PRL)Prolactin (PRL)1.1. Under right conditions, prolactin causes Under right conditions, prolactin causes

milk productionmilk production2.2. Suckling reduces levels of Suckling reduces levels of

hypothalamic inhibition and prolactin hypothalamic inhibition and prolactin levels rise along with milk productionlevels rise along with milk production

3.3. Nursing ceases & milk Nursing ceases & milk production slowsproduction slows

2323

Adrenocorticotrophic Adrenocorticotrophic HormoneHormone

1.1. ACTH stimulates cells ACTH stimulates cells of the adrenal cortex that of the adrenal cortex that produce glucocorticoidsproduce glucocorticoids

2.2. Regulated by Regulated by Corticotropin releasing Corticotropin releasing hormone.hormone.

3.3. Stress causes the Stress causes the increase release of CRHincrease release of CRH

2424

Melanocyte-Stimulating HormoneMelanocyte-Stimulating Hormone1.1. During fetal development in a spot between During fetal development in a spot between

anterior and posterior pituitary (intermediate anterior and posterior pituitary (intermediate lobe).lobe).

2.2. Function is to increase melanin production.Function is to increase melanin production.3.3. Intermediate lobe atrophies as you get older.Intermediate lobe atrophies as you get older.

2525

Posterior Pituitary Gland (Neurohypophysis)Posterior Pituitary Gland (Neurohypophysis)

A.A. Consists of axon Consists of axon terminals of terminals of hypothalamic neurons hypothalamic neurons

B.B. Neurons release two Neurons release two hormones that enter hormones that enter blood streamblood stream

1.1. antidiuretic hormone antidiuretic hormone (ADH)(ADH)

2.2. Oxytocin (OT)Oxytocin (OT)

2626

OxytocinOxytocin1.1. Two target tissues both involved in neuroendocrine Two target tissues both involved in neuroendocrine

reflexesreflexes2.2. During deliveryDuring delivery

a)a) baby’s head stretches cervixbaby’s head stretches cervixb)b) hormone release enhances hormone release enhances

uterine muscle contractionuterine muscle contractionc)c) baby & placenta are deliveredbaby & placenta are delivered

3.3. After deliveryAfter deliverya)a) suckling & hearing baby’s cry stimulates milk ejectionsuckling & hearing baby’s cry stimulates milk ejectionb)b) hormone causes muscle contraction & milk ejectionhormone causes muscle contraction & milk ejection

2727

Antidiuretic Hormone (ADH)Antidiuretic Hormone (ADH)

1.1. Known as vasopressinKnown as vasopressin2.2. FunctionsFunctions

a)a) decrease urine decrease urine productionproduction

b)b) decrease sweatingdecrease sweatingc)c) increase BPincrease BP

2828

Thyroid Gland Thyroid Gland ((Figure 11.9a; page 301)Figure 11.9a; page 301)

A.A. On each side of trachea is lobe of thyroidOn each side of trachea is lobe of thyroidB.B. Weighs 1 oz & has rich blood supplyWeighs 1 oz & has rich blood supply

2929

Histology of Thyroid GlandHistology of Thyroid Gland

A.A. Follicle = sac of stored Follicle = sac of stored hormone (colloid) hormone (colloid) surrounded by follicle surrounded by follicle cells that produced itcells that produced it

1.1. T3 & T4T3 & T4

B.B. Inactive cells are shortInactive cells are shortC.C. In between cells called In between cells called

parafollicular cellsparafollicular cells1.1. produce calcitoninproduce calcitonin

3030

Photomicrograph of Thyroid GlandPhotomicrograph of Thyroid Gland

3131

Actions of Thyroid Actions of Thyroid HormonesHormones

1.1. T3 & T4 = thyroid hormones T3 & T4 = thyroid hormones responsible for our metabolic responsible for our metabolic rate, synthesis of protein, rate, synthesis of protein, breakdown of fats, use of breakdown of fats, use of glucose for ATP productionglucose for ATP production

2.2. Calcitonin = responsible for Calcitonin = responsible for building of bone & stops building of bone & stops reabsorption of bone (lower reabsorption of bone (lower blood levels of Calcium)blood levels of Calcium)

3232

Control of T3 & T4 Control of T3 & T4 Secretion Secretion

1.1. Negative feedback Negative feedback systemsystem

2.2. Low blood levels of Low blood levels of hormones stimulate hormones stimulate hypothalamushypothalamus

3.3. It stimulates pituitary It stimulates pituitary to release TSHto release TSH

4.4. TSH stimulates gland TSH stimulates gland to raise blood levelsto raise blood levels

3333

Parathyroid GlandsParathyroid Glands

A.A. 4 pea-sized glands found on back of thyroid gland4 pea-sized glands found on back of thyroid gland

3434

Histology of Parathyroid GlandHistology of Parathyroid Gland

1.1. Principal cells Principal cells produce produce parathyroid parathyroid hormone (PTH)hormone (PTH)

2.2. Oxyphil cell’s Oxyphil cell’s function is function is unknownunknown

3535

Parathyroid HormoneParathyroid Hormone

1.1. Raise blood calcium levelsRaise blood calcium levelsa)a) increase activity of osteoclastsincrease activity of osteoclastsb)b) increases reabsorption of Caincreases reabsorption of Ca+2+2 by kidney by kidneyc)c) inhibits reabsorption of phosphate (HPOinhibits reabsorption of phosphate (HPO44) ) -2-2

d)d) promote formation of calcitriol (vitamin D3) promote formation of calcitriol (vitamin D3) by kidney which increases absorption of Caby kidney which increases absorption of Ca+2+2 and Mgand Mg+2+2 by intestinal tract by intestinal tract

2.2. Opposite function of calcitoninOpposite function of calcitonin

3636

Adrenal GlandsAdrenal Glands

A.A. General Info:General Info:1.1. One on top of each kidneyOne on top of each kidney2.2. 3 x 3 x 1 cm in size and weighs 5 grams3 x 3 x 1 cm in size and weighs 5 grams3.3. Cortex produces 3 different types of hormones from 3 zones Cortex produces 3 different types of hormones from 3 zones

of cortexof cortex4.4. Medulla produces epinephrine & norepinephrineMedulla produces epinephrine & norepinephrine

3737

Structure of Adrenal GlandStructure of Adrenal GlandFigure 11.12(a); page 305Figure 11.12(a); page 305

3838

Adrenal Cortex: Adrenal Cortex: MineralocorticoidsMineralocorticoids

1.1. 95% of hormonal activity due to aldosterone95% of hormonal activity due to aldosterone2.2. FunctionsFunctions

a)a) increase reabsorption of Naincrease reabsorption of Na++ with Cl with Cl-- , bicarbonate and water , bicarbonate and water following itfollowing it

b)b) promotes excretion of Kpromotes excretion of K++ and H and H++

3.3. Hypersecretion = tumor producing aldosteronismHypersecretion = tumor producing aldosteronisma)a) high blood pressure caused by retention of Nahigh blood pressure caused by retention of Na++ and water in and water in

bloodblood

3939

Adrenal Cortex: GlucocorticoidsAdrenal Cortex: Glucocorticoids1.1. 95% of hormonal activity is due to cortisol95% of hormonal activity is due to cortisol2.2. Functions = help regulate metabolism Functions = help regulate metabolism

a)a) increase rate of protein catabolism & lipolysisincrease rate of protein catabolism & lipolysisb)b) conversion of amino & fatty acids to glucoseconversion of amino & fatty acids to glucosec)c) provide resistance to stress by making provide resistance to stress by making

nutrients available for ATP productionnutrients available for ATP productiond)d) raise BP by vasoconstrictionraise BP by vasoconstrictione)e) anti-inflammatory effects reduced (skin anti-inflammatory effects reduced (skin

cream)cream)• reduce release of histamine from mast cellsreduce release of histamine from mast cells• decrease capillary permeabilitydecrease capillary permeability• depress phagocytosisdepress phagocytosis

4040

Adrenal Sex HormonesAdrenal Sex Hormones

1.1. Small amount of male hormone Small amount of male hormone (androgen) produced.(androgen) produced.

a)a) may stimulate increase of sex hormones by may stimulate increase of sex hormones by gonads.gonads.

b)b) may contribute to sex drive in females.may contribute to sex drive in females.c)c) is converted to estrogen in postmenopausal is converted to estrogen in postmenopausal

females.females.

4141

Adrenal MedullaAdrenal MedullaA.A. Produce epinephrine & norepinephrineProduce epinephrine & norepinephrineB.B. Hormones are sympathomimeticHormones are sympathomimetic

1.1. effects mimic those of sympathetic NSeffects mimic those of sympathetic NS2.2. cause fight-flight behaviorcause fight-flight behavior

C.C. Acetylcholine increase hormone Acetylcholine increase hormone secretion by adrenal medullasecretion by adrenal medulla

4242

Anatomy of Pancreas:Anatomy of Pancreas:Figure 11.14; page 308Figure 11.14; page 308

A.A. Cells (99%) in acini produce digestive enzymesCells (99%) in acini produce digestive enzymesB.B. Endocrine cells in pancreatic islets produce hormonesEndocrine cells in pancreatic islets produce hormones

4343

Cell Organization in PancreasCell Organization in Pancreas

Exocrine acinar cells surround a small ductExocrine acinar cells surround a small duct Endocrine cells secrete near a capillaryEndocrine cells secrete near a capillary

4444

Cell Types in the Pancreatic IsletsCell Types in the Pancreatic Islets

1.1. Alpha cells (20%) produce glucagonAlpha cells (20%) produce glucagona)a) What are the effects?What are the effects?b)b) How are secretions controlled?How are secretions controlled?

2.2. Beta cells (70%) produce insulinBeta cells (70%) produce insulina)a) What are the effects?What are the effects?b)b) How are secretions controlled?How are secretions controlled?

4545

Regulation of Glucagon & Insulin SecretionRegulation of Glucagon & Insulin Secretion

1.1. Low blood glucose Low blood glucose stimulates release of stimulates release of glucagonglucagon

2.2. High blood glucose High blood glucose stimulates secretion stimulates secretion of insulinof insulin

4646

Ovaries and TestesOvaries and TestesA.A. OvariesOvaries

1.1. estrogen, progesterone, relaxin & inhibinestrogen, progesterone, relaxin & inhibin2.2. regulate reproductive cycle, maintain pregnancy & regulate reproductive cycle, maintain pregnancy &

prepare mammary glands for lactationprepare mammary glands for lactation

B.B. TestesTestes1.1. produce testosteroneproduce testosterone2.2. regulate sperm production & 2nd sexual regulate sperm production & 2nd sexual

characteristicscharacteristics

4747

Pineal GlandPineal Gland

A.A. Small gland attached to 3rd Small gland attached to 3rd ventricle of brainventricle of brain

B.B. Produces melatoninProduces melatonin1.1. Melatonin responsible for setting Melatonin responsible for setting

of biological clockof biological clock2.2. Jet lag & SAD treatment is bright Jet lag & SAD treatment is bright

lightlight

4848

Effect of Light on Pineal GlandEffect of Light on Pineal Gland

1.1. Melatonin secretion producing sleepiness occurs Melatonin secretion producing sleepiness occurs during darkness due to lack of stimulation from during darkness due to lack of stimulation from sympathetic ganglionsympathetic ganglion

4949

Thymus GlandThymus Gland

A.A. Important role in maturation of T cellsImportant role in maturation of T cellsB.B. Hormones produced by gland promote the Hormones produced by gland promote the

proliferation & maturation of T cellsproliferation & maturation of T cells1.1. thymosinthymosin2.2. thymic humoral factorthymic humoral factor3.3. thymic factorthymic factor4.4. thymopoietinthymopoietin

5050

Miscellaneous Hormones Miscellaneous Hormones EicosanoidsEicosanoids

A.A. Local hormones released by all body cellsLocal hormones released by all body cells1.1. Leukotrienes influence WBCs & inflammationLeukotrienes influence WBCs & inflammation2.2. Prostaglandins alterProstaglandins alter

a)a) smooth muscle contraction (uterus & intestines), smooth muscle contraction (uterus & intestines), smooth muscle relaxation (lungs and blood vessels), smooth muscle relaxation (lungs and blood vessels), glandular secretion, blood flow, platelet function, nerve glandular secretion, blood flow, platelet function, nerve transmission, metabolism etc.transmission, metabolism etc.

b)b) Ibuprofen & other nonsteroidal anti-inflammatory Ibuprofen & other nonsteroidal anti-inflammatory drugs treat pain, fever & inflammation by inhibiting drugs treat pain, fever & inflammation by inhibiting prostaglandin synthesisprostaglandin synthesis

3.3. Erythropoietin (kidney) stimulate RBC productionErythropoietin (kidney) stimulate RBC production

5151

Pituitary Gland DisordersPituitary Gland Disorders

A.A. Hyposecretion during childhood = pituitary Hyposecretion during childhood = pituitary dwarfism (proportional, childlike body)dwarfism (proportional, childlike body)

B.B. Hypersecretion during childhood = giantismHypersecretion during childhood = giantism1.1. very tall, normal proportionsvery tall, normal proportions

C.C. Hypersecretion as adult = acromegalyHypersecretion as adult = acromegaly1.1. growth of hands, feet, facial features & thickening growth of hands, feet, facial features & thickening

of skinof skin

5252

Thyroid Gland DisordersThyroid Gland DisordersA.A. Hyposecretion during infancy results in Hyposecretion during infancy results in

dwarfism & retardation called dwarfism & retardation called cretinismcretinismB.B. Hypothyroidism in adult produces Hypothyroidism in adult produces

sensitivity to cold, low body temp. weight sensitivity to cold, low body temp. weight gain & mental dullnessgain & mental dullness

C.C. Hyperthyroidism (Grave’s disease)Hyperthyroidism (Grave’s disease)1.1. weight loss, nervousness, tremor & weight loss, nervousness, tremor &

exophthalmos (edema behind eyes)exophthalmos (edema behind eyes)

D.D. Goiter = enlarged thyroid (dietary)Goiter = enlarged thyroid (dietary)

5353

Goiter

5454

Cushing’s SyndromeCushing’s Syndrome

A.A. Hypersecretion of glucocorticoidsHypersecretion of glucocorticoidsB.B. Redistribution of fat, spindly arms & Redistribution of fat, spindly arms &

legs due to muscle losslegs due to muscle lossC.C. Wound healing is poor, bruise easilyWound healing is poor, bruise easily

5555

Addison’s diseaseAddison’s disease

A.A. Hypersecretion of glucocorticoidsHypersecretion of glucocorticoids1.1. hypoglycemia, muscle weakness, low hypoglycemia, muscle weakness, low

BP, dehydration due to decreased NaBP, dehydration due to decreased Na++ in bloodin blood

2.2. mimics skin darkening effects of MSHmimics skin darkening effects of MSH3.3. potential cardiac arrestpotential cardiac arrest

5656

Diabetes Mellitus & HyperinsulinismDiabetes Mellitus & Hyperinsulinism

A.A. Diabetes mellitus marked by hyperglycemiaDiabetes mellitus marked by hyperglycemia1.1. excessive urine production (polyuria)excessive urine production (polyuria)2.2. excessive thirst (polydipsia)excessive thirst (polydipsia)3.3. excessive eating (polyphagia)excessive eating (polyphagia)

B.B. Type I----deficiency of insulin (under 20)Type I----deficiency of insulin (under 20)C.C. Type II---adult onsetType II---adult onset

1.1. drug stimulates secretion of insulin by beta cellsdrug stimulates secretion of insulin by beta cells2.2. cells may be less sensitive to hormonecells may be less sensitive to hormone