Endocrine and Metabolic Disorders: Merck Manual Professional

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Endocrine and Metabolic Disorders

Principles of Endocrinology

Overview of the Endocrine System
	Hypothalamic-Pituitary Relationships
	Hypothalamic Controls
	Anterior Pituitary Function
		Adrenocorticotropic hormone (ACTH)
		Thyroid-stimulating hormone (TSH)
		Luteinizing hormone (LH) and follicle-stimulating hormone (FSH)
		Growth hormone (GH)
		Prolactin
		Other hormones
	Posterior Pituitary Function
		Antidiuretic hormone (ADH)
		Oxytocin
Endocrine Disorders
		Hyperfunction
		Hypofunction
	Laboratory Testing
	Treatment
	Aging and Endocrinology

Pituitary Disorders

Pituitary Lesions
		Empty sella syndrome
		Anterior lobe lesions
		Posterior lobe lesions
Generalized Hypopituitarism
	Symptoms and Signs
	Diagnosis
		Imaging tests
		Laboratory testing
	Treatment
Selective Pituitary Hormone Deficiencies
Hypopituitarism in Children Resulting in Short Stature
	Symptoms and Signs
	Diagnosis
	Treatment
Gigantism and Acromegaly
	Symptoms and Signs
		Pituitary gigantism
		Acromegaly
	Diagnosis
	Treatment
Galactorrhea
	Etiology
	Symptoms and Signs
	Diagnosis
	Treatment
Central Diabetes Insipidus
	Pathophysiology
	Etiology
		Primary CDI
		Secondary CDI
	Symptoms and Signs
	Diagnosis
		Psychogenic polydipsia
	Treatment

Thyroid Disorders

Overview of Thyroid Function
		Synthesis and Release of Thyroid Hormones
		Laboratory Testing of Thyroid Function
Approach to the Patient With a Thyroid Nodule
		Etiology
		Evaluation
			History
			Physical examination
			Testing
		Treatment
Euthyroid Sick Syndrome
		Diagnosis
		Treatment
Hashimoto's Thyroiditis
		Symptoms and Signs
		Diagnosis
		Treatment
Hyperthyroidism
		Etiology
		Pathophysiology
		Symptoms and Signs
			Thyroid storm
		Diagnosis
		Treatment
			Iodine
			Propylthiouracil and methimazole
			β-Blockers
			Radioactive sodium iodine (¹³¹I, radioiodine)
			Surgery
			Treatment of thyroid storm
			Treatment of infiltrative dermopathy and ophthalmopathy
	Subclinical Hyperthyroidism
Hypothyroidism
			Primary hypothyroidism
			Secondary hypothyroidism
		Symptoms and Signs
		Diagnosis
		Treatment
			Myxedema coma
	Subclinical Hypothyroidism
Silent Lymphocytic Thyroiditis
		Symptoms and Signs
		Diagnosis
		Treatment
Subacute Thyroiditis
		Symptoms and Signs
		Diagnosis
		Prognosis
		Treatment
Simple Nontoxic Goiter
		Symptoms and Signs
		Diagnosis
		Treatment
Thyroid Cancers
	Papillary Carcinoma
		Treatment
	Follicular Carcinoma
	Medullary Carcinoma
		Symptoms and Signs
		Diagnosis
		Treatment
	Anaplastic Carcinoma
	Radiation-Induced Thyroid Cancer

Adrenal Disorders

Overview of Adrenal Function
		Cortex
		Medulla
		Clinical syndromes
Addison's Disease
	Etiology
	Pathophysiology
		Mineralocorticoid deficiency
		Glucocorticoid deficiency
	Symptoms and Signs
		Adrenal crisis
	Diagnosis
		Differential diagnosis
		Testing
	Treatment
		Adrenal crisis
		Treatment of complications
Secondary Adrenal Insufficiency
	Symptoms and Signs
	Diagnosis
	Treatment
Adrenal Virilism
	Symptoms and Signs
	Diagnosis
	Treatment
Cushing's Syndrome
	Etiology
	Symptoms and Signs
	Diagnosis
	Treatment
Primary Aldosteronism
	Symptoms and Signs
	Diagnosis
	Treatment
Secondary Aldosteronism
Pheochromocytoma
	Symptoms and Signs
	Diagnosis
		Blood tests
		Urine tests
		Other tests
	Treatment
Nonfunctional Adrenal Masses
	Symptoms and Signs
	Diagnosis
	Treatment

Polyglandular Deficiency Syndromes

Polyglandular Deficiency Syndromes
		Etiology
		Pathophysiology
		Classification
			Type I
			Type II (Schmidt's syndrome)
			Type III
		Symptoms and Signs
		Diagnosis
		Treatment
	IPEX Syndrome
	POEMS Syndrome

Porphyrias Fluid Metabolism

Water and Sodium Balance
			Osmotic forces
			Water intake and excretion
Disorders of Fluid Volume
			Renin-angiotensin-aldosterone axis
			Other natriuretic factors
			Na depletion and excess
	Volume Depletion
		Symptoms and Signs
		Diagnosis
		Treatment
	Volume Overload

Electrolyte Disorders

Hyponatremia
		Etiology
			Hypovolemic hyponatremia
			Euvolemic hyponatremia
			Hypervolemic hyponatremia
			Hyponatremia in AIDS
		Symptoms and Signs
		Diagnosis
			Identification of the cause
		Treatment
			Mild hyponatremia
			Severe hyponatremia
			Osmotic demyelination syndrome
Hypernatremia
		Etiology
			Hypovolemic hypernatremia
			Euvolemic hypernatremia
			Hypervolemic hypernatremia
			Hypernatremia in the elderly
		Symptoms and Signs
		Diagnosis
		Treatment
Disorders of Potassium Concentration
			K shifts
			K metabolism
			False K concentrations
	Hypokalemia
		Etiology
			GI tract losses
			Intracellular shift
			Renal losses
			Drugs
		Symptoms and Signs
		Diagnosis
			ECG
			Diagnosis of cause
		Treatment
		Prevention
	Hyperkalemia
		Etiology
		Symptoms and Signs
		Diagnosis
			ECG
			Diagnosis of the cause
		Treatment
			Mild hyperkalemia
			Moderate to severe hyperkalemia
Disorders of Calcium Concentration
		Regulation of Calcium Metabolism
	Hypocalcemia
		Etiology
			Hypoparathyroidism
			Pseudohypoparathyroidism
			Vitamin D deficiency and dependency
			Renal disease
			Other causes
		Symptoms and Signs
			Neurologic manifestations
			Other manifestations
		Diagnosis
		Treatment
	Hypercalcemia
		Etiology
		Pathophysiology
		Symptoms and Signs
		Diagnosis
			Initial evaluation
			Hyperparathyroidism
			Cancer
			FHH
			Milk-alkali syndrome
			Other causes
		Treatment
			Mild hypercalcemia
			Moderate hypercalcemia
			Severe hypercalcemia
			Hyperparathyroidism
			FHH
Disorders of Phosphate Concentration
	Hypophosphatemia
		Etiology
		Symptoms and Signs
		Diagnosis
		Treatment
			Oral treatment
			Parenteral treatment
	Hyperphosphatemia
		Symptoms and Signs
		Diagnosis
		Treatment
Disorders of Magnesium Concentration
	Hypomagnesemia
		Symptoms and Signs
		Diagnosis
		Treatment
	Hypermagnesemia
		Diagnosis
		Treatment

Acid-Base Regulation and Disorders Diabetes Mellitus and Disorders of Carbohydrate Metabolism

Diabetes Mellitus (DM)
	Etiology
		Type 1
		Type 2
		Miscellaneous types
	Symptoms and Signs
	Complications
		Diabetic retinopathy
		Diabetic nephropathy
		Diabetic neuropathy
		Macrovascular disease
		Cardiomyopathy
		Infection
		Other complications
	Diagnosis
		Screening for disease
		Screening for complications
	Treatment
		Goals and methods
		Patient education
		Diet
		Exercise
		Monitoring
		Insulin
		Complications of insulin treatment
		Insulin regimens for type 1 DM
		Insulin regimens for type 2 DM
		Oral antihyperglycemic drugs
		Injectable antihyperglycemic drugs
		Other antihyperglycemic treatments
		Adjunctive treatments
	Special Populations and Settings
		Children
		Adolescents
		Hospitalization
		Surgery
	Prevention
		Type 1
		Type 2
		Complications
Diabetic Ketoacidosis (DKA)
	Pathophysiology
	Symptoms and Signs
	Diagnosis
	Prognosis
	Treatment
Nonketotic Hyperosmolar Syndrome (NKHS)
	Symptoms and Signs
	Diagnosis
	Treatment
Alcoholic Ketoacidosis
	Pathophysiology
	Symptoms and Signs
	Diagnosis
	Treatment
Hypoglycemia
	Etiology
	Symptoms and Signs
	Diagnosis
	Treatment

Lipid Disorders

Overview of Lipid Metabolism
		Physiology
			Exogenous (dietary) lipid metabolism
			Endogenous lipid metabolism
Dyslipidemia
		Classification
		Etiology
			Primary causes
			Secondary causes
		Symptoms and Signs
		Diagnosis
			Lipid profile measurement
			Other tests
			Secondary causes
			Screening
		Treatment
			General principles
			Elevated LDL cholesterol
			Elevated TGs
			Low HDL
			Elevated Lp(a)
			Secondary causes
			Monitoring treatment
	Elevated High-Density Lipoprotein Levels
Hypolipidemia
		Etiology
			Abetalipoproteinemia (Bassen-Kornzweig syndrome)
			Hypobetalipoproteinemia
			Chylomicron retention disease

Amyloidosis

Amyloidosis
	Etiology
		Primary amyloidosis (AL)
		Secondary amyloidosis (AA)
		Familial amyloidosis
		A β₂-microglobulin (dialysis-related) amyloidosis
		A β-protein amyloidosis
	Symptoms and Signs
	Diagnosis
	Prognosis
	Treatment

Carcinoid Tumors

	Overview of Carcinoid Tumors
	Carcinoid Syndrome
			Etiology
			Pathophysiology
			Symptoms and Signs
			Diagnosis
			Prognosis
			Treatment

Multiple Endocrine Neoplasia (MEN) Syndromes

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