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ENDOCRINE SYSTEM DISORDERS

Adrenal insufficiency

Introduction Adrenal insufficiency arises when the adrenal gland is destroyed by disease, or atrophies following pituitary failure or chronic corticosteroid use or abuse. In these situations, the amount of cortisol produced from the adrenal gland is insufficient to meet the body\’s needs during periods of physical and psychological stress or severe illness. The condition is …

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Hypothyroidism

Introduction Hypothyroidism is a condition associated with reduction in thyroid hormone production. Thyroid hormone is required for normal metabolism and growth. Its deficiency has major consequences on foetal development as well as intellectual and physical development in infants and children (cause of cretinism). In adults, it may be the cause of several problems including heart …

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Goitre

Introduction A goitre is a swelling of the front of the neck due to enlargement of the thyroid gland. It may affect persons of any age. Not all neck swellings are goitres. Goitres are usually benign but may occasionally be malignant. They could be associated with normal, reduced or excessive function of the thyroid gland. …

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Dyslipidaemia

Introduction There is ample evidence linking high blood cholesterol levels to Cardiovascular Disease (CVD) events, including myocardial infarction, strokes, and peripheral vascular disease. On the other hand, there is also evidence for significant reduction in morbidity and mortality from CVDs by reducing blood cholesterol levels in those at risk (primary prevention) and those who have …

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Treatment induced hypoglycaemia

Introduction Hypoglycaemia refers to a blood glucose level below 3.6 mmol/L. Treatment induced hypoglycaemia on the other hand refers to an established hypoglycaemia as a result of treatment. Hypoglycaemia is more common in elderly diabetics and those with kidney function impairment as well as those on long-acting oral anti-hyperglycaemic medications or insulin. Severe hypoglycaemia (blood …

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Diabetic Foot Problems

Introduction People with diabetes are at increased risk of foot ulcers and amputations which are major causes of morbidity and disability. Both foot ulcers and amputations can be prevented by education, anticipation, early recognition and prompt management. The most common predisposing factors for ulcers and amputations are: Peripheral neuropathy with loss of sensation Poor foot …

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Thyrotoxicosis

Introduction Thyrotoxicosis refers to the clinical, physiological and biochemical manifestation of the effect of excess thyroid hormone on tissues as opposed to hyperthyroidism which simply means hyperfunctioning of the thyroid gland. There is a female preponderance due to the role of autoimmunity in the aetiology. Causes of thyrotoxicosis Grave\’s disease (commonest cause) Toxic nodule Toxic …

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Cushing\’s Syndrome

Introduction Cushing\’s syndrome (CS) is a constellation of features associated with prolonged exposure to inappropriately high levels of plasma glucocorticoids. The most common cause of this is from exogenous glucocorticoid use. Endogenous causes of Cushing\’s syndrome are rare. Classification & causes of Cushing\’s Syndrome 1. ACTH-dependent Cushing\’s disease ectopic ACTH Syndrome macronodular Adrenal Hyperplasia 2. …

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Hyperthyroidism (Myxoedema)

Introduction Hypothyroidism refers to subnormal amounts of thyroid hormones in the circulation, and the clinical features associated with it. Aetiology May be primary or secondary Primary hypothyroidism is more common and: Is probably an autoimmune disease; which may occur as a sequel to Hashimoto\’s thyroiditis. Post therapeutic hypothyroidism (medical or surgical) Secondary hypothyroidism: Occurs when …

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Obesity

Introduction Overweight and obesity increase the risk for several diseases such as hypertension, ischaemic heart disease, and diabetes mellitus. Obesity results from an imbalance between energy intake and energy expenditure. However, more recent researches, have suggested that genetics, physiological and behavioural factors also play significant roles in the aetiology of obesity. Management of weight disorders …

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