Block 7
Endocrinology
(and Sexual Health)
1|P a g e
,TABLE OF CONTENTS
Week 1: Hypo and Hyper thyroidism ......................................................................................................................................... 5
Skull and pituitary fossa ............................................................................................................................................................. 6
Anxiety ........................................................................................................................................................................................ 10
Endocrine system: A Functional overview ............................................................................................................................. 12
Introduction to Pt-Dr Endocrinology ...................................................................................................................................... 14
Thyroid hormones ..................................................................................................................................................................... 17
Autoimmunity in endocrine diseases ..................................................................................................................................... 19
Seminar: Endocrine testing ....................................................................................................................................................... 21
Energy and heat production ..................................................................................................................................................... 22
Medmaps mechanism: Hyperthyroidism ............................................................................................................................... 25
Medmaps mechanism: Hypothyroidism ................................................................................................................................ 27
Week 2: Thermoregulation and pituitary gland ...................................................................................................................... 29
Histology of the endocrine glands ........................................................................................................................................... 30
The Hypothalamus: energy balance and reproduction ........................................................................................................ 36
Anterior pituitary hormones .................................................................................................................................................... 39
Posterior pituitary hormones ................................................................................................................................................... 43
Replacement therapy for hormonal deficiencies ................................................................................................................... 47
Testing endocrine function ....................................................................................................................................................... 49
Week 3: Steroid excess ................................................................................................................................................................. 50
HPA Axis..................................................................................................................................................................................... 51
Manifestations of glucocorticoid excess .................................................................................................................................. 54
Seminar: Puberty in males and females .................................................................................................................................. 57
Therapy in adolescence (non-adherance primarily).............................................................................................................. 60
Nuclear medicine – endocrinology, neurology etc. ............................................................................................................... 61
Glycaemic index of foods .......................................................................................................................................................... 63
Suppression of adrenal function .............................................................................................................................................. 64
Steroid biosynthesis ................................................................................................................................................................... 66
Medmaps mechanism: Addison’s disease .............................................................................................................................. 68
Medmaps mechanism: Cushing’s disease and syndrome .................................................................................................... 69
Week 4: Type 1 diabetes .............................................................................................................................................................. 70
Clinical features of Type 1 diabetes ......................................................................................................................................... 71
Fatty acids and ketoacidosis ..................................................................................................................................................... 75
Organ pathology in diabetes .................................................................................................................................................... 77
Team management of diabetes in an ambulatory care setting ............................................................................................ 79
Hormonal control of circulating nutrients .............................................................................................................................. 81
2|P a g e
, Diet and diabetes ........................................................................................................................................................................ 83
Medmaps mechanism: Diabetes Mellitus Type 1 .................................................................................................................. 84
Week 5: Type 2 diabetes and Obesity ....................................................................................................................................... 85
Hormone resistance ................................................................................................................................................................... 86
Type II Diabetes.......................................................................................................................................................................... 88
Complications of obesity ........................................................................................................................................................... 91
Genetic predisposition to disease ............................................................................................................................................ 93
Lipoprotein transport ................................................................................................................................................................ 95
Management in obesity ............................................................................................................................................................. 98
Infectious complications of diabetes ..................................................................................................................................... 100
Ethics in childhood obesity ..................................................................................................................................................... 102
Seminar: community issues in obesity .................................................................................................................................. 103
Medmaps mechanism: Diabetes Mellitus Type 2 diabetes ................................................................................................ 105
Week 6: Infertility ....................................................................................................................................................................... 106
Female reproductive system ................................................................................................................................................... 107
Histology of the female reproductive system ...................................................................................................................... 112
Physiology of pregnancy......................................................................................................................................................... 116
Polycystic ovary syndrome (PCOS)....................................................................................................................................... 119
Medmaps mechanism: PCOS ................................................................................................................................................. 121
Anatomy: MALE Reproductive System ................................................................................................................................ 123
Histology of the male reproductive system ......................................................................................................................... 130
Male reproductive physiology ............................................................................................................................................... 135
Causes of infertility .................................................................................................................................................................. 139
Assisted reproductive technologies ....................................................................................................................................... 142
Androgens ................................................................................................................................................................................. 145
Week 7: - Ectopic pregnancies / STI ......................................................................................................................................... 147
Anatomy: Urinary tract ........................................................................................................................................................... 148
Radiological anatomy: Urinary tract ..................................................................................................................................... 153
HUman sexuality life course .................................................................................................................................................. 154
Sex, ethics, and the adolescent patient .................................................................................................................................. 156
Early complications of pregnancy ......................................................................................................................................... 157
Sexual and gender diversity ................................................................................................................................................... 160
Seminar: Ethical issues of human fertility ............................................................................................................................ 161
Pharmacology of contraception ............................................................................................................................................. 163
Week 9: Menstrual disorders .................................................................................................................................................... 164
Development of reproductive and urinary systems ........................................................................................................... 166
3|P a g e
, Histology of the female reproductive system part 2 ........................................................................................................... 171
Abnormal menstruation .......................................................................................................................................................... 175
Menopause ................................................................................................................................................................................ 178
Medmaps mechanism: Menopause ....................................................................................................................................... 180
Medmaps mechanism: Amenorrhea ..................................................................................................................................... 182
Week 8: HIV ................................................................................................................................................................................. 183
Pathology of HIV: Flow cytometry and resistance phenotyping ...................................................................................... 184
Treatment and management of HIV...................................................................................................................................... 186
Natural history and virology of HIV ..................................................................................................................................... 188
Legal and ethical issues with HIV ......................................................................................................................................... 191
Seminar: Pathology of AIDs: opportunistic infections and neoplasms ............................................................................ 193
Epidemiology and prevention of HIV................................................................................................................................... 195
MIcrobiology and clinical features of STIs ........................................................................................................................... 196
Principles of antimicrobial therapy in the immunocompromised host ............................................................................ 199
STIs and population issues ..................................................................................................................................................... 202
Medmaps mechanism: HIV .................................................................................................................................................... 204
Abdominal and Pelvic anatomy ............................................................................................................................................... 205
Anterior Abdomen Wall ......................................................................................................................................................... 206
Inguinal canal and hernias ...................................................................................................................................................... 210
Anatomy: diaphragm and posterior abdomen wall ............................................................................................................ 213
Pelvis and perineum ................................................................................................................................................................ 217
Others ............................................................................................................................................................................................ 223
Seminar: diagnostic tests 1 and 2 ........................................................................................................................................... 223
Practical ethics of self-health care .......................................................................................................................................... 224
Seminar: Screening in clinical practice .................................................................................................................................. 224
4|P a g e
Endocrinology
(and Sexual Health)
1|P a g e
,TABLE OF CONTENTS
Week 1: Hypo and Hyper thyroidism ......................................................................................................................................... 5
Skull and pituitary fossa ............................................................................................................................................................. 6
Anxiety ........................................................................................................................................................................................ 10
Endocrine system: A Functional overview ............................................................................................................................. 12
Introduction to Pt-Dr Endocrinology ...................................................................................................................................... 14
Thyroid hormones ..................................................................................................................................................................... 17
Autoimmunity in endocrine diseases ..................................................................................................................................... 19
Seminar: Endocrine testing ....................................................................................................................................................... 21
Energy and heat production ..................................................................................................................................................... 22
Medmaps mechanism: Hyperthyroidism ............................................................................................................................... 25
Medmaps mechanism: Hypothyroidism ................................................................................................................................ 27
Week 2: Thermoregulation and pituitary gland ...................................................................................................................... 29
Histology of the endocrine glands ........................................................................................................................................... 30
The Hypothalamus: energy balance and reproduction ........................................................................................................ 36
Anterior pituitary hormones .................................................................................................................................................... 39
Posterior pituitary hormones ................................................................................................................................................... 43
Replacement therapy for hormonal deficiencies ................................................................................................................... 47
Testing endocrine function ....................................................................................................................................................... 49
Week 3: Steroid excess ................................................................................................................................................................. 50
HPA Axis..................................................................................................................................................................................... 51
Manifestations of glucocorticoid excess .................................................................................................................................. 54
Seminar: Puberty in males and females .................................................................................................................................. 57
Therapy in adolescence (non-adherance primarily).............................................................................................................. 60
Nuclear medicine – endocrinology, neurology etc. ............................................................................................................... 61
Glycaemic index of foods .......................................................................................................................................................... 63
Suppression of adrenal function .............................................................................................................................................. 64
Steroid biosynthesis ................................................................................................................................................................... 66
Medmaps mechanism: Addison’s disease .............................................................................................................................. 68
Medmaps mechanism: Cushing’s disease and syndrome .................................................................................................... 69
Week 4: Type 1 diabetes .............................................................................................................................................................. 70
Clinical features of Type 1 diabetes ......................................................................................................................................... 71
Fatty acids and ketoacidosis ..................................................................................................................................................... 75
Organ pathology in diabetes .................................................................................................................................................... 77
Team management of diabetes in an ambulatory care setting ............................................................................................ 79
Hormonal control of circulating nutrients .............................................................................................................................. 81
2|P a g e
, Diet and diabetes ........................................................................................................................................................................ 83
Medmaps mechanism: Diabetes Mellitus Type 1 .................................................................................................................. 84
Week 5: Type 2 diabetes and Obesity ....................................................................................................................................... 85
Hormone resistance ................................................................................................................................................................... 86
Type II Diabetes.......................................................................................................................................................................... 88
Complications of obesity ........................................................................................................................................................... 91
Genetic predisposition to disease ............................................................................................................................................ 93
Lipoprotein transport ................................................................................................................................................................ 95
Management in obesity ............................................................................................................................................................. 98
Infectious complications of diabetes ..................................................................................................................................... 100
Ethics in childhood obesity ..................................................................................................................................................... 102
Seminar: community issues in obesity .................................................................................................................................. 103
Medmaps mechanism: Diabetes Mellitus Type 2 diabetes ................................................................................................ 105
Week 6: Infertility ....................................................................................................................................................................... 106
Female reproductive system ................................................................................................................................................... 107
Histology of the female reproductive system ...................................................................................................................... 112
Physiology of pregnancy......................................................................................................................................................... 116
Polycystic ovary syndrome (PCOS)....................................................................................................................................... 119
Medmaps mechanism: PCOS ................................................................................................................................................. 121
Anatomy: MALE Reproductive System ................................................................................................................................ 123
Histology of the male reproductive system ......................................................................................................................... 130
Male reproductive physiology ............................................................................................................................................... 135
Causes of infertility .................................................................................................................................................................. 139
Assisted reproductive technologies ....................................................................................................................................... 142
Androgens ................................................................................................................................................................................. 145
Week 7: - Ectopic pregnancies / STI ......................................................................................................................................... 147
Anatomy: Urinary tract ........................................................................................................................................................... 148
Radiological anatomy: Urinary tract ..................................................................................................................................... 153
HUman sexuality life course .................................................................................................................................................. 154
Sex, ethics, and the adolescent patient .................................................................................................................................. 156
Early complications of pregnancy ......................................................................................................................................... 157
Sexual and gender diversity ................................................................................................................................................... 160
Seminar: Ethical issues of human fertility ............................................................................................................................ 161
Pharmacology of contraception ............................................................................................................................................. 163
Week 9: Menstrual disorders .................................................................................................................................................... 164
Development of reproductive and urinary systems ........................................................................................................... 166
3|P a g e
, Histology of the female reproductive system part 2 ........................................................................................................... 171
Abnormal menstruation .......................................................................................................................................................... 175
Menopause ................................................................................................................................................................................ 178
Medmaps mechanism: Menopause ....................................................................................................................................... 180
Medmaps mechanism: Amenorrhea ..................................................................................................................................... 182
Week 8: HIV ................................................................................................................................................................................. 183
Pathology of HIV: Flow cytometry and resistance phenotyping ...................................................................................... 184
Treatment and management of HIV...................................................................................................................................... 186
Natural history and virology of HIV ..................................................................................................................................... 188
Legal and ethical issues with HIV ......................................................................................................................................... 191
Seminar: Pathology of AIDs: opportunistic infections and neoplasms ............................................................................ 193
Epidemiology and prevention of HIV................................................................................................................................... 195
MIcrobiology and clinical features of STIs ........................................................................................................................... 196
Principles of antimicrobial therapy in the immunocompromised host ............................................................................ 199
STIs and population issues ..................................................................................................................................................... 202
Medmaps mechanism: HIV .................................................................................................................................................... 204
Abdominal and Pelvic anatomy ............................................................................................................................................... 205
Anterior Abdomen Wall ......................................................................................................................................................... 206
Inguinal canal and hernias ...................................................................................................................................................... 210
Anatomy: diaphragm and posterior abdomen wall ............................................................................................................ 213
Pelvis and perineum ................................................................................................................................................................ 217
Others ............................................................................................................................................................................................ 223
Seminar: diagnostic tests 1 and 2 ........................................................................................................................................... 223
Practical ethics of self-health care .......................................................................................................................................... 224
Seminar: Screening in clinical practice .................................................................................................................................. 224
4|P a g e
