what happens in pan hypopitruatirsm all hormonal pitautatr y acuse shutdown mainly due tumour entering normal tissues whichi s pituatry adenoma, . - treatment surgical, surgery may cause infltiration of normal tissues - pitautatnary anemoa post tissue , granulmoas? grunalomas from tb sacroidissi hsitocytosis x - which can sit iron deposition to iron pititautaion by hemochromoatosis, recurrent blood transfusion thallasemia, pitauatiry infraction due sheehan syndrome, plexy ??? - empty sella turcica syndrome; female grand malterbea - pituatary increases every birth which causes sheehan, after birth it becomes smaller, increase decrease, may cause csf to enter within sella trucica causing compression until it shrinks of pitauatiory gland, this is theoritcal approach. - gran maltebra empty sella turcica post partum sheehan. — clinical features of disease first thing growth hormone decreased greatly, before puberty if so short stature and after puberty cause fariguibility - this is least important hormones as adult, though low gonadotrophin before puberty primary ammengohreia, 2ndry sexual characterestics not appear, if after puberyt inferetility in female, breast atrophy due no estrogen, if no estrogen , thinning of hair and breakable, if male what happens after puberty; loss of libido, female doesnt lose, due test from supragland, gynecomastia result in males because no testerone- great estrogen??? galactrohia can happen? female breast atrophy due no estrogen, - low tsh will present hypothyroidism, cold intolence, - the acth theres no corticsocne for sugar causing hypoglycemia, adh is working fine, we loss glucocorticoids causing hypoglycemia, ,
BP = Cardiac output times rr resistestnafnc
alpha receptor noreaderenaline activate causing binding needs presence of … resulting more sensitive, if no glucocorticiousds causing vasodiltation, resulting in bloop pressure reduciton - in exam test, because of permissiove effect of gluco to bind alpha prot? sp..sdg…a.rge..
hypopigmentation, alsabaster skin apperance, not white - colored like orange,
hypotension, permissive effect lost due corticosteroids - steroid, betareceptor ac be… hypotiturarism…
panhypopituatirism, maybe due gland it self is failing, primary hypothyroidism - polyglandular failure
xxxx pygans. vs PGF ?w decreased / increased glucose decreased / increased Pigmintation decreased / increased potessium normal / high
there are two types one addision and hypoparathyroidism. addision hypoparathyroidism, mucocutanous candiasis, polyglandular failure type 1 - parathyroid is response of calcuim adn calcium colored white, adrenal gland is white, canidididda dark in books? - type 2 include thyroid and diabetes. vitiligo? autommine? antibodies? - most common exam question whats different is gland controller or gland it self is broken. hwo can you differentiate? pan is all decrease, pgf including potassium with everything increased.
Investigations? pth hormones,tsh,fsh, diagnostic test best is insulin tolerance test, resulting in increased growth hormone and acth, if not responsed to hypoglycemia pituatiry is not acrive. automatically growth hormone and acth if not come out is pituatry failure. this is diagnostic - diagnostic - baseline hypoglycemic test. if no reposnes condsidered positive.. target hroomones t3 t4 - blood potssium usually normal due functioning RAS, hemochromatisis deposition ? pitaturaioa mri we look for pitatatry adenoma, chest x-ray for tb and sarcoidosis, - treatment mainly to replace the decreased amount, very imptortant high yield, start by cortico if give thyroid before cortisone, high yield, dont give thyroid hormone until cortisone is fixed, the metabolism is all shut to increaes metabolism reached blood cortisone? if patient given thyroid horrmone cause adrenal cirisis increased metabolism without reaching blood for ocortico… - we give cortisone, compression stockings, and cortisone, sex hormones, estrogen, progestron if no uterus or if male transgender (on when to give estrogen prosgetreron) - we give progersterone to not remove endometrials, if give estrogen (build uterus) progesteroene for shedding, we must give balanced. - sex hormone estrogen progestreorne, for men we give testsetsterone - in one we give fsh lsh if fertility is required - we give due expensive cost - desmopressin if hit posterior pituatatary, gives out adh. comes with craniogeneticdisap encepidis. symptoms polyuria, plasma osmolarity high, urine dilated, cryogenic, fi give adh desmopressin cause water to?… - v2 receptors?? - if develop develop craniogenic diabetisu inspidius, when to achieve growth hormone pigs - chongioforum encephalotis cow mad disease, jackson jacob disease comes from animals - if wfrom animals eating brain. done with recombinant dna technology, we give growth hormone only if we addressed everything and still fatigue we give growth hormone, only if young children we give growth hormone, other sources says if fertility fsh lh growth hormone is better improvement chances of getting pregnant is better.
Questions:?
?? MS:
40 years old women progressive ms progressibve disable convfluent white mater lesion hsitoply kmlymphoid follice - criteria for poor prognisis, what s role of ectopic?
answer is serve as local site for antigen presentation and production.
not produce cytokeine, neurotropic factors or secrotory phenomal related ms pathophpeysgensis.
27 years ms multinocola targeting seduqnce?? rotixumab answer
progresive ms start oral therapy that irrevisresbiel inihibt dehiydrogeninense? answer pyrimidine synthesis traphponiamide? - alopecia liver enzym e high fulminant heepatic failure - if to reeverse we give choelstramin.
38 years old woman ms episode transient blurry vision bright light espicially dark abnormal pupillary response . pupillary defict, constrict sluggishly,. demylentation nucleus afferent nucleus
eddegar westfall is wrong.
demylenation sympathetic fiber is wrong
3 week hx right leg weakness ,numbeness pyrimidial tract urgency hypereflexia spacificity, banbiniski scan, mri brain mspine hyperetintesnse hsoidjfeow ka- color is white like milk csf analysis olcicongon band start modifieying disease agent, four months later develop persistant neusea diarrhea flushing.
T1 t2 helper? promote shift?
Encephalitis nerodent, … anima l model we take myelin sheet protien injection cns later infallammation???
pituatary disorders: we have a 22 years old lady present with diziness fatigue and hypotension, which of follow ing suggest she has polyglandular failure type 2
Frequent candida infection alebaseter skin apperance normal serum potassium increased MCV microcytic anemia (b112 defieciency due type two diabetes thyroid deficiency b12… )
24 28 vaginal delivery twins, was complicatioend uterine inertia, becomes dilated - pathohpysiology hpotension caused by - permissive effect of glucocorticoids…
Not aldestorone action not direct effect, not reduced acth secrteion.
reduced catachelmonines ??