Endocrine Physiology by Patricia Molina

By Patricia Molina

The top endocrine overview to be had for the USMLE Step 1

The fourth version of Endocrine Physiology offers complete insurance of the fundamental technology and anatomy in the back of endocrine functionality. With its specialise in must-know ideas, Endocrine Physiolology is the easiest evaluation on hand for the USMLE Step 1 and the right reference for citizens and fellows.

  • NEW! boxed medical case eventualities permit scholars to use info to actual existence eventualities
  • Learning aids comprise pursuits, key techniques, a precis, and assessment questions
  • Covers the foundations of endocrinology and metabolism on a system-by-system, organ-by-organ basis

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The release of AVP and oxytocin is accompanied by the release of neurophysins from the secretory granules. Originally, neurophysins were considered to have a carrier function as the neuropeptide is transported down its trajectory through the hypothalamo-hypophysial tract. Although the exact function of these byproducts is not clear, it appears that neurophysins play a central role in AVP synthesis. This role has become more evident since the identification of the inherited disease of familial neurogenic diabetes insipidus.

Adapted, with permission, from Melmed S. Acromegaly. NEJM . 2006;355:2558–2573. Copyright Massachusetts Medical Society. ) FUNCTIONAL ANATOMY The hypothalamus is the part of the diencephalon located below the thalamus and between the lamina terminalis and the mamillary bodies forming the walls and the floor of the third ventricle. At the floor of the third ventricle, the 2 halves of the hypothalamus are rejoined to form a bridge-like region known as the median eminence (Figure 2–2). The median eminence is important because this is where axon terminals of hypothalamic neurons release neuropeptides involved in the control of anterior pituitary function.

DISORDERS OF AVP PRODUCTION Either excess or deficiency of AVP can result in clinical disease. The concentrations of AVP may be altered in various chronic pathophysiologic conditions, including congestive heart failure, liver cirrhosis, and nephritic syndrome. The most frequent abnormality is a decrease in AVP release in diabetes insipidus, a clinical syndrome resulting from the inability to form concentrated urine. Diabetes insipidus— Diabetes insipidus is characterized by the excretion of abnormally large volumes (30 mL/kg of body weight per day for adult subjects) of dilute (<250 mmol/kg) urine and excessive thirst.

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