Endocrine

Total Contact Hours:

40 hours

Course Director:

Maria D. Urban, M.D., Associate Professor of Pediatrics

Course Description:

Starting with the physiologic principles that govern the creation, release, and regulation of hormones, this course moves through the common and catastrophic disease states that affect the endocrine organs. Diabetes is given particular emphasis, given its increasing prevalence and morbidity in the US. Small group case discussions highlight diagnostic test interpretation, making a differential diagnosis, and therapeutic intervention options.

Course Objectives & Integration with the Educational Objectives:

By the conclusion of this course, the student will demonstrate an understanding of:

K1 Principles of endocrinology, including:

• General concept of endocrine control
• Mechanism of action of hormones
• Peptide hormone
• Nonpeptide hormone
• Hormone receptors
• Nuclear receptor
• Cell surface receptor
• Feedback regulation of the endocrine function
• Simple and complex feedback loops
• Negative and positive feedback
• Control of hormone secretion
• Transport of hormones and role of hormone binding proteins
• Hormone measurement and its clinical implications
• General categories of endocrine disorders
• Hormone overproduction
• Hormone underproduction
• Altered tissue responses to hormone
• Tumors of endocrine glands

K2 The role of the hypothalamus as an endocrine organ and the action of the hypothalamic releasing hormones on the anterior and posterior pituitary

K3 The normal anatomy of the pituitary gland, as well as clinical disorders related to the abnormal embryologic development of the pituitary

K4The hormones produced by the anterior pituitary and the clinical conditions caused by the overproduction or underproduction of anterior pituitary hormones

K5 The embryologic origin of the posterior pituitary and its unique relationship with the hypothalamus. Identify disorders caused by abnormalities in the hypothalamic-posterior pituitary axis.

K6 The embryological development of the thyroid gland, the hypothalamic-pituitary-thyroid axis, and the difference between primary vs. central hypothyroidism (causes, presentation, and treatment)

K7The anatomy, physiology, and pathology of parathyroid glands; conditions caused by inadequate or excessive PTH production; and the importance of PTH on bone, calcium, and Vitamin D metabolism

K8The hypothalamic-pituitary-adrenal axis, including:

• Discuss anatomy, physiology, and pathology of the adrenal cortex and adrenal medulla
• Be familiar with the pathways of the Cortisol production and show understanding of the deficiency of the specific enzymes (metabolic abnormalities and clinical pictures)
• Discuss primary adrenal insufficiency (pathophysiology, clinical presentation, and treatment)
• Discuss glucorticoids overproduction (pathophysiology, clinical presentation, and treatment)
• Understand the function of adrenal medulla and pathophysiology of the catecholamine excess syndrome
• Understand the causes of endocrine hypertension and its treatment

K9Glucose homoeostasis and effects of insulin and counter-regulatory hormones on glucose levels, including the ability to:

• Discuss the definition of diabetes mellitus and pathophysiology of type 1 and type 2 diabetes mellitus
• Discuss long-term complications of diabetes mellitus and their pathophysiology
• Understand the effect of low blood glucose on brain function
• Discuss genetic disorders that lead to hypoglycemia
• Discuss treatment of acute and chronic hypoglycemia

C1 Interpersonal communication, including the ability to:

• Work effectively in teams, through the team-based learning and clinical case discussions
• Analyze and discuss clinical cases by advanced reading and asking appropriate questions
• Meet with "real" patients, ask questions, and interact to learn the importance of compassion and sensitivity

P1 Professionalism, including the ability to:

• Be punctual and attend required events
• Complete assignments in a timely fashion
• Be truthful
• Be courteous to patients, patients' families, staff, colleagues, and other health professionals
• Maintain confidentiality regarding patient care
• Demonstrate respect, empathy, responsiveness, and concern regardless of the patient's problems, personal characteristics, or cultural background
• Demonstrate scholarship in the form of contributing to a positive learning environment, collaborating with colleagues, and performing self-assessment and self-directed learning

Learning Activities:

Presentations, Team-Based Learning, small group discussions.

Assessment:

One MCQ exam, Team-Based Learning.