By P. Reed Larsen MD FACP FRCP, Henry M. Kronenberg MD, Shlomo Melmed MDMD, Kenneth S. Polonsky MD, Jean D. Wilson, Henry M. Kronenberg, Daniel W. Foster
The cutting-edge, 10th variation of endocrinology's vintage textual content bridges the space among easy technological know-how and endocrinology scientific perform. completely revised and up-to-date, it comprises new fabric at the thyroid and diabetes mellitus to mirror modern-day explosive bring up in wisdom. Written via a great group of authors, the tenth variation positive factors various new authors who supply clean views.
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Additional resources for Williams Textbook of Endocrinology
Gonadotropin-releasing hormone (GnRH) evokes a submaximal increase in follicle-stimulating hormone (FSH) and luteinizing hormone (LH). unavailable) and a free portion able to diffuse into cells and initiate a hormone effect. It is the free or unbound portion that is physiologically regulated; the level of the binding protein may be increased or decreased without physiologic consequence if the free portion is unchanged. The measurement of free T 4 or a free T4 index (FT4 I) (see Chapter 10) has become the standard second step if a screening TSH value is abnormally high or low.
Pituitary cytokine and growth factor expression and action. ) secretion, which feeds back positively to induce further LH release. Pituitary hormones themselves, in a short feedback loop, may also regulate their own respective hypothalamic controlling hormone. Hypothalamic releasing hormones are secreted in nanogram amounts and have short half-lives of a few minutes. Anterior pituitary hormones are produced in microgram amounts and have longer half-lives, whereas peripheral hormones can be produced in up to milligram amounts daily, with much longer half-lives.
The principal observation is whether there is diffuse enlargement of the thyroid gland (most often Graves' diffuse hyperplasia or Hashimoto's thyroiditis) or one or more nodules. Although the consistency of the gland is to be noted, in fact it is often not concordant with the pathology. Functioning tumors of the testis may be too small to be felt with the fingers, and most internists and general physicians are not skilled in palpation of the ovaries. For this reason, ultrasound and other forms of imaging have become key features of gonadal evaluation and are discussed later.
Williams Textbook of Endocrinology by P. Reed Larsen MD FACP FRCP, Henry M. Kronenberg MD, Shlomo Melmed MDMD, Kenneth S. Polonsky MD, Jean D. Wilson, Henry M. Kronenberg, Daniel W. Foster