Preface viii Acknowledgements x 1 Anatomy and Physiology: The Endocrine System 1 Homeostasis 1 The Endocrine Organs 2 Endocrine, Paracrine, Exocrine and Autocrine Signalling 4 Hormones 5 The Transportation of Hormones 5 Control of Hormone Release 6 The Physiology of the Endocrine Organs 6 The Hypothalamus and the Pituitary Gland 6 Growth Hormone 8 Prolactin 9 Folliclestimulating Hormone and Luteinising Hormone (Gonadotrophins) 9 Thyroidstimulating Hormone 9 Adrenocorticotrophic Hormone 9 The Thyroid Gland 10 Parathyroid Glands 12 The Adrenal Glands 13 The Pancreas 13 The Gonads 15 Other Endocrine Glands 16 Conclusion 17 Glossary of Terms 17 Multiple Choice Questions 18 References 20 2 Assessment of the Endocrine System 21 Assessing Needs 22 The Patient History 23 Empathy 23 A Focused Endocrine Assessment 26 Assessing the Thyroid Gland 32 Conclusion 33 Glossary of Terms 33 Multiple Choice Questions 34 References 35 3 Hyperthyroidism 36 The Thyroid Gland 36 Thyroxine and Triiodothyronine 36 Pathophysiological Changes Associated with Hyperthyroidism 37 Epidemiology 39 Risk Factors 39 Clinical Presentation 41 Clinical Investigations and Diagnosis 43 Management 47 Health Teaching 48 Understanding Hyperthyroidism 49 Treatment Options 49 Long-term Management and Follow-up 50 Conclusion 50 Glossary of Terms 50 Multiple Choice Questions 51 References 52 4 Hypothyroidism 54 Total Thyroxine and Free Thyroxine 54 Pathophysiological Changes Associated with Hypothyroidism 55 Myxoedema 55 Primary and Secondary Hypothyroidism 56 Epidemiology 57 Risk Factors 58 Clinical Presentation 61 Clinical Investigations and Diagnosis 63 Management 67 Health Teaching 68 Conclusion 69 Glossary of Terms 69 Multiple Choice Questions 70 References 71 5 Diabetes Mellitus 73 Type 1 Diabetes 73 Type 2 Diabetes 73 Gestational Diabetes 73 Diabetes Insipidus 73 Blood Glucose Regulation 74 Insulin 74 Glucagon 75 Other Factors Influencing Blood Glucose Regulation 75 Pathophysiological Changes Associated with Diabetes Mellitus 77 Epidemiology 80 Risk Factors 82 Clinical Presentation 83 Clinical Investigations and Diagnosis 85 Management 87 Dietary Therapy 87 Non-insulin Therapy 88 Insulin Therapy 88 Monitoring Response to Therapy 91 Physical Activity 93 Education and Self-management Skills 95 Regular Medical Follow-up 96 Psychosocial Support 96 Complications, Screening and Prevention 96 Health Teaching 96 Conclusion 97 Glossary of Terms 98 Multiple Choice Questions 99 References 100 6 Cushing''s Syndrome 101 Pathophysiological Changes Associated with Cushing''s Syndrome 101 Epidemiology 103 Risk Factors 104 Clinical Presentation 105 Clinical Investigations and Diagnosis 108 Management 114 Health Teaching 114 Conclusion 116 Glossary of Terms 116 Multiple Choice Questions 117 References 118 7 Polycystic Ovarian Syndrome 119 Pathophysiological Changes Associated with Polycystic Ovarian Syndrome 119 Epidemiology 120 Risk Factors 122 Clinical Presentation 124 Clinical Investigations and Diagnosis 125 Diagnostic Criteria 129 Management 129 Health Teaching 130 Conclusion 132 Glossary of Terms 133 Multiple Choice Questions 134 References 135 Hypopituitarism and Hyperpituitarism 139 Epidemiology 140 Risk Factors 141 Clinical Presentation 143 Clinical Investigations and Diagnosis 144 Management 148 Observation and Monitoring 149 Medication Therapy 149 Surgery 149 Radiation Therapy 150 Combination Therapy 150 Pituitary Carcinoma 150 Follow-up Care 150 Health Teaching 150 Conclusion 152 Glossary of Terms 152 Multiple Choice Questions 153 References 154 MCQ Answers 155 Index 156 8 Pituitary Tumours 136 The Pituitary Gland: An Overview 136 Pituitary Tumours 137 Pathophysiological Changes Associated with Pituitary Tumours 138.