Medico Guides 5th Block (Module No 08) Physiology Guidelines

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Prepared by: 

                   Alisha Athar (G13)           

                   Ibtihal Iftikhar (G14)       

Compiled by: 

                   Muhammad Ahmad Bhatti (G14)

Recommended Book:

  • Guyton and Hall Textbook of Medical Physiology 14th Edition (Chapter numbers are mentioned according to this edition)

ENDOCRINOLOGY

Chapter 75:

EnR-P-001:

  • Types of Chemical messengers 
  • Chemical structure and synthesis of hormones 
  • Table 75.1
  • Clearance of hormones 
  • Mechanism of action of hormones 
  • Hormone receptor activation
  • Down regulation of receptors
  • Fig # 75.4
  • Enzyme-linked hormone receptor 
  • Table 75.2
  • Fig 75.5
  • Intracellular hormone receptors 
  • Fig 75.6
  • Table 75.3
  • Table 75.4
  • Fig 75.7
  • Fig 75.8 
  • Ca-Calmodulin system
  • Sequence of events of steroid function
  • Read and gain concept of Radioimmunoassay and ELISA (purple boxes)

Chapter 76:

EnR-P-002:

  • Names of anterior and posterior pituitary hormones
  • Sites of synthesis of posterior pituitary hormones
  • Cell types and hormones of pituitary with table 76.1
  • Fig 76.4
  • Hypothalamic releasing and inhibitory hormones(Table 76.2)
  • Growth Hormone full(important)
    • Fig 76.6
    • Metabolic effects
    • Table 76.3(v important)
    • Somatomedins(vvvv important)
    • Regulation
    • Effects on fats, proteins, carbohydrates, bone and cartilage
  • Difference between GH and Somatomedins 
  • Abnormalities of Growth Hormone secretion (complete purple boxes) v important
  • Panhypopituitarism with causes and treatment 
  • Sheehan syndrome from Google (imp) 
  • Panhypopituitarism in childhood and dwarfism 
  • Difference between Loran dwarfs and African pygmies 
  • Gigantism and Acromegaly
  • Posterior pituitary gland
    • Physiological function of ADH
    • Fig 76.10
    • Regulation of ADH
    • Oxytocin functions
  • Make and prepare from flowcharts for hormone regulations.

Chapter 77:

EnR-P-003:

  • Synthesis and secretion of thyroid hormones
  • All steps for synthesis of thyroxine
  • Fig 77.2 (vv important)
  • Difference between T3 and T4 from image
  • Transport of thyroxine 
  • Physiological functions of thyroid hormones with fig 77.5 complete till page 948
  • Regulation of thyroid hormones 
  • TSH
  • Fig 77.7
  • Antithyroid substances all (extremely important MCQs)
  • Hyperthyroidism (causes, symptoms, exophthalmos, diagnosis, treatment)
  • Know the definitions and difference between thyrotoxicosis and Grave’s disease
  • Hypothyroidism (causes, endemic, idiopathic, characteristics, diagnosis)
  • Special attention to exophthalmos and Myxedema
  • Cretinism (Imp)

Chapter 78:

EnR-P-004:

  • Names of adrenal hormones(figure 78.1)
  • Synthesis and Secretions of adrenocortical hormones 
  • Give a read to purple box
  • Fig 78.2 (vvv important)
  • Plasma bound hormones 
  • Adrenocortical hormones are metabolized in liver
  • Functions of Mineralocorticoids 
  • Mineralocorticoid deficiency causes renal NaCl wasting… 
  • Mechanism of prevention of mineralocorticoid effect of Cortisol (11B-HSD2)
  • Apparent Mineralocorticoid Excess Syndrome (vv important)
  • Renal and circulatory effects 
  • Aldosterone escape important
  • Excess aldosterone effects 
  • Deficiency of aldosterone 
  • Fig 78.4
  • Regulation of aldosterone secretion (v imp)
  • Function of glucocorticoids 
  • Effects of cortisol on carbs, protein, fats 
  • Adrenal diabetes 
  • Cortisol prevents inflammation (Important)
  • Anti inflammatory effects
  • Fig 78.7
  • Read purple box especially Modulation of Glucocorticoid Effects
  • Regulation of cortisol secretion 
  • Fig 78.8
  • Circadian rhythm of glucocorticoids 
  • Synthesis and secretion of ACTH
    • Products of POMC1 and POMC2
    • Rest read for concepts
  • Adrenal androgens complete (v important)
  • All abnormalities of Adrenocortical secretion
  • Difference btw Cushing disease and Cushing syndrome (google)

Chapter 79:

EnR-P-005:

  • Physiological anatomy of the pancreas 
  • Insulin chemistry and synthesis with Fig 79.2
  • Activation by insulin and effects with Fig 79.3 (vv important)
  • Effect of insulin on carbohydrate metabolism (complete)
  • Lack of insulin effect on the brain
  • Effect of insulin on fat synthesis and storage 
  • Insulin deficiency causes lipolysis, ketosis and acidosis (important)
  • Effect of insulin on protein metabolism 
  • Secretion of insulin + Fig 79.7 (vv important)
  • Table 79.1 (v imp)
  • Factors that stimulate insulin secretion (including purple box)
  • Under ‘Role of Hormones in Switching Between Carbohydrate and Fat Metabolism’
    • Name of hormones and whether released during hypo or hyperglycemia
    • Effects of epinephrine
  • Glucagon (complete) 
  • Somatostatin in blue box (Imp)
  • Summary of glucose regulation 
  • Importance of blood glucose regulation

EnR-P-006:

  • Diabetes mellitus (give a thorough read to whole topic as it is v important )
  • DM type 1 (Clinical effects with explanations, eg polyphagia, dehydration, acidosis etc.)
  • Treatment of DM type 1 (Imp)
  • Type 2 DM
  • Differences between both types of DM (table 79.3)
  • Metabolic syndrome 
  • Table 79.2
  • Treatment of type 2 DM
  • Names and values of tests for diagnosis of DM 
  • Insulinoma (Important)
  • Hypoglycemia 

Chapter 80:

EnR-P-007, 008:

  • Levels of calcium, calcium ions, phosphate ions and phosphorus in plasma
  • Hypocalcemia and hypercalcemia
  • In absorption and excretion just know:
    • Vitamin D promotes Calcium absorption in intestine
    • Renal excretion of Calcium is regulated at late distal tubules
    • Renal phosphate excretion is controlled by overflow mechanism
  • Important points about bone structure:
    • Cortical and trabecular bone
    • Major bone salt is Hydroxyapatite
    • Tensile strength of bone is due to collagen fibers of matrix
    • Compressional strength is due to Calcium salts
  • Pyrophosphate regulation under Mechanism of Calcification
  • Bone resorption from fig 80.6
  • Control of rate of bone deposition by Bone stress
  • Read Vitamin D and do fig 80.8
  • Parathyroid Hormone:
    • Osteolysis (rapid phase of Ca and phosphate mobilization)
    • Slow phase of bone resorption (activation of osteoclasts)
    • Fig 80.14
    • Summary of effects of parathyroid (Imp)
  • Read Calcitonin
  • Do all clinicals from purple boxes (complete)
  • Difference between rickets, tetany and osteomalacia 

EnR-P-009:

  • Adrenal medullary hormones and pheochromocytoma (from google or lecture slides)

Types of MCQs from Endocrinology:

  • Scenario based about hormonal abnormalities
  • Functions of hormones (options are given to confuse with functions of other hormones)
  • Physiological reasons for increases or decreases in hormone levels + regulation
  • Steps of hormone synthesis especially thyroid
  • Sites and mechanism of action of hormones
  • To pick true or false statements about hormones

REPRODUCTION AND LACTATION

(EnR-P-010 to 016)

Chapter 81:

  • Fig 81.1, 81.2 and 81.3 (total 74 days)
  • Hormonal factors that stimulate spermatogenesis
  • Sites of maturation and storage
  • Compositions of: seminal fluid, prostatic fluid, and semen
  • Capacitation (important)
  • Acrosome reaction (important)
  • Why does only one sperm enter the oocyte? 
  • Effect of temperature and cryptorchidism (read)
  • NOT to do Male Sexual Act
  • Testosterone and Other Male Hormones complete purple box
  • Functions of Testosterone and effect on primary and secondary sexual development
  • Basic intracellular mechanism of action of testosterone (read)
  • Fig 81.10
  • Role of Inhibin
  • HCG secreted by placenta stimulates testosterone secretion by fetal testes
  • Male Climacteric definition
  • All abnormalities from purple box

Chapter 82:

  • Fig 82.1, 82.2 and 82.3
  • Fig 82.4 (concept)
  • Ovarian Follicular Growth complete
  • Ovulation
  • Fig 82.6 (vv important)
  • Luteal Phase read
  • Fig 82.7
  • Fate of Progesterone
  • Fig 82.8
  • Functions of Estrogen complete
  • Functions of Progesterone complete (focus on headings of functions for both)
  • Fig 82.9 and 82.11
  • Anovulatory cycles
  • Puberty and Menarche
  • Menopause (v important)
  • Abnormalities of secretion by ovaries

Chapter 83:

Can do from Firdaus; important topics from Guyton mentioned below:

  • Double Bohr effect (read once) written in diffusion of oxygen through placenta 
  • Human Chorionic Somatomammotropin
  • Response of mother’s body during pregnancy (in purple box)
  • Parturition 
  • Oxytocin causes contraction of the uterus 
  • Onset of labor (+ve feedback)
  • Fig 83.10
  • Suppression of female ovarian cycles in nursing mothers after delivery

Chapter 84:

Only these two topics:

  • Respiratory system from first page + onset of breathing and cause of breathing at birth (page 1063)
  • Changes in fetal circulation at birth (focus on headings)
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