Microsoft Word - 内分泌・代謝分野.doc

Similar documents
20-121

SC-85X2取説


<4D F736F F F696E74202D C835B B E B8CDD8AB B83685D>

高脂血症の検査

2.7.6 MJR a MRI CT b 2 Beecham r-afs mg/ mg/ Gn-RH 742

III


II

これわかWord2010_第1部_ indd

パワポカバー入稿用.indd

これでわかるAccess2010

untitled

i

2


平成18年版 男女共同参画白書

活用ガイド (ソフトウェア編)

untitled


エクセルカバー入稿用.indd

A B 1.A B A B 2.A B A B 3.A

01_.g.r..






...J QX

活用ガイド (ソフトウェア編)


困ったときのQ&A

sick contact1l

ii

活用ガイド (ソフトウェア編)

i

はしがき・目次・事例目次・凡例.indd

ONS60409_gencyo.indd

橡6.プログラム.doc

(1) ) ) (2) (3) (4) (5) (1) (2) b (3)..

パソコン機能ガイド

パソコン機能ガイド

Javaと.NET

untitled

2004年度日本経団連規制改革要望


A B C (PP)() B 11 (11p) (S-S) C ()C CPR CPR C peptide immunoreactivity C CPR () () B GLUT TCA ATP - 2 -

ii


『戦時経済体制の構想と展開』


長崎県地域防災計画

i


Wide Scanner TWAIN Source ユーザーズガイド

™…

125 2 P 1st washout 2 PB P mg/dL nd washout 2 P 5.5mg/dL< mg/dL <2.5mg/dL P P 2 D D 3 Ca 10


untitled

活用ガイド (ハードウェア編)


入門ガイド





1) a) b) CRP c) d) e) a,b b,c c,d d,e a,e b,d 2) CKD a) ACE ARB b) 2mg/dL ACE ARB c) 2mg/dL d) e) ACE ARB a,b b,c c,d d,e a,e b,d 3) a) 130/85mmHg b)

困ったときのQ&A

/12/28 UP 3+, TP 4.2g/dl, Alb 1.9g/dl PSL 50mg/day 1/17 PSL 45mg/day PSL 2006/4/4 PSL 30mg/day mpsl mpsl1000mg 3 2 5/ :90 / :114/64 mmhg

結婚生活を強める

[] 1

2 129-B*-006P 129-B*-007P C*-004P 129-D*-001P ADH B*-006P B*-007P C*-004P D*-001P Na

=PAS.. =.. =.... 1% 01% ] = = = = 4 (A/A 2 / /B ) 1 8 2n / n n 64 n 64 n ] ] 4


SC Ł\†EŒÚ M-KL.ec6

(報告書まとめ 2004/03/  )

名称未設定

Sample2 g/dl Target1 : 6.01 g/dl TP Target2 : 8.39 g/dl

生活設計レジメ

44 4 I (1) ( ) (10 15 ) ( 17 ) ( 3 1 ) (2)

I II III 28 29



調査報告書

四校_目次~巻頭言.indd

日本呼吸器学会雑誌第44巻第10号

ONLINE_MANUAL

ONLINE_MANUAL


178 5 I 1 ( ) ( ) ( ) ( ) (1) ( 2 )

untitled


I


report.indd

慈大呼吸器_25-1_02T_CS5.indd

物理化学I-第12回(13).ppt


LBP-350 ユーザーズガイド

Step2 入門

Transcription:

TRH, TRH TSH, a. GH, PRL b.acth, FSH, LH, TSH GH PRL Kallmann KAL LHRH Laurence-Moon-Biedl AR Frohlich

Prader-Willi Hypotonia Hypogonadism Hypomentia Obesity Sheehan DIC T4 GH 80% Laron GH IGF-I GH GH acromegaly) GH

J-15 GH 10 ng/ml 5 ng/ml double floor ballooning heel pad thickness GH IGF-I -C IGF-I GH GH TRH, GnRH, CRH GH GH GH GH IGF-I P Ca FSH, LH Hardy II Chiari-Frommel Argonz del Castillo Frobes-Albright

10 mm MRI T2 10mm, anorexia nervosa 30-20% GH T3 reverse T3 low T3 T.Chol ADH ADH DI; diabetes insipidus)

ADH DI MRI T1 DI ADH ADH ADH receptor Ca, Li, K Na Na, Na, SIADH ADH ADH ADH Na K T3, T4, rt3 T3 80% T4 low T3

Basedow Af) Stellwag Mobius Grafe TSH C, C,C Chol CK-MM ChE TSH-R R ) R ) ChE ChE Plummer I123- hot nodule

C, C, L Chol CK-MM LDH TSA T3, T4 17-OHCS, 17-KS TSH T4 ESR,CRP CRP, ESR

CK-MM Chol LDH 70-80% PBC RA, SjS PBC B-42 SjS SS-A, SS-B F-69 T4 R ) Schmidt Addison TSH C

CEAMEN2A,2B MEN1 (PPP) Parathyroid, Pituitary, Pancreas MEN2A (PTA) Parathyroid, Thyroid, Adrenal MEN2B (NTA) Nerve, Thyroid, Adrenal 1,2 PPPTA PTA) 1 Ca Ca PTH V.D 3 ) PTH V.D 3 Ca, P PTH Ca P V.D3 Ca P Ca P Ca (ADH ADH Ca Li K Ca, P Ca, P QT Ca PTH camp II RTA PTH HCO3 K, P,Cl

K, P II RTA PTH II RTA I RTA I I RTA PTH PTH II RTA I RTA ALP3 MEN I MEN II I HAM HAM PTH Addison Ca PTH Ca, P

II ACTH K ACTH ACTH 17-KS 17-OH DHEA 17-OHP DOC 11- OHCS ACTH OHCS I II ACE

JG apparatus ADH ACTH, GH Cushing Cushing ACTH microadenoma) Ca Na K K 2mg) Cushing 8mg) 17-OHCS Cushing ACTH MRI/CT

17KS ACTH MRI/CT ACTH Cushing CRH ACTH Nelson ACTH ACTH Barter-Gitelman Barter Liddel 17-OHCS, 17-KS Na K Ca K Li K Barter Na-K-2Cl

Gitelman Mg Ca Na-Cl Barter Liddel Na Addison Schmidt Addison

ACTH Addison Basedow Waterhouse-Friderichsen PC; pheochromocytoma 5H disease: Hypertension Hypermetabolism Hyperglycemia Headache Hyperhydrosis VMA, 17-OHP 21 11 17

MEN1 (PPP) Parathyroid, Pituitary, Pancreas MEN2A (PTA) Parathyroid, Thyroid, Adrenal MEN2B (NTA) Nerve, Thyroid, Adrenal 1,2 PPPTA PTA) 1 Zollinger-Ellison Langerhans 80% K Ca PTHMEN1 ZE Wipple's triad 50mg/ml hypervasculr

5-20 U/ml triad WDHA Watery Diarrhea, Hypokalemia K, Achlorhydria GHACTH) DM DM

DM 740 1620 40 10 1 DM 1.5 10 ICA: islet cell antibody GAD 1 DM MODY 75% C-1 20 g/day 200 mg/dl FBS (fasting blood sucrose) 126 mg/dl 75gOGTT (oral glucose tolerance test) 200mg/dl HbA1c 6.5% 75gOGTT 126 200 110 140 HbA1c 6.5 4.3-5.8%) DM DM 25

25kcal/kg 30kcal/kg 35 kcal/kg (kcal/day) 1000+(age-1)x100 11 2000kcal FBS>250mg/dl HbA1c>9%) SU BG MODY: maturity-onset diabetes of the young) 25 DM DM DM 1 DM DM DM

Kussmaul ph HCO3 BE PCO2 0.9% K K HCO3 GI glucose-insulin K DM 0.45% DKA K K Ca GI Ca

330mOsm/l 4ml x (kg) x (%) 24 100ml/kg) K

I, III, IV, VI, VIII II, III, V, VII I von Gierke I, III II Pompe Wilson IV I GAG) Hurler, Hunter, Morquio Hunter Hunter Morquio

TG TC: 220 240 TG: 150 LDL: 160 TC>220, LDL>160, TG>150 CM, VLDL, IDL, LDL, HDL origin, pre-, pre- +, origin, pre =LDL pre V CM, VLDL, IDL, LDL, HDL TG Chol B-100 B-100 B-100 E E E C C A-1 CM VLDL IDL LDL HDL HDL-Chol HDL

TC>220, LDL>160, TG>150 HDL 40 R ) TG IIa IIb III IV V I LDL, LDL VLDL, IDL, VLDL, VLDL CM, CM C C,T C,T T T T PBC IIa)IV CM VLDL TG LDL C LDL: VLDL: CM: Friedewald LDL=TC-HDL-1/5TG AIP) -ALAPBG

SIADH Wilson AR Kayser-Fleischer Fanconi Wilson D- Menkes Cu Cu Cu Wilson, Menkes, PBC Wilson Cu Cu Menkes Cu Cu PBC Cu Cu 25%) Wilson

CT MRI (T2) low PRPP HGPRT de novo salvage de novo PRPP salvage HGPRT 3-7 mg/dl; 2.5-6.5 mg/ml 8 mg/dl Ca ACE Lesch-Nyhan HGPRT

J-46 4-8Hz; pill rolling) Wilson base excess (B.E. 0 2 meq/l anion gap (AG) = [Na + ]-([Cl - ] +[HCO 3- ]) 12 2 meq/l [HCO - 3 ] 24 2 meq/l Ca 8-10 mg/dl K4 meq/l

AG KUSSMAL K DKA U uremia S S sepsis M A L lactic K K T QRS K T U Ca QT Ca QT K Ca GI Ca Na Na CPM; central pontine myelinolysis) Na Ca Mg Ca hyperventilation ADH Ca, Li, K Ca Na Na DEKA A: D:

E: K: II, IX, VII, X B1 Wernicke B2 B6INH B12 C: