By David G. Ferriman

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The standard dose of water is 20 ml. per kg. and more than 80 per cent will be excreted in 4 hours in normal subjects. Adrenal deficiency, renal disease, dehydration, malabsorption, and thyroid deficiency cause inability to excrete this load. ) given 4 hours before the test will correct the deficiency in the case of adrenal failure only. ADRENAL ASSESSMENT 55 2. — a. — i. —Glucocorticoid measured as 17-oxogenic steroids. Androgen measured as 17-oxosteroids (normal values above). ii. —11-Hydroxycorticosteroids can be estimated in many laboratories with sufficient accuracy to demonstrate diurnal variations in healthy adults (normal values above).

Weakness of external ocular muscles commonly accompanies exophthalmos but may occur independently. Upward, lateral, and convergent movements are most commonly affected. Myasthenia gravis sometimes associated. 2. — a. —Normally a single nodule is palpable in the thyroid gland. Occasionally more than one nodule is present. b. —Signs and symptoms essentially the same as in the LATS-produced syndrome. c. E Y E SIGNS ARE MINIMAL OR ABSENT. — 1. —Various arrhythmias, notably atrial fibrillation and congestive cardiac failure.

Corticosteroids have been recommended to prevent further fibrous tissue formation—doubtful value. MISCELLANEOUS Other forms of thyroiditis are due to pyogenic infection, tuberculosis, syphilis, sarcoidosis, and amyloidosis. DEVELOPMENTAL ANOMALIES Various developmental anomalies may occur rarely. —Formed from persistence of thyroglossal duct. Midline structures. Often become infected and form sinuses. Treatment is by excision. —Found at root of tongue. Give rise to dysphagia and dysphonia. —May be found elsewhere in midline of neck or in upper mediastinum.

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A Synopsis of Endocrinology and Metabolism by David G. Ferriman
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