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ding to intracellular receptors. ? binding to receptors on the cell surface ? binding to intracellular receptors hormones bind to receptors on the cell surface ? Peptide and catecholamine hormones and prostaglandins bind to receptors on the cell surface, where the hormonereceptor interactions affect intracellular mediators, or second messengers. Second messengers ? cAMP: ? Glucagon, ACTH, PTH ? Protein kinase activity ? Insulin ? Calcium ? Alphaadrenergic agonists, AT II ? phospholipids ? ADH, GnRH, TRH. hormones bind to receptors on the cell surface binding to intracellular receptors intracellular receptors Disorders of the endocrine and metabolic system ? Most recognizable disorders of the endocrine system are due to an excess or a deficiency of particular hormones, whether caused by abnormalities of endocrine glands, ectopic production of hormones, abnormal conversion of prohormones to their active forms, or iatrogenic factors. Hypofunction of endocrine glands ? Endocrine glands may be injured or destroyed by neoplasia, infections, hemorrhage, autoimmune disorders, and other causes. Hormone deficiency secondary to extraglandular disorders ? Impaired conversion of a prohormone to a hormone occurs in chronic renal failure, in which there is defective conversion of 25hydroxycholecalciferol to 1,25dihydroxycholecalciferol. Hyporesponsiveness to hormones ? Hormone levels may be normal or even elevated in the presence of manifestations of endocrine deficiency. Hormone exess syndrome ?Hyperfunction of endocrine glands ?Ectopic hormone production ?Hormone administration ?Tissue hypersensitivity Hyperfuction of endocrine glands ? The most mon cause of hormone excess syndromes is hyperfunction of endocrine glands secondary to tumors of the glands or hyperplasia of several causes. Metabolic disorders ? Diabetes mellitus ? Hypoglycemia ? Hyperuricemia and gout ? Disorders of lipid metabolism ? Nutritional/vitamin deficiencies Symptoms and signs of endocrine and metabolic diseases ? Hormones affect the function of all tissues and an systems. ? Consequently, the symptoms and signs of endocrine disease are extremel