Jordan University of Science and Technology

Faculty of Medicine
2018-2019

COURSE TITLE: Endocrine System.

COURSE CODE: MED 320.

CREDIT HOURS: 4 CREDIT HOURS

SEQUENCE: YEAR 3, 4 WEEKS

COURSE COORDINATOR: Dr. Ahmed Al-Dwairi

CONTACT: andwairi7@just.edu.jo
 Course Description:
The endocrine system module is 32-hour course (4 credit hours) of which 24 hours are
devoted to didactic classroom lectures utilizing PowerPoint presentations, 2 hours of
active learning through small group discussions, and 6 hours of laboratory exercises in
anatomy and pathology of the endocrine system.

This course is designed to provide a broad overview of human endocrinology. Course

topics will include studying the major endocrine glands, production and synthesis of
hormones, mechanisms of action and regulation of hormone secretion, as well as
various aspects regarding the anatomy, biochemistry and physiology of the endocrine
systems and the pathophysiology, epidemiology, and treatment of various endocrine
diseases. These topics will equip the students with the basic knowledge to understand
the normal function of the endocrine system and will introduce basic principles of clinical
diagnosis and management of endocrine disorders.

Laboratory exercises are designed to supplement lectures and are well coordinated with
the lecture materials. Thus, lectures in anatomy and pathology are coordinated with the
laboratory material and are given at the same time.

The course objectives for the endocrine system course are clearly outlined. The course
director and instructors were familiar with the objectives. The course director informs
students of the objectives by distributing handouts at the beginning of the course.

The breadth and depth of the course appears to be well balanced, without
overwhelming students with more materials than they can handle. The course appears
to cover all aspects of human endocrinology with sufficient thoroughness.

The frequency and method of student evaluation in the endocrine system consist of one
midterm objective written examination in multiple choice questions format, and a final
practical examination in a multiple choice format covering the laboratory material and
clinical sessions.

Average class score on standardized exams ranged from 70-80%. The failure rate has
ranged consistently between 2 to 5%.

Student evaluation on the endocrine system course shows a great deal of satisfaction
and students expressed general satisfaction that they possess an excellent level of
knowledge.
 Course Learning Outcomes
Students enrolled in this course are expected to acquire the following set of skills:

1. Structures of the various endocrine glands, their development, their histology and their
blood supply.
2. The classification of the hormones, their basic structure, their mechanism of action
and their synthetic pathways.
3. The regulation of hormone synthesis and secretion.
4. The physiological role of hormones in achieving homeostasis, including their
interaction with the other chemical messenger systems of the body.
5. Pathogenesis, morphological changes and the complications associated with the
disruption of endocrine function.
6. The use of hormones and their derivatives in the diagnosis and treatment of the
various endocrine disorders.
7. The Public health issues associated with the more common endocrine disease in
Jordan, in the region and elsewhere in the world.
Recommended Textbooks and Atlases:
Subject Book (Resources)
Anatomy 1. Gray's anatomy for students, Drake,Vogl, Mitchell
2. Clinical Anatomy for Medical Students. By R. S. Snell,
Latest Edition.
3. Grants Atlas of Anatomy or any other Atlas of Human
Anatomy.
4. Basic Histology. By L. Carlos Junqueira, Latest Edition.
5. Before we are born. By K. L. Morre and T. V. N. Persuade,
latest edition.
6. Langman’s medical embryology
7. Color textbook of histology Gartner and Hiatt
Physiology • Textbook of Medical physiology. By Guyton and Hall, Latest
Edition.
Biochemistry • Delvin: Textbook of Biochemistry with Clinical correlations.
Pathology • Basic Pathology. By Kumar, Cotran, and Robbins, Latest
Edition.
Pharmacology 1. Lippincott’s Illustrated Reviews: Pharmacology, Latest Edition.
2. Goodman and Gilman’s: The pharmacological basis of
therapeutics, Latest Edition.
3. Basis and Clinical Pharmacology B.G. Katzung Latest Edition.
4. Pharmacology Rang, Dale, Ritter and Moore Latest Edition.
Public Health • Supplementary Departmental handouts.
Clinical Lectures • To be assigned by the lecturer.
 Learning Objectives

(A) Lectures objectives

# LECTURE OBJECTIVES
1 Introduction to 1. Understand nature and major classes of the
endocrinology; hormones and their roles in the human
mechanisms of hormone body.
actions and second
messengers 2. Characterize the major hormonal
biorhythms.
3. Describe the general aspects that govern
the regulation of hormone secretion.
4. Describe how feedback relationship is
important in determining the level of
circulating hormones.
5. Describe the mechanism of action of
peptide hormones
6. Describe the mechanism of action of amino
acid derivative hormones
7. Describe the mechanism of action of
hormones derived from cholesterol.
2 Morphology of the 1. Review the differences between endocrine
endocrine glands and exocrine glands.
2. List the endocrine glands.
3. Describe the structure of the major
endocrine glands.
4. Describe the location, relation, blood supply,
nerve supply, and lymphatic drainage of the
major endocrine glands.

3 Histology and 1. Describe the development of the major

embryology of the endocrine glands (thyroid, parathyroid,
endocrine glands pituitary, adrenal, and the pancreas).
2. Describe the microscopic structure and cells
of the pituitary gland.
 3. Describe the microscopic structure of the
thyroid follicle, follicular and parafollicular
cells.

4 Hypothalamic-pituitary 1. List the adenohypophyseal and the

relationships neurohypophyseal hormones
2. Describe the regulation of anterior pituitary
hormones by the hypothalamus.
3. Describe the posterior pituitary gland
relationship with the hypothalamus.
5 Anterior and posterior 1. Describe growth and the metabolic effects
pituitary hormones of the growth hormone.
2. Describe the regulation of the growth
hormone secretion (role of insulin-like
growth factors and hypothalamic GHRH and
somatostatin,).
3. List the major physiological effects of
antidiuretic hormone and the regulation of
its secretion.
4. List the major physiological effects of
oxytocin and the regulation of its secretion.

6 Pathology of the anterior 1. Describe the neoplasms of the anterior and

and posterior pituitary posterior pituitary glands and their clinical
glands syndromes.
2. Describe the causes the different clinical
entities related to hypopituitarism.
3. Discuss diabetes insipidus and the
syndrome of inappropriate antidiuretic
hormone secretion.

7 Thyroid hormones 1. Describe the bio-synthetic pathway of

(synthesis, regulation, thyroid hormones.
and actions) 2. Describe the regulation of thyroid hormone
synthesis.
3. Discuss the physiological actions of thyroid
hormones.

8 Pathology of the thyroid I 1. Define and describe the pathogenesis and

clinical findings of thyrotoxicosis, diffuse
 hyperplasia of thyroid and Graves’s
disease.
2. Define and describe the pathogenesis of
multinodular goitre.
3. List types of solitary thyroid nodules and
define the meaning of “cold” and “hot”
nodule.
4. Describe the clinical findings & pathology of
hypothyroidism and define the terms
Cretinism & Myxedema.
5. Define and describe the pathogenesis of
Hashimoto’s thyroiditis, lymphocytic
thyroiditis, subacute thyroditis and Reidle’s
thyroiditis

9 Pathology of the thyroid 1. Describe adenomas and carcinomas and their

II and parathyroid glands differential diagnosis.

2. Discuss various types of malignancies in the

thyroid.

3. Discuss primary & secondary

hyperparathyroidism.

4. Differentiate between parathyroid hyperplasia

& parathyroid adenoma.

5. Describe hypoparathyroidism & its clinical

manifestations & etiology.

10 Hormonal control of 1. Discuss the absorption, metabolism and

calcium metabolism excretion of calcium and phosphate.
2. Discuss the role of vitamin D in calcium and
phosphate absorption.
3. Outline the effect of calcium ion
concentration on the regulation of the active
form of vitamin D levels
4. List the major physiological effects of
calcitonin and PTH and their regulation.
11 Pharmacology of the 1. Characterize the pharmacology of
thyroid and parathyroid thyroid hormones.
hormones.
2. Describe the pharmacology of
antithyroid drugs.

3. Describe the clinical uses, routes of

administration, and adverse reactions of
thyroid and antithyroid drugs.
4. Characterize the pharmacology of the
parathyroid hormone, vitamin D, and
calcitonin.
5. List synthetic analogs of the above
hormones, and describe their routes of
administration, clinical uses, and
adverse reactions.

12 Clinical approach to an 1. List the causes of an enlarged thyroid gland,

enlarged thyroid gland its presentation in the clinic and the tests
performed to differentiate between the
various causes and reach the correct
diagnosis.
2. Describe how the management of an
enlarged thyroid differs according to its
cause.

13 Endocrine functions of 1. Discuss the principal hormones that affect

the pancreas blood glucose concentration.
2. Discuss the metabolic effects of insulin.
3. Discuss the regulation of insulin secretion.
4. Discuss the physiological effects of
glucagon and its regulation.

14 Regulation of glucose 1. Describe the enzymatic changes of

metabolism; feed-fast carbohydrate and lipid metabolic pathways
cycle in the well-fed state and during starvation in
various tissues (liver, brain, muscle and
adipose tissues).
2. Describe the regulation of glycogen
metabolism, glycolysis, hexose
monophosphate pathway and
 gluconeogenesis by insulin/counter-
regulatory hormones ratio.

15 Pathology of the 1. Pathogenesis of diabetes mellitus type I.

endocrine pancreas,
2. Pathogenesis of diabetes mellitus type II.
including diabetes I

16 Insulin and oral anti- 1. Discuss the pharmacology of insulin.

diabetic agents I
2. Be able to differentiate between the
clinically available types of insulin, their
clinical uses and adverse reactions.

17 Pathology of the 1. Discuss the major complications of

endocrine pancreas, diabetes.
including diabetes II. 2. Discuss islet cell tumors.

18 Insulin and oral anti- 1. Discuss the pharmacology of oral

diabetic agents II hypoglycemic drugs.
2. Understand the various mechanisms of
actions of these drugs.
3. Describe the clinical uses of oral
hypoglycemic drugs.

19 Acute diabetic 1. Describe the pathophysiology, precipitating

complications factors, clinical presentation and the
(ketoacidosis, nonketotic metabolic basis of diabetic ketoacidosis.
hyperosmolar state) 2. Describe the pathophysiology, precipitating
factors, clinical presentation and the
metabolic basis of diabetic ketoacidosis.

20 Epidemiology of 1. To highlight the incidence and prevalence of

diabetes mellitus diabetes mellitus in Jordan and worldwide.
2. To suggest suitable methods of intervention to
reduce prevalence of diabetes mellitus.
21 The adrenal hormones 1. Describe the physiological effects of
mineralocorticoids (aldosterone), the regulation
of aldosterone secretion, and the clinical
consequences of hypo and
hyperaldosteronism.
 2. Describe the major physiological effects of
glucocorticoids (cortisol), the regulation of
cortisol secretion, and the clinical
consequences of hypo and hyperadrenalism.
3. List the catecholamines secreted by the
adrenal medulla and describe their actions
and the regulation of their secretion.

22 Steroidogenesis 1. Describe the biosynthesis of the steroid

hormones.
2. Describe the role of cytochromes P-450 in
steroidogenesis.
3. Describe the metabolic consequences of
the deficiency of any of the enzymes
involved in steroidogenesis.

23 Pathology of the adrenal 1. Describe the pathological features of benign

glands and malignant tumors of the adrenal gland.
2. List the causes of Addison's diseases and
their pathological features.
3. Classify the various types of multiple
endocrine neoplasia.

24 Pharmacology of 1. Characterize the pharmacology of the

glucocorticoids and mineralocorticoids in terms of their
mineralocorticoids pharmacokinetics, mechanisms of actions,
and adverse reactions.
2. Characterize the pharmacology of the
glucocorticoids in terms of their
pharmacokinetics, mechanisms of action,
and adverse reactions.
3. Describe the synthetic analogs of the
mineralocorticoids and the glucocorticoids.
(B) Labs objectives

# TOPIC OBJECTIVES
1 Morphological and 1. Identify different parts of the thyroid gland and study its
microscopic features of the relations.
endocrine glands 2. Identify the adrenal gland and study its relations.
3. Identify the pituitary gland and study its relations.
4. Identify the ultra-structural components of the following glands
and correlate between them:
a. Pituitary gland
b. Thyroid gland
c. Parathyroid glands
d. Pancreas
e. Adrenal glands
2 Pathology of the major A. Pathology of the thyroid gland:
endocrine glands I
1. Describe the morphology of various types of thyroiditis.
2. Describe the features of nodular colloid goitre.
3. Describe the features of adenomas.
4. Describe the features of various carcinomas.

B. Pathology of the pituitary gland.

1. Identify various types of adenomas and the significance

of using immunological stains in their categorization.
2. Describe the morphology of craniopharyngioma.
3 Pathology of the major A. The parathyroid gland.
endocrine glands II
Identify the morphological features of hyperplasic gland and
compare with adenoma.

B. The endocrine pancreas.

1. Identify the morphological features of the pancreas in

diabetes
2. Identify the morphological features of islet cell adenoma.

C. The adrenal gland

1. Identify the morphological features of atrophic and

hyperplasic glands and compare with the features of
cortical adenoma.
2. Identify the morphological features of
pheochromocytoma.

3. Identify the morphological features of neuroblastoma.

 Course Assessment

Assessment
Assessment Type Expected Due Date Weight
First Exam --
Second Exam --
Midterm Exam (Theory) 60
Evaluation 5
Quizzes --
Research activity 5
OSCE --
Mini-OSCE --
Final Exam (Practical) 30
Final Exam(Oral) --

Total 100
 Students Learning Outcomes
Student Learning Outcomes (SLOs)
(4-8 Maximum)
Upon successful completion of this course, students should be able to:
Evaluation Criteria
Related
(MCQ, OSCE, Homework…)
ILO(s)*
SLOs Type of Criteria
(numbers Weight
only) (MCQ, OSCE, (%)
Homework…)
Describe the anatomical and histological
structure, development, and function of the 1 MCQ 25
different organs of the endocrine system.

Describe the various pathologic diseases

affecting the endocrine system and 1,2 MCQ 25
understand their mechanisms.

Explain signs, symptoms and

investigations related to endocrine
disorders and explain the scientific bases
for common disease presentations by 1-3,7,8 MCQ 25
Integrating basic sciences with clinical
sciences of the endocrine system.

Describe drugs used in the treatment of

various endocrine diseases and discuss
the epidemiology of those diseases, their 9 MCQ 25
prevention and control.

100
 Intended Learning Outcomes (ILOs)

1) Demonstrate a sufficient understanding of the structural organization and functions of the

following systems of the human body: circulatory, respiratory, gastrointestinal, endocrine,
hematopoietic & lymphatic, musculoskeletal, nervous, and genitourinary systems.
2) Conceptualize the cellular, molecular, genetic, and biochemical mechanisms that maintain
body’s homeostasis and their derangements in disease states.
3) Apply their knowledge of human anatomy and function to solve questions regarding major
clinical cases and diseases.
4) Attain appropriate and systematic clinical history of different medical conditions and
settings.
5) Demonstrate proficiency in performing clinical skills and procedures.
6) Perform relevant physical examination on patients professionally and ethically.
7) Identify the major signs and symptoms of disease states, recognizing risk factors and
etiologies, in an interdisciplinary approach to differentially diagnose patients.
8) Order and interpret results of relevant basic diagnostic procedures, such as laboratory
investigations and conventional imaging procedures.
9) Apply safe and accurate methods of pharmacotherapy of major disease states.
10) Critically appraise research studies guided by evidence-based medicine.
11) Demonstrate ability to work in diverse settings and communities.