M2 Sequence Overview
Sequence Directors

Arno K. Kumagai, M.D.
Associate Professor, Internal Medicine
Email: akumagai@umich.edu

Nazanene Esfandiari, M.D.
Assistant Professor, Internal Medicine
Email: nazanene@umich.edu

Sequence Description

The Endocrine sequence is a two-week unit designed to teach the basic principles of hormone secretion and action and the clinical disorders which result from abnormalities of hormonal activity. Students are expected to be familiar with the functions of the endocrine glands, the structure, secretion and action of the important hormones, and the major clinical endocrine disorders. Emphasis will be placed on understanding pathophysiology and being able to use general principles in endocrine physiology (e.g. negative feedback) or in the management of endocrine disorders (e.g., insulin management) in consideration of specific circumstances and clinical cases. Instruction regarding pathogenesis, clinical presentation, diagnosis, and treatment is given in the following areas.

  1. General pituitary anatomy and physiology; feedback loops in hormonal homeostasis.
  2. Anterior pituitary disorders, including acromegaly, Cushing’s disease, prolactinoma, and non-functioning pituitary tumors; panhypopituitarism.
  3. Posterior pituitary structure and function, including water balance.
  4. Thyroid physiology, including thyroid hormone biosynthesis and actions.
  5. Thyroid disorders: hyperthyroidism, hypothyroidism, thyroid nodules, and thyroid cancers.
  6. Adrenal physiology and steroid pharmacology.
  7. Endocrine pathology of the pituitary, thyroid, and adrenal.
  8. Calcium metabolism.
  9. Endocrine causes of abnormal growth and development.
  10. Glucose metabolism and insulin action.
  11. Obesity.
  12. Diabetes: Epidemiology, pathophysiology, psychosocial and societal impact; acute and chronic complications; management; living with diabetes.
  13. Spontaneous hypoglycemia disorders.
  14. Endocrine pathology of the parathyroids and pancreas.